[Discuss Thrower]

Originally Posted by 'Hamas' Jenkins

Depends entirely upon the pathophysiology of the disease in question, the mechanism of the drug, and how one defines "infected".

Take something like HIV. There are multiple stages in the viral life cycle, many of which provide specific targets for therapy.

There are drugs you can use for pre-exposure prophylaxis (PrEP), post-exposure prophylaxis, and treatment. Once you are past the stage of acute infection where viral reservoirs are established in places like memory cells and the DNA of T-cells, dendrites, etc, you can only treat for the remainder of the patient's life, but outside of a bone marrow transplant for someone with two alleles of the CCR5 delta 32 mutation, you aren't going to eliminate the virus.

AZT has a 30+ year history of efficacy in preventing transmission from mother to child, but is only effective for treatment of seropositive individuals when used in combination with other agents.

In the case of COVID, if you had a therapeutic that could prevent fusion of the viral spike to the ACE2 receptor, you might be able to prevent enough replication in the initial phases to prevent the virus from establishing a foothold within the body. However, past a certain phase, that same therapeutic may not have equal efficacy, because drugs are not always evenly distributed in all tissues and fluids of the body--the blood brain barrier being the best example, but there are several others (you don't want to use an antibiotic that has poor concentration in the urine in treating a UTI).

In contrast, the proposed beneficial mechanism for steroids is reduction in cytokine storm and acute inflammation as part of the disease process. Their use will not help with infection (and use over a week will cause both adrenal and immune suppression), but they can lessen the damaging sequelae of the disease.

Thanks. Makes sense with whatever biology lessons I've received over the years.