Antiviral therapeutic approaches for human rhinovirus infections

Casanova, Victor; Sousa, Filipa H; Stevens, Craig; Barlow, Peter G

Ribavirin is a synthetic guanosine nucleoside that can interfere with the synthesis of viral mRNA. It is frequently used as an effective therapeutic in combination with pegylated IFNα-2a for the treatment of hepatitis C infection and has also been used individually by clinicians in the treatment of severe lower respiratory tract infections caused by RSV [21, 22] . Other infections caused by respiratory pathogens such as adenovirus have also been treated by ribavirin, normally in patients that are immunocompromised or those who have received bone marrow or stem cell transplants [23] . Coronaviruses associated with severe acute respiratory syndrome (SARS-CoV) or Middle East respiratory syndrome have also been studied in the context of ribivirin therapy, although the outcomes have been mixed, and conjunctive therapy with pegylated IFNα-2a has again been suggested [24, 25] . In addition, ribavirin has also been utilized in the treatment of several viral hemorrhagic fevers, caused by pathogens such as hantavirus and Lassa virus, but also in the treatment of nairovirus, the cause of the tick-borne disease Crimean-Congo hemorrhagic fever [26, 27, 28] . However, the drug is not reported to be active against Marburg virus, Ebola virus and dengue virus, and only appears to have limited activity against HSV, but not HIV [29, 30, 31] . In the context of RV infection, ribavirin and a number of modified analogs have been shown to have moderate antiviral activity against RV-13 [32] . RV-87 was also reported to be moderately susceptible to treatment, although other in vitro studies using alternative serotypes of RV, such as RV-14, have suggested that ribavirin is relatively ineffective [33, 34] . However, clinical reports of ribavirin therapy twinned with the use of IFNα-2a have indicated that combinatorial therapy could be of value with patients reportedly exhibiting enhanced clearance of RV infections following treatment with these two compounds [35] .