Hantavirus Infections—Treatment and Prevention

Abstract

Purpose of review Hantavirus infection is an emerging zoonosis and there are two main clinical presentations, hemorrhagic fever with renal syndrome (HFRS) and Hantavirus pulmonary syndrome (HPS). Although Hantavirus infections have a worldwide distribution with a high mortality rate, a safe and effective vaccine or an antiviral drug against the Hantavirus disease is yet to be available. This review summarizes all the efforts undertaken to develop medical countermeasures in vitro, in vivo, and human clinical trials against Hantavirus infections. Recent findings Multiple antivirals are shown to be effective with limited evidence and recent studies on immunotherapy were not very conclusive. There are multiple vaccine candidates with evidence of conferring long protective immunity against Hantaviruses. Some of these had been already trialed on humans. Summary At present, severe HPS or HFRS case management is purely based on supportive treatments, often in an intensive care unit. Rodent control and public health education and promotion play a major role in preventing Hantavirus infection.

Immune response during hantavirus diseases: implications for immunotherapies and vaccine design

“…35 Clinical studies using a 4-week interval with three-dose scheme indicate that PUUV and HNTV DNA vaccines delivered through IM electroporation increase immunogenicity as compared to gene gun delivery, rising detectable nAbs titres in near of 78% of volunteers. 24 Current clinical trials focus on vaccine dosage and different delivery methods to optimize immunogenicity with a successful safety profile. 35 DNA vaccines have also been experimentally tested as a panhantavirus vaccine candidate, showing that rabbits immunized with a plasmid mix targeting SNV, ANDV, PUUV and HNTV develop nAbs.…”

“…23 Due to the lack of effective antiviral treatments or vaccines, clinical interventions rely mostly on treating symptoms and on supportive care to provide haemodynamic and oxygen support in patients suffering more severe clinical forms of these diseases. 24 An early neutralizing antibody (nAb) response has been associated with a favourable clinical outcome in HCPS individuals. 25 Despite the importance of T cells in controlling viral infections, little is known about their contribution to hantavirus infection and immunity.…”

A Comprehensive Review on the Hantavirus Epidemiology and Potential Therapeutic Prospects

“…In China and Korea, both cell culture and rodent-brain-derived vaccines have been developed and tested in humans. [47].…”

“…Among various hantavirus species, the nucleocapsid proteins are more conserved. Therefore, high crossreactive antibody responses have been said to be induced by nucleocapsid proteins [47].…”

“…HTNV Gn or HTNV Gc targeting DNA vaccines were developed combined with Lysosome-Associated Membrane Protein (LAMP1). Antigen-presenting pathway and stimulated CD4+ T cells are altered by LAMP1 which evokes a strong, humoral, cellular immune response and eternal immune reaction in the body of the organism [47].…”