Prevention and treatment of respiratory viral infections: Presentations on antivirals, traditional therapies and host-directed interventions at the 5th ISIRV Antiviral Group conference

Abstract

The International Society for Influenza and other Respiratory Virus Diseases held its 5th Antiviral Group (isirv-AVG) Conference in Shanghai, China, in conjunction with the Shanghai Public Health Center and Fudan University from 14-16 June 2017. The three-day programme encompassed presentations on some of the clinical features, management, immune responses and virology of respiratory infections, including influenza A(H1N1)pdm09 and A(H7N9) viruses, MERS-CoV, SARS-CoV, adenovirus Type 80, enterovirus D68, metapneumovirus and respiratory syncytial virus (RSV). Updates were presented on several therapeutics currently in clinical trials, including influenza polymerase inhibitors pimodivir/JNJ6362387, S033188, favipiravir, monoclonal antibodies MHAA45449A and VIS410, and host directed strategies for influenza including nitazoxanide, and polymerase ALS-008112 and fusion inhibitors AK0529, GS-5806 for RSV. Updates were also given on the use of the currently licensed neuraminidase inhibitors. Given the location in China, there were also presentations on the use of Traditional Chinese Medicines. Following on from the previous conference, there were ongoing discussions on appropriate endpoints for severe influenza in clinical trials from regulators and clinicians, an issue which remains unresolved. The aim of this conference summary is to provide information for not only conference participants, but a detailed referenced review of the current status of clinical trials, and pre-clinical development of therapeutics and vaccines for influenza and other respiratory diseases for a broader audience.

Novel activities of safe-in-human broad-spectrum antiviral agents

“…Ribavirin blocks viral RNA synthesis of FLUAV, HCV and RSV (Hong and Cameron, 2002). Favipiravir and BCX4430 also inhibit replication of different RNA viruses (McKimm-Breschkin et al, 2018). However, viruses are able to develop resistance to some of these nucleotide and nucleoside analogues.…”

Advances in respiratory virus therapeutics – A meeting report from the 6th isirv Antiviral Group conference

“…For influenza, therapeutic development focuses on targeting the influenza virus replication complex and the cap-binding/fusion mechanism. Pimodivir (JNJ-63623872) is a PB2 cap-binding inhibitor that has undergone Phase 2b studies, including in combination with oseltamivir, in ambulatory and hospitalized patients (Finberg et al, 2018;McKimm-Breschkin et al, 2018). The results demonstrate potential value in combination with oseltamivir, and further phase 3 studies are currently underway (ClinicalTrials.gov Identifier NCT03381196, NCT03376321).…”

Focus on Middle East respiratory syndrome coronavirus (MERS-CoV)

“…The three most frequent symptoms are: fever (77% [IQR: 59-82]), cough (90% [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69]), and dyspnea (68% ).…”

“…Several therapeutic options targeting various viral elements are currently available or under development ( Fig. 4) [62]. The different classes of available treatment are (i) immunotherapy with specific anti-MERS-CoV antibodies, (ii) molecules with antiviral activity, (iii) symptomatic treatment.…”