Ribavirin - current status of a broad spectrum antiviral agent

Abstract

Ribavirin is a very broad-spectrum virustatic antiviral agent, first synthesised in 1972. It is characterised by low toxicity apart from reversible anaemia, usually mild. Its multiple mechanisms of action mean that viral resistance rarely develops. It can be administered orally, intravenously, or via a nebuliser. It has shown varying degrees of clinical efficacy in a variety of human diseases including respiratory tract infections due to respiratory syncytial virus and influenza, measles, herpesvirus infections, HIV infection, Lassa fever, haemorrhagic fever with renal syndrome, and (in combination with IFN-alpha) chronic hepatitis C infection. It may well prove of value against other emerging exotic infections (e.g., West Nile virus, Nipah virus).

High-Throughput Screening Using a Whole-Cell Virus Replication Reporter Gene Assay to Identify Inhibitory Compounds against Rift Valley Fever Virus Infection

“…There is a need for a safe antiviral treatment that hitherto is lacking. Ribavirin, a nucleoside analog only approved for compassionate use treatment of RVF, 4,22 has shown some activity against RVFV in vitro and in vivo. 23,24 However, in animal models, ribavirin has caused anemia and teratogenic effects, which has limited the application to compassionate use under investigational new drug protocols.…”

In vitroanti-influenza activity of a protein-enriched fraction from larvae of the housefly (Musca domestica)

“…Ribavirin (1-β-d-ribofuranosy-l,2,4-triazole-3-carboxamide), discovered over 30 years ago, is the first synthetic, broad spectrum antiviral nucleoside which exerts antiviral activity against a wide range of DNA and RNA viruses including influenza viruses (Snell, 2001). Ribavirin was used as positive control in the experiment and four different modified protocols were applied to investigate the antiviral activity of PEF and ribavirin against human influenza virus in vitro.…”

Development of FGI-106 as a broad-spectrum therapeutic with activity against members of the family Bunyaviridae

“…However, issues with the use of ribavirin leading to hemolytic anemia and potential teratogenicity still remain a major concern. 17,18 In the case of hantavirus infection, there is evidence that ribavirin might be useful for treatment of HFRS, but ribavirin does not appear to be effective for HPS. This latter finding is notable in light of our preliminary evidence that FGI-106 can become enriched within the lung at levels sufficient to block hantavirus infection (as indicated by cellbased assays).…”

“…First, there are concerns about its side-effects such as hemolytic anemia and potential teratogenicity. 17,18 Second, it is most effective when administered early in disease; therefore, developing a therapeutic that is better tolerated and effective at later time points in infection a priority. The antiviral T-705 was shown to be effective against a portion of the Bunyaviridae family: LACV, Punto Toro virus (genus Phlebovirus) and an attenuated strain of RVFV (MP-12 vaccine strain).…”