Vaccines and Therapeutics Against Hantaviruses

Abstract

Hantaviruses (HVs) are rodent-transmitted viruses that can cause hantavirus cardiopulmonary syndrome (HCPS) in the Americas and hemorrhagic fever with renal syndrome (HFRS) in Eurasia. Together, these viruses have annually caused approximately 200,000 human infections worldwide in recent years, with a case fatality rate of 5-15% for HFRS and up to 40% for HCPS. There is currently no effective treatment available for either HFRS or HCPS. Only whole virus inactivated vaccines against HTNV or SEOV are licensed for use in the Republic of Korea and China, but the protective efficacies of these vaccines are uncertain. To a large extent, the immune correlates of protection against hantavirus are not known. In this review, we summarized the epidemiology, virology, and pathogenesis of four HFRS-causing viruses, HTNV, SEOV, PUUV, and DOBV, and two HCPS-causing viruses, ANDV and SNV, and then discussed the existing knowledge on vaccines and therapeutics against these diseases. We think that this information will shed light on the rational development of new vaccines and treatments.

Ocular manifestations of emerging viral diseases

“…At present, there are currently no approved treatments or vaccines available for hantavirus infections [ 96 ]. Supportive management in the intensive care unit is the current mainstay of treatment, with better patient outcomes associated with ICU admission earlier in the disease course (CDC).…”

Biodefense Implications of New-World Hantaviruses

“…There are no US FDA-approved vaccines available for hantavirus infections, however, there are a variety of live-attenuated vaccines (Hantavax), DNA vaccines, subunit vaccines, and virus-like particle (VLP) vaccines that all demonstrate varying degrees of effectiveness (Schmaljohn et al, 1992;Cho and Howard, 1999;Choi et al, 2003;Ying et al, 2016;Liu et al, 2019). The Hantavax vaccine is available and is instituted in the Republic of Korea, with effectiveness against HFRS-causing hantaviruses such as HTNV and SEOV and resulting in a subsequent reduction in HFRS-related hospitalizations (Yi et al, 2018).…”

“…There are currently no US FDA-approved post-exposure therapeutics against Hantaviral infections, however, there are treatment strategies present to manage HFRS and HCPS (Liu et al, 2019). Virus-targeting antivirals including antiviral drugs, antibodies, or novel-small molecules are designed to block hantavirus entry or to reduce viral replication.…”

“…Antivirals also function effectively only during the early infection stage and not after the start of viremia (Brocato and Hooper, 2019). This could largely be attributed to the uncontrolled immune response which predominates the Hantaviral pathogenesis process after immediate infection (Liu et al, 2019). The Hantaviral prodrome phase can also be difficult to differentiate from other febrile illnesses, which may benefit infection by impeding proper identification and treatment (Brocato and Hooper, 2019).…”

“…Hantaviruses are emerging zoonotic viruses that are responsible for two human diseases: Hantavirus Cardiopulmonary Syndrome (HCPS) associated with New-World Hantaviruses found in the western hemisphere; and Hemorrhagic Fever with Renal Syndrome (HFRS) associated with Old-World Hantaviruses in the eastern hemisphere (Mittler et al, 2019). Collectively, 150,000 -200,000 cases of hantavirus disease are reported annually with the majority of HFRS cases occurring in Asia, specifically in the People's Republic of China which constitutes upwards of 90% of cases (Schmaljohn, 2009;Iannetta et al, 2019;Liu et al, 2019). HCPS, comparatively, presents a stark minority in annual cases, roughly 300, with the majority of cases being in South America and primarily Brazil (Watson et al, 2014;Duehr et al, 2020).…”