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. 2002 Nov 12;5(6):307–324. doi: 10.1016/0166-3542(85)90001-4

The need for new antiviral agents

DS Freestone 1
PMCID: PMC7134137  PMID: 3004326

Abstract

Population density and immune status, vectors and virulence of infection, nutritional status, sanitation, genetic susceptibility and medical management of cases, are important factors influencing the incidence and/or severity of virus infections. Thus, the prevalence and clinical importance of virus infections and the need for antiviral drugs differ from place to place and from time to time. National and World Health Statistics of notifications of disease give some index of the incidence of infections but not all virus infections are notifiable. Such statistics can be misleading also through failures to notify from sloth on the part of the physician or, in the absence of pathognomonic symptoms or signs, from errors in diagnosis.

Any assessment of the need for new antiviral drugs should consider the availability, safety, effectiveness and cost of alternative measures, including prevention of spread of infection by control of vectors, immunization by use of viral vaccines, or treatment with existing antiviral drugs. Early start of treatment of acute virus infections with existing drugs gives the best results and, where the clinical diagnosis is uncertain, accurate rapid virus diagnosis is of paramount importance. Many virus infections are asymptomatic or of trivial importance and without sequelae. However, new or improved antiviral drugs are needed for the prevention and/or treatment of a number of significant conditions caused by viruses which are not at present adequately controlled. These include upper and lower respiratory tract infections, influenza, chronic hepatitis, gastroenteritis, infectious mononucleosis, measles, rabies, haemorrhagic fevers and warts. Furthermore, such drugs might prove of therapeutic value in the prevention or treatment of virus-associated tumours, such as hepatoma, nasopharyngeal carcinoma, Burkitt's lymphoma, Kaposi's sarcoma and possibly carcinoma of the cervix.

Keywords: antivirals, vaccines, immunoglobulins

References

  • 1.Barnes G.L., Doyle L.W., Houson P.H., Knoches A.M.L., McLellan J.A., Kitchen W.H., Bishop R.F. A randomised trial of oral gammoglobulin in low birth weight infants infected with rotavirus. Lancet. 1982;i:1371–1373. doi: 10.1016/s0140-6736(82)92496-5. [DOI] [PubMed] [Google Scholar]
  • 2.Centers for Disease Control Reported Morbidity and Mortality in the United States. Annual Summary 1980Morb. Mort. Weekly Rep. 1981;29:7. [Google Scholar]
  • 3.Centers for Disease Control Influenza Vaccines 1982–1983. Morb. Mort. Weekly Rep. 1982;31:349–353. [PubMed] [Google Scholar]
  • 4.Cooper L.Z., Ziring P.R., Ockerse A.B., Fedun B.A., Kiely B., Krugman S. Rubella: clinical manifestations and management. Am. J. Dis. Child. 1969;118:18–29. [PubMed] [Google Scholar]
  • 5.Department of Health and Social Security . HMSO; London: 1980. (Health and Personal Social Services Statistics for England 1978). [Google Scholar]
  • 6.Dolin R., Reichman R.C., Madore H.P., Maynard R., Linton P.N., Webber-Jones J. A controlled trial of amantadine and rimantadine in the prophylaxis of influenza A infection. N. Engl. J. Med. 1982;307:580–584. doi: 10.1056/NEJM198209023071002. [DOI] [PubMed] [Google Scholar]
  • 7.Falcon M.G. HSV infections of the eye and their management with acyclovir. J. Antimicrob. Chemother.; Kensington, London, May 1983; 1983. pp. 39–43. [DOI] [PubMed] [Google Scholar]
  • 8.Fiddian A.P., Yeo J.M., Stubbings R., Dean D. Successful treatment of herpes labialis with topical acyclovir. Br. Med. J. 1983;i:1699–1701. doi: 10.1136/bmj.286.6379.1699. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Ganem D. Persistent infection of humans with hepatitis B virus: Mechanisms and consequences. Rev. Infect. Dis. 1982;4:1026–1047. doi: 10.1093/clinids/4.5.1026. [DOI] [PubMed] [Google Scholar]
  • 10.Giraldo G., Beth E., Henle W. Antibody patterns to herpesviruses in Kaposi's sarcoma. II. Serological association of American Kaposi's sarcoma with cytomegalovirus. Int. J. Cancer. 1978;22:126–131. doi: 10.1002/ijc.2910220204. [DOI] [PubMed] [Google Scholar]
  • 11.Giraldo G., Beth E., Huang E.-S. Kaposi's sarcoma and its relationship to cytomegalovirus (CMV). III. CMV DNA and CMV early antigens in Kaposi's sarcoma. Int. J. Cancer. 1980;26:23–29. doi: 10.1002/ijc.2910260105. [DOI] [PubMed] [Google Scholar]
  • 12.Groopman J.E. The acquired immunodeficiency syndrome. Vol. 99. 1983. Kaposi's sarcoma and other neoplasms; pp. 208–220. (Ann. Int. Med.). Gottleib, M.S., moderator. [Google Scholar]
  • 13.Haglund S., Lundquist P.G., Cantell K., Strander H. Interferon therapy in juvenile laryngeal papillomatosis. Arch. Otolaryngol. 1981;107:327–332. doi: 10.1001/archotol.1981.00790420001001. [DOI] [PubMed] [Google Scholar]
  • 14.Hall C.B., Walsh E.E., Hruska J.F., Betts R.F., Hall W.J. Ribavirin treatment of experimental respiratory syncytial viral infection. J. Am. Med. Assoc. 1983;249:2666–2670. [PubMed] [Google Scholar]
  • 15.Hirsch M.S., Schooley R.T., Cosimi A.B., Russell P.S., Delmonico F.L., Tolkoff-Rubin N.E., Herrin J.T., Cantell K., Farrell M.L., Rota T.R., Rubin R.H. Effects of interferon-alpha on cytomegalovirus reactivation syndromes in renal-transplant recipients. N. Engl. J. Med. 1983;308:1489–1493. doi: 10.1056/NEJM198306233082501. [DOI] [PubMed] [Google Scholar]
  • 16.Hinman A.R., Bart K.J., Orenstein W.A., Preblud S.R. Rational strategy for rubella vaccination. Lancet. 1983;i:39–41. doi: 10.1016/s0140-6736(83)91572-6. [DOI] [PubMed] [Google Scholar]
  • 17.Howard C.R. Viral haemorrhagic fevers; properties and prospects for treatment and prevention. Antiviral Res. 1984;4:169–186. doi: 10.1016/0166-3542(84)90016-0. [DOI] [PubMed] [Google Scholar]
  • 18.Lang D.J. Cytomegalovirus immunization: Status, prospects, and problems. Rev. Infect. Dis. 1980;2:449–458. doi: 10.1093/clinids/2.3.449. [DOI] [PubMed] [Google Scholar]
  • 19.Lewis M.J., Cameron A.H., Shah K.J., Purdham D.R., Man J.R. Giant cell pneumonia caused by measles and methotrexate in childhood leukaemia in remission. Br. Med. J. 1978;i:330–331. doi: 10.1136/bmj.1.6109.330. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Marker S.C., Howard R.J., Simmons R.L., Kalis J.M., Connelly D.P., Najarian J.S., Balfour H.H. Cytomegalovirus infection: A quantitative prospective study of three hundred and twenty consecutive renal transplants. Surgery. 1981;89:660–671. [PubMed] [Google Scholar]
  • 21.Merigan T.C., Rand K.H., Pollard R.B., Abdallah P.S., Jordan G.W., Fried R.P. Human leukocyte interferon for the treatment of herpes zoster in patients with cancer. N. Engl. J. Med. 1978;298:981–987. doi: 10.1056/NEJM197805042981801. [DOI] [PubMed] [Google Scholar]
  • 22.Merz D.C., Scheid A., Choppin P.W. Importance of antibodies to the fusion glycoprotein of paramyxoviruses in the prevention of spread of infection. J. Exp. Med. 1980;151:275–288. doi: 10.1084/jem.151.2.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Meyers J.D., Wade J.C., McGuffin R.W., Springmeyer S.C., Thomas E.D. The use of acyclovir for cytomegalovirus infections in the immunocompromised host. J. Antimicrob. Chemother. 1983;12(Suppl. B):181–193. doi: 10.1093/jac/12.suppl_b.181. [DOI] [PubMed] [Google Scholar]
  • 24.Mindel A., Weller L.V.D., Faherty A., Sutherland S., Hindley D., Fiddian A.P. Prophylactic oral acyclovir in recurrent genital herpes. Lancet. 1984;ii:57–59. doi: 10.1016/s0140-6736(84)90237-x. [DOI] [PubMed] [Google Scholar]
  • 25.Morbidity and Mortality Weekly Report Imported human rabies. Morb. Mort. Weekly Rep. 1983;32:78–86. [PubMed] [Google Scholar]
  • 26.Nilsen A.E., Aasen T., Halsos A.M., Kinge B.R., Tjøtta E.A.L., Wikstrom K., Fiddian A.P. Efficacy of oral acyclovir in the treatment of initial and recurrent genital herpes. Lancet. 1982;ii:571–573. doi: 10.1016/s0140-6736(82)90658-4. [DOI] [PubMed] [Google Scholar]
  • 27.Norrby E. Springer Verlag; Vienna-New York: 1969. Rubella virus. (Virology Monographs No. 7). [Google Scholar]
  • 28.OPCS Monitor. (Office of Population Consensus and Surveys). References MB2 81/2, MB2 83/1.
  • 29.Paccaud M.F. World trends in poliomyelitis, morbidity and mortality 1951–1975. World Health Stat. 1979;32:198–224. [PubMed] [Google Scholar]
  • 30.Peterslund N.A., Seyer-Hansen K., Ipsen J., Esmann V., Schonheyder H., Juhl H. Acyclovir in herpes zoster. Lancet. 1981;ii:827–830. doi: 10.1016/s0140-6736(81)91102-8. [DOI] [PubMed] [Google Scholar]
  • 31.Phillpotts R.J., Jones R.W., Delong D.C., Reed S.E., Wallace J., Tyrrell D.A.J. The activity of enviroxime against rhinovirus infection in man. Lancet. 1981;i:1342–1344. doi: 10.1016/s0140-6736(81)92520-4. [DOI] [PubMed] [Google Scholar]
  • 32.Phillpotts R.J., Higgins P.G., Willman J.S., Tyrrell D.A.J., Freestone D.S., Shepherd W.M. Intranasal lymphoblastoid interferon (‘Wellferon’) prophylaxis against rhinovirus and influenza virus in volunteers. J. Interferon Res. 1984;4:535–541. doi: 10.1089/jir.1984.4.535. [DOI] [PubMed] [Google Scholar]
  • 33.Popovick M., Sargadharan M.G., Read E., Gallo R.C. Detection, isolation and continuous production of cytopathic retroviruses (HTLV-III) from patients with AIDS and pre-AIDS. Science. 1984;224:497–500. doi: 10.1126/science.6200935. [DOI] [PubMed] [Google Scholar]
  • 34.Quinnan G.V., Kirmani N., Rook A.H., Manischewitz J.F., Jackson L., Moreschi G., Santos G.W., Saral R., Burns W.H. Cytotoxic T cells in cytomegalovirus infection. N. Engl. J. Med. 1982;307:6–13. doi: 10.1056/NEJM198207013070102. [DOI] [PubMed] [Google Scholar]
  • 35.Report on the outbreak of poliomyelitis during 1961 in Kingston-upon-Hull and the East Riding of Yorkshire. HMSO; London: 1963. (Reports on Public Health and Medical Subjects). No. 107. [Google Scholar]
  • 36.Sabin A.B. Present status of attenuated live virus poliomyelitis vaccine. Bull. N.Y. Acad. Med. 1957;33:17–39. [PMC free article] [PubMed] [Google Scholar]
  • 37.Samo T.C., Greenberg S.B., Couch R.B., Quarles J., Johnson P.E., Hook S., Harmon M.W. Efficacy and tolerance of intranasally applied recombinant leukocyte A interferon in normal volunteers. J. Infect. Dis. 1983;148:535–542. doi: 10.1093/infdis/148.3.535. [DOI] [PubMed] [Google Scholar]
  • 38.Schouten T.J., Weimar W., Bos J.H., Bos C.E., Cremers C.W.R.J., Schellekens H. Treatment of JLP with two types of interferon. Laryngoscope. 1982;92:686–688. doi: 10.1002/lary.1982.92.6.686. [DOI] [PubMed] [Google Scholar]
  • 39.Scott G.M., Csonka G.W. Effect of injections of small doses of human fibroblast interferon into genital warts. A pilot studyBr. J. Vener. Dis. 1979;55:442–445. doi: 10.1136/sti.55.6.442. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Scullard G.H., Pollard R.B., Smith J.L., Sacks S.L., Gregory P.B., Robinson W.S., Merigan T.C. Antiviral treatment of chronic Hepatitis B virus infection. I. Changes in viral markers with interferon combined with adenine arabinoside. J. Infect. Dis. 1981;143:772–783. doi: 10.1093/infdis/143.6.772. [DOI] [PubMed] [Google Scholar]
  • 41.Selby P.J., Powles R.L., Jameson B., Kay H.E.M., Watson J.G., Thornton R., Morgenstern G., Clink H.M., McElwain T.J., Prentice H.G., Corringham R., Ross M.G., Hoffbrand A.V., Brigden D. Parenteral acyclovir therapy for herpesvirus infections in man. Lancet. 1979;ii:1267–1270. doi: 10.1016/s0140-6736(79)92281-5. [DOI] [PubMed] [Google Scholar]
  • 42.Skoldenberg B., Forsgren M., Alestig K., Bergstrom T., Burman L., Dahlqvist E., Forkman A., Fryden A., Lovgren K., Norlin K., Norrby R., Olding-Stenkvist E., Stiernstedt G., Uhnoo I., de Vahl K. Acyclovir versus vidarabine in herpes simplex encephalitis. Lancet. 1984;ii:707–711. doi: 10.1016/s0140-6736(84)92623-0. [DOI] [PubMed] [Google Scholar]
  • 43.Smee D.F., Sidwell R.W., Clark S.M., Barnett B.B., Spendlove R.S. Inhibition of rotaviruses by selected antiviral substances: mechanism of viral inhibition and in vivo activity. Antimicrob. Agents Chemother. 1982;21:66–73. doi: 10.1128/aac.21.1.66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 44.Smith C.I., Kitchen L.W., Scullard G.H., Robinson W.S., Gregory P.B., Merigan T.C. Vidarabine monophosphate and human leukocyte interferon in chronic Hepatitis B infection. J. Am. Med. Assoc. 1982;247:2261–2265. [PubMed] [Google Scholar]
  • 45.Smith J.W.G., Wherry P.J. Poliomyelitis surveillance in England and Wales 1969–1975. J. Hygiene (Cambridge) 1978;80:155–167. doi: 10.1017/s0022172400053481. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Smithells R.S., Sheppard S., Marshall W.C., Milton A. National Congenital Rubella Surveillance Programme, 1971–1981. Br. Med. J. 1982;ii:1363. [PubMed] [Google Scholar]
  • 47.Spicer C.C. The incidence of poliomyelitis virus in normal children aged 0–5 years. J. Hygiene (Cambridge) 1961;59:143–159. doi: 10.1017/s002217240003881x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Van Voris L.P., Betts R.F., Hayden F.G., Christmas W.A., Gordon-Douglas R., Jr Successful treatment of naturally occurring influenza A/USSR/77 H1N1. J. Am. Med. Assoc. 1981;245:1128–1131. doi: 10.1001/jama.245.11.1128. [DOI] [PubMed] [Google Scholar]
  • 49.Weekly Epidemiological Record Rabies in Europe. 1978;53:61–68. [Google Scholar]
  • 50.Weimar W., Heijtink R.A., ten Kate F.J.P., Schalm S.W., Masurel N., Schellekens H., Cantell K. Double-blind study of leucocyte interferon administered in chronic HSsAg-positive hepatitis. Lancet. 1980;i:336–338. doi: 10.1016/s0140-6736(80)90885-5. [DOI] [PubMed] [Google Scholar]
  • 51.Weinmann E., Majer M., Hilfenhaus J. Intramuscular and/or intralumbar post-exposure treatment of rabies virus infected cynomolgus monkeys with human interferon. Infect. Immun. 1979;24:24–31. doi: 10.1128/iai.24.1.24-31.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 52.Weller I.V.D., Carreno V., Fowler M.J.F., Monjardino J., Makinen D., Thomas H.C., Sherlock S. Acyclovir inhibits Hepatitis B virus replication in man. Lancet. 1982;i:273. doi: 10.1016/s0140-6736(82)90990-4. [DOI] [PubMed] [Google Scholar]
  • 53.the Collaborative Study Group. Whitley R.J., Soong S.-J., Dolin R., Galasso G.J., Ch'ien L.T., Alford C.A. Adenine arabinoside therapy of biopsy-proved herpes simplex encephalitis. N. Engl. J. Med. 1977;297:289–294. doi: 10.1056/NEJM197708112970601. [DOI] [PubMed] [Google Scholar]
  • 54.Whitley R.J., Nahmias A.J., Visintine A.M., Fleming C.L., Alford C.A. The natural history of HSV infection of Mother and Newborn. J. Pediatr. 1980;66:489–494. [PubMed] [Google Scholar]
  • 55.Whitley R.J., Soong S.-J., Dolin R., Betts R., Linnemann C., Jr, Alford C.A. Early vidarabine therapy to control the complications of herpes zoster in immunosuppressed patients. N. Engl. J. Med. 1982;307:971–975. doi: 10.1056/NEJM198210143071602. [DOI] [PubMed] [Google Scholar]
  • 56.Whooping Cough. Department of Health and Social Security. HMSO; London: 1981. (Report from the Committee on Safety of Medicines and the Joint Committee on Vaccination and Immunization). [Google Scholar]
  • 57.WHO; Geneva: 1981. (World Health Annual Statistics, 1980–1981). [Google Scholar]
  • 58.Zlydnikov D.M., Kubar O.I., Kovaleva T.P., Kamforin L.E. Study of Rimantadine in the USSR: A review of the literature. Rev. Infect. Dis. 1981;3:408–421. doi: 10.1093/clinids/3.3.408. [DOI] [PubMed] [Google Scholar]
  • 59.Zukermann A.J. Hepatitis B. Its prevention by vaccineJ. Infect. Dis. 1981;143:301–304. doi: 10.1093/infdis/143.2.301. [DOI] [PubMed] [Google Scholar]
  • 60.Zur Hausen H. Herpes simplex virus in human genital cancer. Int. Rev. Exp. Pathol. 1983;25:307–326. [PubMed] [Google Scholar]

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