Abstract
Summary
This report reviews the current state-of-art of antiviral approaches including
vaccines, pharmaceuticals and innovative technologies for delivery of
therapeutics. The introduction starts with a practical classification of viral
diseases according to their commercial importance. Various antiviral
approaches are described including pharmaceuticals and molecular biological
therapies such as gene therapy and RNA interference (RNAi) as well as vaccines
for virus infections. Expert opinion is given about the current problems and
needs in antiviral therapy. SWOT (strengths, weaknesses, opportunities and
threats) analysis of antiviral approaches is presented against the background
of concept of an ideal antiviral agent.
A novel feature of this report is the use of nanotechnology in virology and
its potential for antiviral therapeutics. Interaction of nanoparticles with
viruses are described. NanoViricides are polymeric micelles, which act as
nanomedicines to destroy viruses. Various methods for local as well as
systemic delivery of antiviral agents and vaccines are described.
Nanobiotechnology plays an important role in improving delivery of antivirals.
Advantages and limitations of delivery of gene-based, antisense and RNAi
antiviral therapeutics are discussed.
Anti-influenza measures applicable to human as well as avian forms are
described including the recent epidemic of swine flu. Resistance can develop
against neuraminidase inhibitors although it is less than that with
adamantanes. Considering these problems, there is need for a more effective
agent. Investigations into alternative anti-influenza target will probably
expand in the coming years. These include the development of mechanisms to
inhibit fusion between the virus envelope and the cell membrane.
After a discussion of current therapies of AIDS/HIV and their limitations, new
strategies in development of antiviral agents are described. Drug resistance
and toxicities are emerging as major treatment challenges. Based on a review
of technologies and drugs in development, it can be stated that there are good
prospects are of finding a cure for HIV/AIDS in the next decade.
Hepatitis viruses are described with focus on hepatitis C virus (HCV) and
hepatitis B virus (HBV). Despite the presence of numerous drug candidates in
the anti-HCV pipeline, and the commitment of major R&D resources by many
pharmaceutical companies, it might still take several years for any new
anti-HCV drugs to reach the market. Although many companies are focusing their
efforts on developing viral inhibitors, cellular targets in the host are
beginning to emerge as attractive possibilities because they might enable the
development of broad-spectrum antiviral drugs with less chance for developing
viral resistance.
Various commercially important viruses include herpes simplex (HSV) and human
papilloma virus (HPV). There a number of treatments but HSV is not destroyed
completely and remains dormant and activates from time to time to cause
various clinical manifestations. There is discussion about the role of HPV in
cervical cancer and vaccines available now seem to be adequate in preventing
HSV-induced cervical cancer. There is no effective vaccine for respiratory
syncytial virus (RSV) although monoclonal antibody (MAb) treatment is useful
for prophylaxis and reducing the clinical manifestations. There is a need for
an agent to eliminate this virus.
Various viruses that either occur in epidemics or in tropics and some
naturally emerging infectious diseases are described, e.g. viral hemorrhagic
fevers such as dengue and West Nile virus infection. These are a constant
threat and impossible to anticipate. Some of these lack antiviral agents or
vaccines for prevention. Although these include some of the most serious viral
disorders, the development of antiviral agents for these is not commercially
attractive. Current research and approaches to these virus infections are
discussed.
Markets for antivirals are considered according to viruses and diseases caused
by them and also according to management approaches: antiviral drugs,
vaccines, MAbs and innovative approaches that include immunological and use of
other technologies such as gene therapy, antisense, RNAi and
nanobiotechnology. Antiviral markets are estimated starting with 2008 with
projections up to the year 2018.
Profiles of 169 companies that are involved in developing various technologies
and products are profiled and with 148 collaborations. These include major
pharmaceutical companies (13), those developing antiviral therapeutics (102)
as well as viral vaccine companies (54). The report is supplemented with 47
tables, 11 figures and 350 references from the literature.
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