Why are there so few antivirals? The answer boils down to biology, and specifically the fact viruses use our own cells to multiply. This makes it hard to kill viruses without killing our own cells in the process - Christine Carson & Rachel Roper


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Developing antiviral drugs is not easy – here’s why

The reason there are few effective broad-spectrum antivirals is that viruses are much more diverse than bacteria, including in how they store their genetic information (some in the form of DNA and some as RNA). Unlike bacteria, viruses have fewer of their own protein building blocks that can be targeted with drugs.

For a drug to work, it has to reach its target. This is particularly difficult with viruses because they replicate inside human cells by hijacking our cellular machinery. The drug needs to get inside these infected cells and act on processes that are essential for the normal functioning of the human body. Unsurprisingly, this often results in collateral damage to human…

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 Developing antiviral drugs is not easy – here’s why

Unlike broad-spectrum antibiotics, which can be used to treat a wide range of bacterial infections, drugs that work against one type of virus rarely work at treating other viruses. For example, remdesivir, originally developed for treating hepatitis C, was at one point suggested as a treatment for COVID, but clinical trials have shown that it has only a limited effect against this coronavirus.


The recommendation follows review and analysis of clinical trials for the monoclonal antibodies mAb114 (known as Ansuvimab or Ebanga) and REGN-EB3 (Inmazeb), which have demonstrated clear benefits for people who have tested positive for Ebola, which is often fatal.

Hep B

There are currently 7 approved drugs in the United States for adults living with chronic hepatitis B infection. These include 5 types of antiviral drugs that are taken as a pill once a day for 1 year or longer. And there are 2 types of immune modulator drugs called “interferon” that are given as an injection for 6 months to 1 year.

Hep C

Antiviral medicine eliminates hepatitis C in 97% of patients, but Stanford Medicine researchers and colleagues find that many don’t receive the treatment.

Herpes Simplex

Acyclovir is an agent used to treat infections caused by the herpes simplex virus (HSV). It is FDA approved to treat genital herpes and HSV encephalitis. Non-FDA-approved indications are mucocutaneous HSV, herpes zoster (shingles), and varicella-zoster (chickenpox). Acyclovir is the first-line treatment for HSV encephalitis.


Recent advances in treatment and prevention of HIV warrant updated recommendations to guide optimal practice.

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