Respiratory syncytial virus disease: update on treatment and prevention

Expert Rev Anti Infect Ther. 2011 Jan;9(1):27-32. doi: 10.1586/eri.10.140.

Abstract

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infections in infants and young children, accounting for more than 100,000 hospitalizations per year in the USA. The majority of hospitalizations occur in infants less than 1 year of age. Worldwide, RSV is associated with an annual mortality rate of 160,000-600,000 deaths. Premature infants, and infants with congenital heart disease, neuromuscular disease, structural airway abnormalities and immunodeficiencies are at increased risk for severe RSV disease. Despite the magnitude of RSV disease, treatment remains primarily supportive. Trials of bronchodilators, corticosteroids and montelukast have not demonstrated conclusive clinical benefit. The antiviral drug ribavirin has demonstrated only marginal clinical benefit and is not routinely indicated in treatment of RSV disease. Palivizumab is beneficial in prophylaxis for infants at high-risk for severe RSV infection although optimal indications based on cost-effectiveness considerations have not been defined. Future directions in treatment and prevention of RSV infections likely include the second-generation monoclonal antibody motavizumab, more potent antiviral compounds and more unique anti-inflammatory agents. Vaccination against RSV is in development but not eminent.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents / therapeutic use*
  • Bronchiolitis, Viral / drug therapy
  • Bronchiolitis, Viral / prevention & control
  • Bronchiolitis, Viral / virology
  • Bronchodilator Agents / therapeutic use
  • Child
  • Clinical Trials as Topic
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Premature, Diseases / prevention & control*
  • Infant, Premature, Diseases / virology
  • Palivizumab
  • Respiratory Syncytial Virus Infections / drug therapy*
  • Respiratory Syncytial Virus Infections / prevention & control*
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Virus, Human
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / prevention & control
  • Respiratory Tract Infections / virology
  • Ribavirin / therapeutic use*
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • Bronchodilator Agents
  • Ribavirin
  • motavizumab
  • Palivizumab