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This report is written by MaltSci based on the latest literature and research findings

What are the latest advances in antiviral therapy? ​

Abstract ​

The emergence of viral infections has posed significant challenges to global health, highlighting the urgent need for effective antiviral therapies. Recent years have seen a rapid increase in viral diseases, particularly those caused by coronaviruses and influenza viruses, revealing the limitations of existing antiviral treatments. Traditional antiviral strategies, while instrumental, often face hurdles such as drug resistance and inadequate bioavailability. This review explores the latest advances in antiviral therapy, focusing on novel drug developments and innovative therapeutic strategies. Key areas of progress include direct-acting antivirals (DAAs), which have revolutionized the treatment of chronic infections like hepatitis C, demonstrating high cure rates and reduced side effects. Additionally, host-targeted therapies that inhibit viral replication by modulating host cellular pathways present promising avenues for treatment. Monoclonal antibodies, RNA interference (RNAi), and CRISPR-based strategies are also at the forefront of antiviral research, providing new mechanisms to combat viral infections. The review further discusses the importance of combination therapies to enhance efficacy and manage resistance, alongside recent clinical trials that offer insights into practical applications. Future directions in antiviral therapy emphasize personalized medicine approaches and the ongoing need for vaccine development. By synthesizing current literature and recent findings, this review serves as a comprehensive resource for researchers and clinicians engaged in the dynamic field of antiviral therapy.

Outline ​

This report will discuss the following questions.

  • 1 Introduction
  • 2 Mechanisms of Antiviral Action
    • 2.1 Direct-acting Antivirals (DAAs)
    • 2.2 Host-targeted Therapies
  • 3 Novel Therapeutic Approaches
    • 3.1 Monoclonal Antibodies
    • 3.2 RNA Interference (RNAi)
    • 3.3 CRISPR-based Strategies
  • 4 Combination Therapies
    • 4.1 Synergistic Drug Combinations
    • 4.2 Resistance Management Strategies
  • 5 Recent Clinical Trials and Outcomes
    • 5.1 Overview of Key Trials
    • 5.2 Implications for Clinical Practice
  • 6 Future Directions in Antiviral Therapy
    • 6.1 Personalized Medicine Approaches
    • 6.2 Vaccine Development and Preventive Strategies
  • 7 Conclusion

1 Introduction ​

The emergence of viral infections poses significant challenges to global health, underscoring the urgent need for effective antiviral therapies. Recent years have witnessed a rapid proliferation of viral diseases, notably those caused by coronaviruses, influenza viruses, and other respiratory pathogens, which have highlighted the limitations of existing antiviral treatments. While traditional antiviral strategies have been instrumental in managing various viral infections, they often face hurdles such as drug resistance, toxicity, and inadequate bioavailability [1][2]. These challenges necessitate innovative approaches to antiviral therapy, aiming not only to enhance efficacy but also to broaden the therapeutic arsenal against diverse viral pathogens.

The significance of advancing antiviral therapies cannot be overstated. Viral infections are responsible for substantial morbidity and mortality worldwide, affecting vulnerable populations disproportionately. The recent COVID-19 pandemic has further emphasized the critical need for rapid and effective therapeutic interventions, driving research into novel antiviral agents and treatment strategies [3]. The landscape of antiviral therapy is evolving, propelled by advancements in molecular biology, pharmacology, and biotechnology. Understanding the intricate mechanisms of viral replication and host-pathogen interactions has paved the way for the development of direct-acting antivirals (DAAs), monoclonal antibodies, and gene-editing technologies such as CRISPR [4][5].

Current research has made significant strides in understanding viral biology and the mechanisms underlying viral pathogenesis. For instance, the development of DAAs has revolutionized the treatment of chronic infections like hepatitis C, demonstrating high cure rates and minimal side effects [6]. Furthermore, the exploration of host-targeted therapies, which inhibit viral replication by modulating host cellular pathways, presents a promising avenue for reducing viral load and preventing disease progression [2]. This review will delve into the latest advances in antiviral therapy, encompassing novel drug developments and innovative therapeutic strategies.

The organization of this review will follow a structured outline, beginning with an exploration of the mechanisms of antiviral action, focusing on both direct-acting antivirals and host-targeted therapies. Subsequent sections will address novel therapeutic approaches, including monoclonal antibodies, RNA interference (RNAi), and CRISPR-based strategies, which are at the forefront of antiviral research. We will also discuss combination therapies that leverage synergistic effects to enhance treatment efficacy and manage resistance [1]. Recent clinical trials and their outcomes will be summarized, providing insights into the practical implications of these advancements for clinical practice [3]. Finally, we will consider future directions in antiviral therapy, emphasizing personalized medicine approaches and the ongoing need for vaccine development and preventive strategies [7].

By synthesizing the current literature and recent findings, this review aims to serve as a comprehensive resource for researchers, clinicians, and policymakers engaged in the dynamic field of antiviral therapy. The ongoing innovation in antiviral drug development is crucial not only for addressing existing viral threats but also for preparing for future pandemics and emerging viral diseases.

2 Mechanisms of Antiviral Action ​

2.1 Direct-acting Antivirals (DAAs) ​

Recent advances in antiviral therapy, particularly concerning direct-acting antivirals (DAAs), have revolutionized the treatment landscape for viral infections, notably hepatitis C virus (HCV) and more recently, SARS-CoV-2. DAAs are specifically designed to inhibit viral targets, providing a mechanism that is distinct from traditional antiviral therapies that often target host factors.

In the context of hepatitis C, the development of DAAs has been significant. As outlined by Li and De Clercq (2017), these agents have shown high efficacy, with sustained virologic response rates exceeding 90% in many patients, including those with advanced liver disease. The therapeutic approach has shifted from interferon-based regimens, which were associated with considerable side effects and lower cure rates, to interferon-free combinations of DAAs. These newer regimens not only enhance efficacy but also improve tolerability and simplify treatment protocols, reducing the treatment duration from 48 weeks to as little as 8 to 12 weeks in many cases[8].

The U.S. FDA has approved a remarkable 27 new DAAs between 2013 and 2024, which marks a significant leap in antiviral therapy compared to the previous 50 years, during which only a handful of DAAs were introduced[5]. These agents are characterized by their ability to specifically target viral enzymes critical to the viral life cycle, thereby inhibiting replication effectively. For instance, in the treatment of HCV, DAAs such as protease inhibitors and polymerase inhibitors have become standard, often administered in combination to maximize efficacy and prevent the emergence of resistant viral strains[9].

In the realm of SARS-CoV-2, DAAs have also emerged as vital therapeutic options. Current DAAs targeting SARS-CoV-2 include nucleoside analogs like remdesivir and molnupiravir, which inhibit the RNA-dependent RNA polymerase, and nirmatrelvir/ritonavir, which targets the main protease of the virus[10]. The effectiveness of these agents has been assessed against various viral variants, including Alpha, Delta, and Omicron, indicating their potential in managing evolving viral threats[10].

The molecular mechanisms of action for DAAs are diverse. They typically act by directly inhibiting viral enzymes necessary for replication or by blocking the host cell factors that viruses exploit during their life cycle. This specificity allows for targeted therapeutic strategies that can significantly reduce viral load and improve patient outcomes[11].

Moreover, the advent of all-oral regimens has simplified treatment protocols, allowing for improved adherence and reduced complexity in managing patients with chronic infections[12]. The shift towards these modern therapies has not only enhanced cure rates but has also facilitated the development of shorter treatment durations and regimens that are easier for patients to follow, thereby addressing previous barriers to treatment access.

In summary, the latest advances in antiviral therapy, particularly through the development of DAAs, have led to transformative changes in the treatment of viral infections. These agents have established new standards of care that promise improved efficacy, reduced side effects, and greater accessibility for patients suffering from chronic viral diseases.

2.2 Host-targeted Therapies ​

Recent advancements in antiviral therapy have increasingly focused on host-targeted therapies (HTTs), which aim to exploit host cellular mechanisms to combat viral infections. This approach offers several advantages over traditional direct-acting antivirals (DAAs), particularly in addressing issues related to drug resistance and broad-spectrum efficacy.

HTTs target host factors that viruses rely on for their replication and survival. By interfering with these host pathways, HTTs can disrupt the viral life cycle without directly targeting the virus itself. This strategy not only reduces the likelihood of developing drug-resistant viral strains but also enables the treatment of multiple viral infections with a single therapeutic agent. The increasing understanding of host-virus interactions has facilitated the identification of novel therapeutic targets within the host cellular environment.

One significant aspect of HTTs is their ability to modulate the immune response. For instance, therapies can enhance protective immune responses or mitigate excessive inflammatory reactions that can be detrimental to the host. This dual approach not only aims to eliminate the virus but also to restore a balanced immune response, which is crucial in the context of severe viral infections. Recent studies have highlighted the potential of host-directed therapies in managing infections caused by various viruses, including Zika, dengue, HIV, influenza, and COVID-19 [13].

Moreover, the development of host-targeting antivirals has shown promise in addressing the limitations of DAAs. For example, alisporivir, a host-targeting antiviral, has demonstrated efficacy in reducing viral loads in hepatitis C virus (HCV) infections by inhibiting the activity of cyclophilin A, a host protein critical for HCV replication. This mechanism not only provides a high barrier against the development of resistance but also offers a pangenotypic treatment option, making it effective against various HCV genotypes [14].

Another innovative strategy within HTTs involves lipid-targeting approaches, which exploit the fact that many viruses hijack specific lipids during their life cycle. Research has explored the antiviral properties of compounds that target lipid metabolism, such as statins and sphingolipid modulators, demonstrating their potential in combating a range of viral infections [15].

Furthermore, genome-wide approaches utilizing techniques like CRISPR screening have accelerated the identification of host factors essential for viral replication. These methods have unveiled new targets for antiviral drug development, focusing on cellular pathways that support viral life cycles [16].

Overall, the shift towards host-targeted therapies represents a promising frontier in antiviral research. By leveraging the host's cellular machinery and immune responses, these therapies not only hold the potential for treating existing viral infections but also provide a framework for developing broad-spectrum antiviral agents that can preemptively address emerging viral threats [17].

3 Novel Therapeutic Approaches ​

3.1 Monoclonal Antibodies ​

Monoclonal antibodies (mAbs) have emerged as a significant therapeutic modality in the treatment and prevention of viral infections, representing a major advancement in antiviral therapy. The development and application of mAbs have gained momentum due to their high specificity, versatility, and the unique biological mechanisms they employ to combat viral pathogens.

Recent advancements in monoclonal antibody technology include the engineering of antibodies to enhance their efficacy and safety profiles. The introduction of hybridoma technology in 1975 has paved the way for innovations such as chimeric and humanized antibodies, which improve compatibility with the human immune system. Additionally, phage display and transgenic mouse platforms have facilitated the identification and production of antibodies with desired specificities and affinities. As of August 2025, there are 144 FDA-approved antibody drugs on the market, with 1,516 candidates in clinical development worldwide[18].

The specificity of mAbs allows them to effectively neutralize viral pathogens and modulate immune responses. This capability is particularly important in addressing viral diseases that lack effective vaccines. For instance, the COVID-19 pandemic highlighted the potential of mAbs in providing rapid therapeutic responses to emerging viral threats[19]. Furthermore, monoclonal antibodies have been developed against a variety of viral targets, including newly emerging pathogens such as Ebola and established viruses like human cytomegalovirus[20].

Despite the promising landscape, challenges remain in the development and application of mAbs for antiviral therapy. The high cost of production, storage, and administration can hinder their accessibility, particularly in resource-limited settings. However, the advantages of mAbs, such as low toxicity and high specificity, position them as valuable tools in the therapeutic arsenal against viral infections[21].

Recent studies have underscored the need for continued innovation in mAb discovery and development. Advances in artificial intelligence and machine learning, coupled with next-generation sequencing and structural modeling, are expected to streamline the design and optimization of mAbs, allowing for more efficient identification of high-affinity candidates[22].

In summary, the latest advances in antiviral therapy through monoclonal antibodies highlight a dynamic and evolving field. With ongoing research and technological advancements, mAbs are poised to play a critical role in addressing unmet clinical needs in the prevention and treatment of viral diseases.

3.2 RNA Interference (RNAi) ​

Recent advances in antiviral therapy, particularly in the realm of RNA interference (RNAi), have showcased the potential of this technology as a powerful tool in combating viral infections. RNAi functions through the use of small interfering RNAs (siRNAs) to induce sequence-specific degradation of viral RNA, thus preventing viral replication and spread. This innovative approach is gaining traction as a viable alternative to traditional antiviral treatments.

A significant development in RNAi-based therapeutics is the utilization of lipid nanoparticles (LNPs) for effective delivery of siRNAs. LNPs have emerged as an ideal delivery vehicle, enhancing the stability and bioavailability of siRNAs in vivo. This delivery method has shown promise in preclinical models, particularly for targeting pandemic viruses such as SARS-CoV-2 and HIV, where rapid response to emerging viral threats is critical [23][24].

Furthermore, recent studies highlight the role of RNAi in addressing the challenge of antiviral resistance. The specificity and adaptability of siRNAs allow for the targeting of conserved viral gene regions, providing a strategic advantage against viral mutations that often render traditional therapies ineffective [25]. Research emphasizes the importance of developing multi-target siRNAs that can simultaneously address multiple viral strains, thereby enhancing therapeutic efficacy and reducing the likelihood of resistance [26].

The clinical landscape for RNAi-based therapies has also evolved, with several siRNA drugs advancing through clinical trials. The approval of liver-targeted siRNA therapeutics has marked a significant milestone, indicating a shift towards more widespread applications of RNAi in treating chronic viral infections [27]. The progress in gene delivery technologies, alongside the discovery of critical roles for microRNAs (miRNAs) in viral pathogenesis, further underscores the therapeutic potential of RNAi in managing viral diseases [28].

Despite these advancements, challenges remain, particularly concerning the stability of siRNAs, off-target effects, and the immune response to RNAi therapies. Addressing these obstacles is crucial for the successful implementation of RNAi-based antiviral strategies [29]. Continuous research efforts are directed at improving the design and delivery mechanisms of RNAi therapeutics, ensuring their efficacy and safety in clinical applications [30].

In summary, the field of RNAi as an antiviral therapy is rapidly evolving, characterized by innovative delivery systems, the exploration of multi-target strategies, and the ongoing refinement of siRNA design. These advancements not only enhance the therapeutic landscape for viral infections but also pave the way for more resilient strategies against emerging viral threats.

3.3 CRISPR-based Strategies ​

Recent advances in antiviral therapy have increasingly focused on CRISPR-based strategies, which offer innovative approaches to combat viral infections. The CRISPR/Cas system has emerged as a revolutionary tool in genetic engineering, enabling precise manipulation of viral genomes and enhancing our understanding of virus-host interactions. This section highlights several key developments in CRISPR-based antiviral strategies.

  1. Targeting Viral Genomes: The CRISPR/Cas9 system allows for the direct manipulation of viral genomes, which has significant implications for developing antiviral therapies. For instance, studies have demonstrated that CRISPR/Cas9 can be utilized to target and edit the genomes of various clinically relevant viruses, including human immunodeficiency virus (HIV), hepatitis B virus, and herpesviruses. This capability not only facilitates the study of viral biology but also opens avenues for creating novel antiviral therapies aimed at chronic viral infections (Lee 2019) [31].

  2. Mechanisms of Action: CRISPR-based antiviral strategies can operate through multiple mechanisms. These include inhibiting the active lytic replication cycle of viruses by targeting viral lytic genes or host genes that the viruses exploit. Additionally, CRISPR technologies can remove latent viral genomes from infected cells by destabilizing the viral genome or targeting genes essential for latency maintenance. Such approaches are particularly relevant for herpesvirus infections, where latency poses a significant therapeutic challenge (Hanssens & Van Cleemput 2025) [32].

  3. Enhancing Immune Responses: Another innovative application of CRISPR involves inducing viral reactivation to enhance recognition by the host immune system. This strategy can improve the efficacy of existing antiviral therapies and potentially lead to better outcomes in managing chronic infections. Furthermore, CRISPR can be used to develop or enhance cellular immunotherapy, making it a versatile tool in the fight against viral pathogens (Hanssens & Van Cleemput 2025) [32].

  4. Challenges and Future Directions: Despite the promising potential of CRISPR-based antiviral therapies, several challenges remain. Issues related to the delivery of CRISPR systems, biosafety, and the timing of treatment need further investigation before widespread clinical implementation can be realized. The current research emphasizes the importance of developing safe and effective delivery mechanisms to ensure the therapeutic efficacy of CRISPR applications in vivo (Najafi et al. 2022) [33].

  5. Integration with Other Therapeutic Approaches: The combination of CRISPR technology with other therapeutic strategies, such as immunotherapy and antiviral agents, could lead to synergistic effects, enhancing overall treatment outcomes. For example, CRISPR-based approaches are being explored in conjunction with therapeutic vaccines and pre-exposure prophylaxis (PrEP) strategies, thereby expanding the preventive and therapeutic arsenal against viral infections (Mundlia et al. 2025) [34].

In conclusion, CRISPR-based strategies represent a significant advancement in antiviral therapy, offering novel mechanisms to target and eliminate viral infections. Ongoing research is crucial to address existing challenges and to harness the full potential of CRISPR technologies in clinical settings, ultimately contributing to improved management of viral diseases.

4 Combination Therapies ​

4.1 Synergistic Drug Combinations ​

Recent advancements in antiviral therapy have increasingly focused on combination therapies, particularly synergistic drug combinations, which have shown promise in enhancing therapeutic efficacy and addressing challenges posed by viral infections. The combination of antiviral agents is becoming a critical strategy in the management of chronic viral infections, such as HIV and hepatitis C, as well as emerging viral diseases like SARS-CoV-2.

One notable area of progress is the application of combination therapies in treating HIV. Research has demonstrated that combination therapy with antiretroviral agents is more effective than monotherapy, with significant improvements in viral load suppression and overall patient outcomes. For instance, recent developments in antiretroviral therapy have allowed for the selection of combinations that provide effective suppression of viral load while minimizing the risk of drug resistance [35]. The combination of different classes of antiretroviral agents has led to maximally effective regimens that optimize treatment without limiting future options [36].

In the context of hepatitis C, the use of direct-acting antivirals (DAAs) in combination has revolutionized treatment outcomes, achieving high rates of sustained virological response (SVR) with fewer side effects compared to traditional therapies [37]. The shift towards combination therapies aims to create pangenotypic regimens that are effective across various patient demographics and stages of fibrosis [37].

Emerging research also highlights the potential of drug repurposing and the identification of synergistic combinations to combat multidrug-resistant pathogens and viral infections. For example, recent studies have shown that drug repurposing can accelerate the development of effective therapies by utilizing existing compounds with established safety profiles [38]. The identification of synergistic drug combinations can enhance therapeutic efficacy while reducing the required dosages, thereby minimizing toxicity [38].

Furthermore, advancements in computational methods have facilitated the prediction of synergistic drug combinations for treating viral diseases. Innovative models, such as those incorporating deep learning techniques, have been employed to identify novel combinations that exhibit synergistic effects, as demonstrated by the validation of specific combinations against herpes simplex virus [39].

In the case of SARS-CoV-2, studies have explored the synergistic interaction between approved antiviral agents, such as remdesivir and ivermectin, showing enhanced antiviral activity in vitro [40]. Although clinical application of such combinations is still under investigation, the potential for combination therapies to improve treatment outcomes against COVID-19 is significant.

Overall, the latest advances in antiviral therapy underscore the importance of combination strategies in enhancing treatment efficacy, minimizing resistance development, and addressing the challenges posed by both chronic and emerging viral infections. The ongoing exploration of synergistic drug combinations and the utilization of innovative computational approaches are expected to play a crucial role in the future of antiviral drug development.

4.2 Resistance Management Strategies ​

Recent advancements in antiviral therapy have highlighted the significance of combination therapies and resistance management strategies in combating viral infections, particularly in the context of emerging resistance patterns.

Combination therapies have gained traction as a promising approach to enhance the efficacy of antiviral treatments. These regimens utilize multiple agents that may act synergistically, thereby increasing overall antiviral effectiveness while reducing the likelihood of resistance development. For instance, in the context of SARS-CoV-2, combination treatments have been proposed to optimize therapeutic outcomes by leveraging the strengths of various direct-acting antivirals such as remdesivir, molnupiravir, and nirmatrelvir/ritonavir. These combinations are particularly crucial given the ongoing emergence of resistant variants, which underscores the need for adaptable and durable therapeutic strategies (Soares et al., 2025) [41].

The management of antiviral resistance remains a critical challenge in the field. Antiviral resistance can develop rapidly due to viral mutations, leading to treatment failures and complicating clinical management. For example, in chronic hepatitis B therapy, antiviral resistance is a significant concern, necessitating a shift from sequential monotherapy to combination therapy to prevent the emergence of resistant strains (Yim & Hwang, 2013) [42]. Combination therapies have been shown to mitigate resistance, as evidenced by studies indicating that employing complementary antiviral agents can decrease the likelihood of developing resistance during treatment (Sasadeusz et al., 2007) [43].

Moreover, innovative strategies are being explored to address the complexities of resistance mechanisms. For example, recent developments in antiviral drug discovery have focused on multi-target drug design and the use of host-targeting strategies to enhance therapeutic efficacy against drug-resistant viruses. This includes the identification of compounds that can engage multiple binding sites or utilize host cellular pathways to inhibit viral replication (Ma et al., 2021) [44].

In the realm of bacterial infections, the principles of combination therapy are also being applied to combat multidrug-resistant bacteria. The synergy between different antibacterial agents can enhance treatment efficacy and suppress resistance (Zhu et al., 2021) [45]. The evolution of combination therapy from traditional applications in viral and mycobacterial infections to broader bacterial infections illustrates its potential in managing resistance across various pathogens.

The future of antiviral therapy hinges on the continued exploration of combination regimens and the development of innovative resistance management strategies. This includes ongoing research into novel compounds with broad-spectrum activity, improved pharmacokinetics, and favorable safety profiles. Additionally, the integration of advanced technologies, such as bioinformatics and nanomedicine, promises to further enhance the identification and efficacy of antiviral candidates, ensuring that therapeutic strategies remain robust against evolving viral threats (De Jesús-González et al., 2024) [2].

In summary, the latest advances in antiviral therapy emphasize the critical role of combination therapies and proactive resistance management strategies in effectively addressing the challenges posed by viral infections and the emergence of resistant strains.

5 Recent Clinical Trials and Outcomes ​

5.1 Overview of Key Trials ​

Recent advancements in antiviral therapy have been marked by significant progress in clinical trials targeting various viral infections, particularly in response to the ongoing challenges posed by pathogens such as SARS-CoV-2 and HIV-1.

In the context of SARS-CoV-2, numerous antiviral agents have been developed and repurposed to combat COVID-19. A review by Zhao et al. (2021) highlights the increasing number of clinical studies on antiviral treatments including remdesivir, chloroquine, hydroxychloroquine, and several others. However, the efficacy of these drugs remains controversial, necessitating high-quality randomized clinical trials to confirm their safety and effectiveness [46]. Additionally, Lan et al. (2024) discuss the limited clinical efficacy of many antivirals, particularly in light of the emergence of variants of concern (VOCs). This underscores the urgent need for the development of more potent and broad-spectrum antivirals with improved pharmacokinetic properties to effectively address infections caused by SARS-CoV-2 and its variants [3].

Moreover, Singh and de Wit (2022) note that the rapid development and application of antiviral therapies during the COVID-19 pandemic have significantly improved clinical outcomes for patients, particularly when treatments are administered early in the disease course. Their analysis emphasizes the lessons learned from these experiences, which could inform future pandemic responses [47].

In the realm of HIV-1, Borrajo (2025) outlines innovative strategies including gene editing technologies and immune-modulatory interventions aimed at achieving a definitive cure for HIV-1. The focus on eliminating viral reservoirs is critical for achieving durable viral remission without the need for continuous antiretroviral therapy. Despite the promising developments in this field, significant challenges remain in translating laboratory findings into clinical applications [4].

Additionally, advancements in antiviral therapy for chronic viral hepatitis have also been noteworthy. Khoo et al. (2021) detail the impact of modern antiviral treatments on clinical outcomes for chronic hepatitis B and C infections. The introduction of directly acting antivirals (DAAs) has transformed the treatment landscape, resulting in improved patient quality of life, reduced transmission rates, and decreased hospitalizations and mortality associated with liver disease [48].

Overall, the landscape of antiviral therapy is evolving rapidly, driven by the urgent need to address emerging viral threats and improve patient outcomes. The integration of innovative technologies, rigorous clinical trials, and a focus on comprehensive therapeutic strategies are crucial for advancing the field of antiviral medicine.

5.2 Implications for Clinical Practice ​

Recent advances in antiviral therapy have significantly influenced the management of viral infections, particularly in response to the challenges posed by emerging viruses and their variants. The ongoing COVID-19 pandemic has accelerated the development and clinical application of antiviral agents, leading to a surge in clinical trials aimed at evaluating their efficacy and safety.

A comprehensive review of antiviral therapy for COVID-19 highlights the increased number of clinical studies focused on various antiviral agents, including remdesivir, chloroquine, hydroxychloroquine, and favipiravir, among others. However, the efficacy of these treatments remains controversial, necessitating high-quality randomized clinical trials to validate their effectiveness and safety (Zhao et al. 2021) [46]. The rapid clinical development of antiviral therapies during the pandemic has underscored the importance of timely intervention, with early administration of antiviral agents showing improved clinical outcomes in COVID-19 patients (Singh & de Wit 2022) [47].

In addition to COVID-19, the development of antiviral agents for other respiratory viruses has made notable progress. For instance, the introduction of baloxavir marboxil for influenza treatment represents a significant advancement, particularly for high-risk patients (Beigel & Hayden 2021) [49]. The emergence of new antiviral classes enhances the public health response to viral infections, allowing for better management of potential resistant strains.

Innovative strategies such as nanoplatform technologies are being explored to enhance drug solubility, provide sustained or targeted delivery, and improve the overall efficacy of antiviral therapies (Rana et al. 2025) [1]. These technologies, combined with genetic modulation approaches, hold promise for effectively combating viral infections, particularly in light of the limitations of existing therapies, such as drug resistance and poor bioavailability.

The development of broad-spectrum antivirals with favorable pharmacokinetic and pharmacodynamic properties is also critical in addressing infections caused by SARS-CoV-2 and its variants (Lan et al. 2024) [3]. The focus on targeting critical stages of the viral replication cycle and employing innovative approaches, including CRISPR gene editing and advanced bioinformatics tools, aims to optimize the identification and efficacy of antiviral candidates (De Jesús-González et al. 2024) [2].

Overall, the advancements in antiviral therapy are marked by a combination of new drug development, innovative delivery systems, and the integration of cutting-edge technologies. These developments not only enhance treatment options for current viral infections but also provide valuable insights and strategies for managing future pandemics, emphasizing the need for ongoing research and clinical trials to ensure effective antiviral therapies in clinical practice.

6 Future Directions in Antiviral Therapy ​

6.1 Personalized Medicine Approaches ​

Recent advances in antiviral therapy have highlighted the importance of personalized medicine approaches, particularly in the context of the ongoing challenges posed by viral infections. A notable focus has been on enhancing the efficacy and specificity of antiviral treatments through innovative strategies.

One significant area of development is the application of nanotechnology in antiviral drug delivery. This approach aims to improve drug solubility, provide sustained or targeted delivery, and enhance the overall effectiveness of antiviral therapies. The integration of nanoplatform technologies with novel strategies, such as genetic modulation, has the potential to significantly combat viral infections more effectively. These innovations are crucial in addressing the limitations of existing antiviral therapies, such as drug resistance and poor bioavailability, which have hindered treatment outcomes for new and emerging viruses [1].

Moreover, the use of advanced bioinformatics tools has been instrumental in optimizing the identification of antiviral candidates. This has facilitated the exploration of therapeutic strategies that target critical stages of the viral replication cycle, including inhibitors of viral entry, replication, and assembly. Innovative approaches, such as repurposing existing drugs and inhibiting host cellular proteins to reduce viral resistance, are also being investigated [2].

The clinical development of antivirals against specific pathogens, such as SARS-CoV-2, has underscored the necessity for more potent and broad-spectrum antivirals. Current challenges include the loss of sensitivity to variants of concern and the need for improved pharmacokinetic and pharmacodynamic properties of antiviral agents. The ongoing research aims to develop novel therapeutics that can effectively address infections from SARS-CoV-2 and other human coronaviruses [3].

In addition, the concept of personalized medicine is gaining traction within the realm of antiviral therapy. The push for personalized therapeutics recognizes that treatment plans should be tailored to individual patient profiles, which may involve the use of biomimetic nanotechnology to create more effective and individualized vaccination strategies. These approaches seek to enhance the potency and antigenic breadth of vaccines, thereby improving the overall response to viral infections [50].

Overall, the future of antiviral therapy is leaning towards a combination of traditional methods and advanced technologies, emphasizing the need for continuous innovation to meet the evolving challenges posed by viral diseases. The focus on personalized medicine, particularly through the application of nanotechnology and genetic strategies, represents a promising direction for improving the efficacy and safety of antiviral treatments [1][2][3].

6.2 Vaccine Development and Preventive Strategies ​

Recent advancements in antiviral therapy have been significant, particularly in the context of the ongoing challenges posed by viral infections such as HIV and respiratory viruses, including SARS-CoV-2. The evolution of antiviral strategies has been marked by innovative therapeutic approaches and a concerted effort towards vaccine development.

In the realm of HIV treatment, there has been a continuous exploration of new antiretroviral agents (ARVs) and treatment strategies. Recent findings indicate that several new ARVs are undergoing clinical investigation, including the non-nucleoside reverse transcriptase inhibitor rilpivirine, the integrase inhibitor elvitegravir, the chemokine receptor 5 co-receptor antagonist vicriviroc, and the maturation inhibitor bevirimat. These developments are complemented by strategies aimed at optimizing antiretroviral therapy (ART), such as treatment interruption, induction-maintenance, and class-sparing regimens, which have shown varying degrees of success [51].

Despite the advancements in treatment, the quest for an effective HIV vaccine remains paramount. A second-generation preventive HIV vaccine has shown encouraging results in a recent phase III trial, underscoring vaccination as the optimal long-term solution for HIV prevention [51]. The need for a comprehensive approach that includes both treatment and prevention strategies is critical, as the limitations of current ART highlight the urgency for effective vaccines and potential cures [52].

In the context of respiratory viruses, particularly SARS-CoV-2, antiviral development has progressed in response to the pandemic. Therapeutic strategies targeting critical stages of the viral replication cycle have been emphasized, including inhibitors of viral entry, replication, and assembly. Innovative approaches, such as repurposing existing drugs and employing advanced bioinformatics tools, have been explored to identify potential antiviral candidates. Emerging technologies like nanomedicine and CRISPR gene editing are also being investigated for their potential to enhance treatment efficacy [2].

The development of antivirals for SARS-CoV-2 has been challenging, particularly due to issues such as viral evolution and the limited clinical efficacy of many available treatments. There is a pressing need for the creation of more potent and broad-spectrum antivirals that possess favorable pharmacokinetic and pharmacodynamic properties [3]. This is particularly important as the global health landscape continues to evolve, necessitating ongoing innovation in biotechnology to address the limitations of current antiviral therapies.

Overall, the future directions in antiviral therapy emphasize a dual focus on enhancing treatment modalities and advancing vaccine development. The integration of traditional and cutting-edge approaches will be essential in combating viral diseases and improving global health outcomes [2][52].

7 Conclusion ​

The recent advances in antiviral therapy underscore the critical importance of innovative strategies in addressing the challenges posed by viral infections. The emergence of direct-acting antivirals (DAAs) has transformed the treatment landscape for chronic viral diseases such as hepatitis C and SARS-CoV-2, showcasing high efficacy and improved patient outcomes. Additionally, host-targeted therapies have opened new avenues for treatment by leveraging host cellular mechanisms, thus reducing the risk of drug resistance. Monoclonal antibodies, RNA interference, and CRISPR-based strategies further exemplify the diversification of therapeutic approaches, enhancing specificity and effectiveness in combating viral pathogens. Combination therapies represent a significant advancement, enabling the synergistic effects of multiple agents to improve treatment outcomes while managing resistance. Ongoing clinical trials continue to provide valuable insights into the efficacy of these therapies, emphasizing the need for robust and adaptable strategies in the face of emerging viral threats. Looking forward, the integration of personalized medicine and innovative vaccine development will be paramount in the continuous fight against viral infections, ensuring that future antiviral therapies are both effective and accessible. The evolving landscape of antiviral therapy is a testament to the collaborative efforts of researchers, clinicians, and policymakers in enhancing global health and preparedness for future pandemics.

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