{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:29:03Z","timestamp":1787887743033,"version":"build-2784847793"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose of review<\/jats:title>\n                    <jats:p>Respiratory syncytial virus (RSV) remains a leading cause of bronchiolitis in infants and young children, of pneumonia in children under 5\u200ayears of age and is also associated with significant mobility and mortality in immunocompromised patients and older adults. As RSV epidemiology evolves and our preventive strategies expand, developing safe and effective antivirals have the potential to significantly change the trajectory of RSV infections in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent findings<\/jats:title>\n                    <jats:p>The landscape of RSV prevention has undergone substantial progress in recent years, and early reductions in burden of acute disease has already been observed among infants who have received these preventive interventions. Nonetheless, RSV continues to pose significant challenges, particularly in regions where prophylactic measures have not yet been implemented, in older children who remain vulnerable beyond their first RSV season and in special patient populations with a weakened immune system. Therapeutic options remain limited: ribavirin is currently the only approved antiviral for severe RSV-LRTI, and despite modest efficacy, its use is largely restricted to immunocompromised patients. Several antivirals with distinct mechanisms of action, have been evaluated in the past decade, but many were discontinued due to limited clinical benefits or concerns with safety. Nonetheless, three major classes of antivirals (fusion inhibitors, polymerase inhibitors and N-protein inhibitors) are now in development with promising results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>This review provides an updated overview of current antivirals against RSV, highlighting the need to develop new therapeutic drugs to reduce both acute disease severity and associated long-term respiratory morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/qco.0000000000001184","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:00:08Z","timestamp":1769576408000},"page":"153-159","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Antiviral therapies for respiratory syncytial virus infection: current expectations"],"prefix":"10.1097","volume":"39","author":[{"given":"Mar\u00eda","family":"Alvarez de Toledo","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Vall d\u2019Hebron Children's Hospital. Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette I.","family":"Taveras","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Infectious Diseases, Nationwide Children's Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavio","family":"Ramilo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, St Jude Children's Research Hospital"},{"name":"The University of Tennessee Health Science Center, Memphis, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuncion","family":"Mejias","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, St Jude Children's Research Hospital"},{"name":"The University of Tennessee Health Science Center, Memphis, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"R1-20260226","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1016\/S0140-6736(22)00478-0","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5\u200ayears in 2019: a systematic analysis","volume":"399","author":"Li","year":"2022","journal-title":"Lancet"},{"key":"R2-20260226","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/S0140-6736(24)00138-7","article-title":"Global disease burden of and risk factors for acute lower respiratory infections caused by respiratory syncytial virus in preterm infants and young children in 2019: a systematic review and meta-analysis of aggregated and individual participant data","volume":"403","author":"Wang","year":"2024","journal-title":"Lancet"},{"key":"R3-20260226","doi-asserted-by":"crossref","first-page":"e2023062574","DOI":"10.1542\/peds.2023-062574","article-title":"Respiratory syncytial virus-associated hospitalizations among children <5 years old: 2016 to 2020","volume":"153","author":"Curns","year":"2024","journal-title":"Pediatrics"},{"key":"R4-20260226","doi-asserted-by":"crossref","first-page":"e350","DOI":"10.1097\/INF.0000000000002065","article-title":"Re: \u2018Discharge Criteria for Bronchiolitis: Does Age Matter?\u2019","volume":"37","author":"Garcia-Maurino","year":"2018","journal-title":"Pediatr Infect Dis J"},{"key":"R5-20260226","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/S2213-2600(22)00414-3","article-title":"The burden of respiratory syncytial virus in healthy term-born infants in Europe: a prospective birth cohort study","volume":"11","author":"Wildenbeest","year":"2023","journal-title":"Lancet Respir Med"},{"key":"R6-20260226","doi-asserted-by":"crossref","first-page":"e2444756","DOI":"10.1001\/jamanetworkopen.2024.44756","article-title":"Burden of Respiratory Syncytial Virus-Associated Hospitalizations in US Adults, October 2016 to September 2023","volume":"7","author":"Havers","year":"2024","journal-title":"JAMA Netw Open"},{"key":"R7-20260226","doi-asserted-by":"crossref","first-page":"e799","DOI":"10.1093\/infdis\/jiaf343","article-title":"Incidence of respiratory syncytial virus-associated hospitalization among adults in Ontario, Canada, 2017\u20132019","volume":"232","author":"Buchan","year":"2025","journal-title":"J Infect Dis"},{"key":"R8-20260226","doi-asserted-by":"crossref","first-page":"e31484","DOI":"10.1002\/pbc.31484","article-title":"Clinical outcomes of respiratory syncytial virus infection among pediatric immunocompromised hosts","volume":"72","author":"Ross","year":"2025","journal-title":"Pediatr Blood Cancer"},{"key":"R9-20260226","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/S0140-6736(23)00811-5","article-title":"Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study","volume":"401","author":"Rosas-Salazar","year":"2023","journal-title":"Lancet"},{"key":"R10-20260226","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/pai.13131","article-title":"Risk of childhood wheeze and asthma after respiratory syncytial virus infection in full-term infants","volume":"31","author":"Mejias","year":"2020","journal-title":"Pediatr Allergy Immunol"},{"key":"R11-20260226","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S2213-2600(24)00246-7","article-title":"Early-life respiratory syncytial virus disease and long-term respiratory health","volume":"12","author":"Zar","year":"2024","journal-title":"Lancet Respir Med"},{"key":"R12-20260226","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1056\/NEJMoa2110275","article-title":"Nirsevimab for prevention of RSV in healthy late-preterm and term infants","volume":"386","author":"Hammitt","year":"2022","journal-title":"N Engl J Med"},{"key":"R13-20260226","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1056\/NEJMoa2216480","article-title":"Bivalent prefusion F vaccine in pregnancy to prevent RSV illness in infants","volume":"388","author":"Kampmann","year":"2023","journal-title":"N Engl J Med"},{"key":"R14-20260226","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1056\/NEJMoa2502984","article-title":"Clesrovimab for prevention of RSV disease in healthy infants","volume":"393","author":"Zar","year":"2025","journal-title":"N Engl J Med"},{"key":"R15-20260226","doi-asserted-by":"crossref","first-page":"e14083","DOI":"10.1111\/pai.14083","article-title":"Age-specific predictors of disease severity in children with respiratory syncytial virus infection beyond infancy and through the first 5\u200ayears of age","volume":"35","author":"Brenes-Chacon","year":"2024","journal-title":"Pediatr Allergy Immunol"},{"key":"R16-20260226","doi-asserted-by":"crossref","first-page":"2912","DOI":"10.1099\/jgv.0.000959","article-title":"ICTV virus taxonomy profile: Pneumoviridae","volume":"98","author":"Rima","year":"2017","journal-title":"J Gen Virol"},{"key":"R17-20260226","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.anai.2020.03.017","article-title":"The journey to a respiratory syncytial virus vaccine","volume":"125","author":"Mejias","year":"2020","journal-title":"Ann Allergy Asthma Immunol"},{"key":"R18-20260226","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.vaccine.2016.09.026","article-title":"Development and clinical applications of novel antibodies for prevention and treatment of respiratory syncytial virus infection","volume":"35","author":"Mejias","year":"2017","journal-title":"Vaccine"},{"key":"R19-20260226","doi-asserted-by":"crossref","first-page":"106148","DOI":"10.1016\/j.antiviral.2025.106148","article-title":"Insights in the RSV L polymerase function and structure","volume":"237","author":"Bonneux","year":"2025","journal-title":"Antiviral Res"},{"key":"R20-20260226","doi-asserted-by":"crossref","first-page":"4153","DOI":"10.1038\/s41467-019-12137-1","article-title":"A potent broadly neutralizing human RSV antibody targets conserved site IV of the fusion glycoprotein","volume":"10","author":"Tang","year":"2019","journal-title":"Nat Commun"},{"key":"R21-20260226","doi-asserted-by":"crossref","first-page":"7788","DOI":"10.1128\/JVI.00555-11","article-title":"Structure of respiratory syncytial virus fusion glycoprotein in the postfusion conformation reveals preservation of neutralizing epitopes","volume":"85","author":"McLellan","year":"2011","journal-title":"J Virol"},{"key":"R22-20260226","doi-asserted-by":"crossref","first-page":"eaaj1879","DOI":"10.1126\/sciimmunol.aaj1879","article-title":"Rapid profiling of RSV antibody repertoires from the memory B cells of naturally infected adult donors","volume":"1","author":"Gilman","year":"2016","journal-title":"Sci Immunol"},{"key":"R23-20260226","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1093\/infdis\/jix489","article-title":"Prefusion F, postfusion F, G antibodies, and disease severity in infants and young children with acute respiratory syncytial virus infection","volume":"216","author":"Capella","year":"2017","journal-title":"J Infect Dis"},{"key":"R24-20260226","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.coi.2019.03.005","article-title":"Immunological goals for respiratory syncytial virus vaccine development","volume":"59","author":"Graham","year":"2019","journal-title":"Curr Opin Immunol"},{"key":"R25-20260226","doi-asserted-by":"crossref","first-page":"e0092923","DOI":"10.1128\/jvi.00929-23","article-title":"Vaccination with prefusion-stabilized respiratory syncytial virus fusion protein elicits antibodies targeting a membrane-proximal epitope","volume":"97","author":"McCool","year":"2023","journal-title":"J Virol"},{"key":"R26-20260226","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/s44298-025-00119-8","article-title":"A single amino acid mutation alters multiple neutralization epitopes in the respiratory syncytial virus fusion glycoprotein","volume":"3","author":"Oraby","year":"2025","journal-title":"NPJ Viruses"},{"key":"R27-20260226","doi-asserted-by":"crossref","first-page":"e2165","DOI":"10.1016\/S2214-109X(25)00379-1","article-title":"The path to equitable respiratory syncytial virus prevention for infants: challenges and opportunities for global implementation","volume":"13","author":"Shaaban","year":"2025","journal-title":"Lancet Glob Health"},{"key":"R28-20260226","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1001\/jamapediatrics.2023.1088","article-title":"Shifting epidemiology and severity of respiratory syncytial virus in children during the COVID-19 pandemic","volume":"177","author":"Rao","year":"2023","journal-title":"JAMA Pediatr"},{"key":"R29-20260226","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1001\/jamapediatrics.2023.5431","article-title":"Mejias A: trends in age and disease severity in children hospitalized with RSV infection before and during the COVID-19 pandemic","volume":"178","author":"Garcia-Maurino","year":"2024","journal-title":"JAMA Pediatr"},{"key":"R30-20260226","doi-asserted-by":"crossref","first-page":"e1474","DOI":"10.1542\/peds.2014-2742","article-title":"Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis","volume":"134","author":"Ralston","year":"2014","journal-title":"Pediatrics"},{"key":"R31-20260226","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1164\/rccm.201002-0221OC","article-title":"Viral load drives disease in humans experimentally infected with respiratory syncytial virus","volume":"182","author":"DeVincenzo","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"issue":"(Suppl 1)","key":"R32-20260226","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1093\/infdis\/jiu828","article-title":"Challenges and opportunities in developing respiratory syncytial virus therapeutics","volume":"211","author":"Simoes","year":"2015","journal-title":"J Infect Dis"},{"key":"R33-20260226","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1093\/infdis\/jiy655","article-title":"Viral load dynamics and clinical disease severity in infants with respiratory syncytial virus infection","volume":"219","author":"Garcia-Maurino","year":"2019","journal-title":"J Infect Dis"},{"key":"R34-20260226","doi-asserted-by":"crossref","first-page":"4037","DOI":"10.1007\/s12325-022-02256-5","article-title":"Ribavirin for treatment of subjects with respiratory syncytial virus-related infection: a systematic review and meta-analysis","volume":"39","author":"Tejada","year":"2022","journal-title":"Adv Ther"},{"key":"R35-20260226","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1086\/314523","article-title":"Reduction of respiratory syncytial virus (RSV) in tracheal aspirates in intubated infants by use of humanized monoclonal antibody to RSV F protein","volume":"178","author":"Malley","year":"1998","journal-title":"J Infect Dis"},{"key":"R36-20260226","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1097\/INF.0000000000000240","article-title":"Motavizumab treatment of infants hospitalized with respiratory syncytial virus infection does not decrease viral load or severity of illness","volume":"33","author":"Ramilo","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"R37-20260226","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1097\/INF.0b013e3181343b7e","article-title":"Intravenous palivizumab and ribavirin combination for respiratory syncytial virus disease in high-risk pediatric patients","volume":"26","author":"Chavez-Bueno","year":"2007","journal-title":"Pediatr Infect Dis J"},{"key":"R38-20260226","first-page":"CD009417","article-title":"Immunoglobulin treatment for hospitalised infants and young children with respiratory syncytial virus infection","volume":"10","author":"Sanders","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"R39-20260226","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1093\/infdis\/jiy227","article-title":"Antiviral activity of oral JNJ-53718678 in healthy adult volunteers challenged with respiratory syncytial virus: a placebo-controlled study","volume":"218","author":"Stevens","year":"2018","journal-title":"J Infect Dis"},{"key":"R40-20260226","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.01884-19","article-title":"A randomized, placebo-controlled, respiratory syncytial virus human challenge study of the antiviral efficacy, safety, and pharmacokinetics of RV521, an inhibitor of the RSV-F protein","volume":"64","author":"DeVincenzo","year":"2020","journal-title":"Antimicrob Agents Chemother"},{"key":"R41-20260226","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1056\/NEJMoa2313551","article-title":"Ziresovir in hospitalized infants with respiratory syncytial virus infection","volume":"391","author":"Zhao","year":"2024","journal-title":"N Engl J Med"},{"key":"R42-20260226","doi-asserted-by":"crossref","first-page":"3346","DOI":"10.1128\/AAC.00211-07","article-title":"RSV604, a novel inhibitor of respiratory syncytial virus replication","volume":"51","author":"Chapman","year":"2007","journal-title":"Antimicrob Agents Chemother"},{"key":"R43-20260226","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.healun.2015.08.012","article-title":"ALN-RSV01 for prevention of bronchiolitis obliterans syndrome after respiratory syncytial virus infection in lung transplant recipients","volume":"35","author":"Gottlieb","year":"2016","journal-title":"J Heart Lung Transplant"},{"key":"R44-20260226","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1056\/NEJMoa2108903","article-title":"EDP-938, a respiratory syncytial virus inhibitor, in a human virus challenge","volume":"386","author":"Ahmad","year":"2022","journal-title":"N Engl J Med"}],"container-title":["Current Opinion in Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/QCO.0000000000001184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T22:00:20Z","timestamp":1772143220000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/QCO.0000000000001184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":44,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/qco.0000000000001184","relation":{},"ISSN":["0951-7375","1473-6527"],"issn-type":[{"value":"0951-7375","type":"print"},{"value":"1473-6527","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]}}}