Reviews in Medical Virology最新文献

{"title":"Human Cytomegalovirus Genetic Diversity, Clinical Relevance, and Emerging Insights.","authors":"Hajar Y AlQahtani, Fadilah Sfouq Aleanizy, Fulwah Yahya Alqahtani","doi":"10.1002/rmv.70197","DOIUrl":"10.1002/rmv.70197","url":null,"abstract":"<p><p>Human cytomegalovirus (HCMV) is a globally prevalent virus that poses a significant public health concern, especially for newborns and immunocompromised patients, causing a wide range of infections. Clinical outcomes associated with HCMV infection include congenital disease, graft rejection in transplant recipients, and life-threatening systemic infections with significant morbidity and mortality. HCMV is a member of the Beta-herpesvirinae subfamily. Distinguishing characteristics of HCMV, in particular, and herpesviruses in general are their ubiquitous presence in nature and the initial infection that often results in lifelong latency. Over the past 40 years, the genetics of HCMV have been explored, leading to the isolation of various genotypes, including those of glycoprotein B, glycoprotein N, and UL144. Despite operational obstacles in isolating HCMV genotypes due to heterogeneity in the technologies used for genotyping the virus, studies have been able to describe their clinical implications across a variety of human hosts. This review summarises the genotypic variation of HCMV and discusses its clinical relevance and impact on antiviral resistance and vaccine development. Understanding the genetic diversity of HCMV genotypes is crucial for advancing drug development to combat resistant strains and for developing new vaccines and treatment modalities.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70197"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epitranscriptomic Regulation in Oncogenic Viruses: Emerging Roles of RNA Modifications in Viral Persistence and Tumourigenesis.","authors":"Zinan Yang, Yang Bai, Lihui Jia, Ying Zhang, Qiang Sun","doi":"10.1002/rmv.70204","DOIUrl":"https://doi.org/10.1002/rmv.70204","url":null,"abstract":"<p><p>Oncogenic viral pathogens, such as human papillomavirus (HPV), Epstein-Barr virus (EBV), hepatitis B and C viruses (HBV, HCV), and Kaposi's sarcoma-associated herpesvirus (KSHV), are involved in a significant proportion of human cancers worldwide. While genetic and epigenetic mechanisms underlying viral oncogenesis have been thoroughly investigated, emerging evidence underscores a critical role for epitranscriptomic regulation in virus-host interactions and their clinical consequences. RNA modifications such as N6-methyladenosine (m6A), 5-methylcytosine (m5C), and pseudouridine (Ψ) dynamically modulate RNA stability, translation, and immune recognition, thereby regulating viral replication and persistence. The present review describes current knowledge on the epitranscriptomic landscape of oncogenic viral pathogens and its functional implications. This review discusses how viral and host transcripts are selectively modified by cellular writers, erasers, and readers, shaping key stages of the viral life cycle, including replication, latency, and reactivation. Particular emphasis is placed on the role of RNA modifications in maintaining chronic infection and promoting tumourigenesis through the regulation of oncogenic pathways, cell proliferation, and apoptosis. Additionally, the present review examines how epitranscriptomic marks contribute to immune evasion by altering innate immune sensing and interferon responses. Finally, it explores the therapeutic potential of targeting epitranscriptomic machinery, highlighting recent advances in small-molecule inhibitors and the challenges associated with specificity and off-target effects. A deeper understanding of epitranscriptomic regulation in oncogenic viruses may reveal novel biomarkers and therapeutic strategies for virus-linked malignancies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70204"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Appraisal of the Potential Downstream Benefits of RSV Vaccination in Older Adults.","authors":"Piotr Rzymski","doi":"10.1002/rmv.70198","DOIUrl":"10.1002/rmv.70198","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) has long been underrecognized as a significant pathogen in older adults, despite accumulating evidence of its substantial morbidity and mortality burden in this population. While RSV vaccination is now well established as an effective intervention for preventing lower respiratory tract disease, this narrative review examines whether its public health value may extend beyond these primary clinical endpoints. A targeted search of Scopus and Web of Science from database inception to May 2026 was conducted to identify biological, epidemiological, observational, interventional, and modelling evidence relevant to potential downstream vaccine effects. The available evidence potentially supports hypotheses concerning possible reductions in cardiovascular complications and secondary bacterial infections, possible decreases in transmission to younger household contacts, and potential preservation of functional status and independence. However, the strength of evidence varies substantially across these outcomes. Cardiovascular protection has not been independently demonstrated in randomized trials, bacterial and antimicrobial-use outcomes have rarely been prespecified, real-world household transmission studies are unavailable, and functional trajectories may be strongly modified by baseline frailty and pre-existing disability. RSV vaccination in older adults therefore remains a well-validated strategy for preventing acute respiratory disease, whereas its proposed broader effects should be regarded as biologically plausible but incompletely demonstrated benefits. Future studies should incorporate prespecified cardiovascular, bacterial, transmission, geriatric, and functional outcomes, with particular attention to frailty, antimicrobial use, and longer-term follow-up.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70198"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13532495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut Microbiota Alterations in People Living With HIV: Dysbiosis, Immune Dysfunction and Therapeutic Perspectives.","authors":"Soukaina El Mheddeb, Assiya El Kettani, Ahmed Aziz Bousfiha, Sayeh Ezzikouri, Ahd Ouladlahsen","doi":"10.1002/rmv.70202","DOIUrl":"10.1002/rmv.70202","url":null,"abstract":"<p><p>The interaction between the human immunodeficiency virus (HIV) and the gut microbiota is attracting growing interest due to its potential role in the progression of infection and the development of comorbidities. This review provides a comprehensive and critically appraised synthesis of current evidence on the bidirectional relationship between HIV infection and gut microbiota disruption, structured around four central themes: the mechanistic basis of HIV-associated gut dysbiosis and mucosal immune dysfunction and its link to chronic inflammation; the effects of different antiretroviral therapy (ART) classes on the intestinal ecosystem; the emerging role of the microbiota-gut-brain axis in the pathogenesis of HIV-associated neurocognitive disorders (HAND); and the therapeutic potential of microbiota-targeted interventions, including probiotics, prebiotics, synbiotics, faecal microbiota transplantation (FMT), and dietary strategies in people living with HIV (PLWH). By synthesising the current mechanistic, clinical, and translational evidence, this review aims to delineate the critical knowledge gaps and define the research priorities that will drive the next generation of microbiota-informed strategies for improving long-term outcomes in PLWH. This summary highlights the importance of considering the gut microbiota as a key player in the overall management of HIV infection.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70202"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CRISPR-Engineered CAR-T Cell Therapy for Epstein-Barr Virus-Associated Nasopharyngeal Carcinoma: A Review of Emerging Therapeutic Prospects.","authors":"Noor Allehyani, Mohammed Alissa, Abdullah Alghamdi, Mohammed A Alshehri, Ghadah S Abusalim, Alaa S Alhegaili, Tawfiq N Juraybi, Meshari A Alsuwat","doi":"10.1002/rmv.70199","DOIUrl":"10.1002/rmv.70199","url":null,"abstract":"<p><p>Epstein-Barr virus (EBV)-associated nasopharyngeal carcinoma (NPC) remains a clinically challenging malignancy, particularly in recurrent or metastatic disease where durable responses to chemoradiotherapy and immune checkpoint blockade are limited. The viral aetiology of NPC provides a strong biological rationale for immune-based treatment; however, translation of chimaeric antigen receptor (CAR) T-cell therapy into this solid tumour setting is constrained by poor tumour trafficking, antigen heterogeneity, limited surface accessibility of EBV latent antigens, T-cell exhaustion, and an immunosuppressive tumour microenvironment. This review critically evaluates the emerging therapeutic prospects of CRISPR-engineered CAR-T cell therapy for EBV-associated NPC. It synthesises evidence on EBV latency biology, NPC immune evasion, solid-tumour CAR-T limitations, and genome-engineering strategies including conventional CRISPR-Cas9, base editing, prime editing, and double-strand-break-sparing targeted integration. Particular attention is given to genotoxicity, chromosomal rearrangements, chromosome loss, bystander and off-target editing, manufacturing heterogeneity, and the regulatory and biological barriers that currently separate technical feasibility from NPC-specific clinical implementation. Available clinical evidence from checkpoint blockade, EBV-specific adoptive T-cell therapy, base-edited CAR-T cells in haematologic malignancy, and early CRISPR-edited T-cell trials supports the feasibility of immune and genetic redirection but does not establish efficacy of a clinically validated CRISPR-engineered CAR-T platform for NPC. Future development should prioritise surface-accessible antigen validation, fit-for-purpose selection of editing technology, genomic safety, scalable manufacturing, and biomarker-driven early-phase trials.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70199"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Effectiveness of the Recombinant Zoster Vaccine Against Herpes Zoster, Herpes Zoster Ophthalmicus, Postherpetic Neuralgia and Dementia: A Systematic Review and Meta-Analysis.","authors":"E Heen, J Øverbø, I H Tveteraas, S L Solberg, H Nøkleby, J E Midtbø, F Di Rusco, F Kasteng, A Ersson, S Andersson, K Johansen, L K Juvet","doi":"10.1002/rmv.70203","DOIUrl":"10.1002/rmv.70203","url":null,"abstract":"<p><p>Herpes zoster (HZ, shingles) constitutes a significant public health concern, particularly in ageing populations, and there is growing global interest in the recombinant zoster vaccine (RZV) from a public health perspective. In this systematic review with meta-analysis, we assessed the efficacy and effectiveness of RZV against HZ and its complications, including a possible association with a reduced risk of dementia, among immunocompetent individuals aged 50 years and older. We synthesised the latest evidence on long-term effects, incorporating recent data from both trials and real-world effectiveness studies. A total of 27 publications based on 18 primary studies, 3 randomised controlled trials (RCTs) and 15 observational studies, were included. RZV provides very high protection against HZ in immunocompetent adults ≥ 50 years in RCTs, with approximately 95% efficacy and high certainty of evidence (CoE) according to GRADE. Observational studies also consistently indicate substantial protection, but effect estimates vary across settings (high CoE). Among vaccinated individuals who develop HZ, RZV is associated with reduced loss of quality of life and decreased analgesic use. The vaccine also substantially reduces the risk of herpes zoster ophthalmicus (HZO) (high CoE) and likely postherpetic neuralgia (PHN) (moderate CoE). Long-term follow-up suggests durable protection for at least 11 years (low CoE). RZV may be associated with a reduced risk of dementia (low CoE), due to uncertainty the true effect may be substantially different, and similar associations have been observed with other vaccines and may be confounded by healthy vaccinee bias.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70203"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco and Alcohol Exposure as Confounders in Assessing HPV-Related Cancer Trends After Male Vaccination.","authors":"Carlos Marin-Lopez, Amir Reza Akbari, Noor Farhoud, Carmen Cajina Aguirre, Benyamin Alam","doi":"10.1002/rmv.70192","DOIUrl":"10.1002/rmv.70192","url":null,"abstract":"","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70192"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiviral Resistance in the Genomic Era: Molecular Mechanisms, Clinical Challenges, and Pharmacogenetic Perspectives.","authors":"Laith Al-Eitan, Rania Al-Samama'h","doi":"10.1002/rmv.70205","DOIUrl":"https://doi.org/10.1002/rmv.70205","url":null,"abstract":"<p><p>Antiviral treatment (ART) resistance is an emerging global phenomenon that reduces the effectiveness of antiviral therapies and raises strong challenges for public health systems. This literature review focuses on the factors that contribute to developing antiviral drug resistance and the scope of pharmacogenetics. Studies have shown that inefficient use of antiviral therapies, genetic mutations in virus strains, and a limited healthcare framework are the main factors that increase resistance rates. Specifically, the poor adherence in HIV patients, combined with the virus high mutation, are the primary driver of drug-resistant strains development. The mutations in NS5A region reduce the efficacy of HCV direct-acting antivirals (DAAs). Where Influenza virus resistance to neuraminidase inhibitors (NAIs) like oseltamivir has been identified in seasonal strains, most notably the H275Y mutation in H1N1. Consequently, development of these resistant strains demands multidisciplinary strategies, global coordination, effective resistance monitoring systems, and public health initiatives to overcome this phenomenon. The paper aims to present a full picture of the antiviral drug resistance, which may provide better insights for clinicians and researchers.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 5","pages":"e70205"},"PeriodicalIF":5.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hantavirus: A Comprehensive Narrative Review of Virology, Epidemiology, Pathogenesis, Clinical Manifestations, Diagnostics, and Emerging Therapeutic Strategies.","authors":"Muhammad Kamran, Muhammad Bilal Habib, Adeel Shahid, Muhammad Ans Ahmar","doi":"10.1002/rmv.70190","DOIUrl":"10.1002/rmv.70190","url":null,"abstract":"<p><p>Hantaviruses are a genus of negative-sense, single-stranded, tri-segmented RNA viruses that are distributed worldwide. They cause two severe zoonotic diseases in humans: haemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS), also known as hantavirus cardiopulmonary syndrome (HCPS). Hantaviruses are primarily spread by inhaling aerosolised excreta from infected rodent reservoirs. Over 50 rodent species on six continents have been found to carry hantaviruses, with only one reported case of human-to-human transmission, involving the Andes virus (ANDV) in South America. HFRS is estimated to cause 100,000-150,000 cases worldwide annually, mainly in Asia and Europe. HPS/HCPS is far less common, with case fatality rates of 25%-40%, predominantly in the Americas. The pathogenesis of hantaviral disease is characterised by viral infection of endothelial cells, dysregulation of vascular permeability, and dysregulated innate and adaptive immune responses, leading to cytokine storm physiology. Diagnosis relies on enzyme-linked immunosorbent assay (ELISA)-based serology and reverse transcription polymerase chain reaction (RT-PCR). Strain characterisation and outbreak investigations are increasingly being performed using next-generation sequencing. No hantavirus species has a licenced vaccine outside of HTNV and SEOV, for which inactivated rodent-brain-derived vaccines remain in limited regional use in Korea and China. Regulatory-agency-approved antiviral therapy is similarly lacking worldwide, and management remains largely supportive. Ribavirin has shown benefit in reducing mortality and renal morbidity in HFRS when initiated early, but has not demonstrated efficacy in HPS/HCPS in controlled trials. Recent advancements include the development of monoclonal antibodies, candidate mRNA and subunit vaccines, and an improved understanding of the mechanisms of immune evasion. This review synthesises the latest information on hantavirus biology, clinical medicine and public health. This highlights the critical gaps that must be addressed to counter the growing threat posed by this pathogen in an era of climate change and global ecological transformation.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 4","pages":"e70190"},"PeriodicalIF":5.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncogenic Viruses and Inhaled Microplastics: A Double Hit Hypothesis for Asthma Progression and Lung Cancer Development.","authors":"Jiacheng Yin, Muzhe Su, Minhao Xu, Ruiyan Hua, Qian Fu, Wenhui Xu, Sumin Hu, An Wang","doi":"10.1002/rmv.70181","DOIUrl":"10.1002/rmv.70181","url":null,"abstract":"<p><p>Oncogenic viruses have emerged as potential contributors to chronic airway disease and lung carcinogenesis through mechanisms involving viral persistence, immune evasion, genomic instability, and sustained inflammation. Increasing evidence suggests that environmental factors may critically influence these virus-host interactions. Among such factors, airborne microplastics (MPs) have gained attention because of their ability to accumulate within the respiratory tract, disrupt epithelial barrier integrity, impair antiviral immune responses, and induce chronic oxidative and inflammatory stress. This review suggests a 'double-hit' hypothesis in which inhaled MPs act as environmental cofactors that enhance susceptibility to oncogenic viruses and facilitate virus-associated pulmonary pathology. MPs may affect viral adsorption, airway deposition, epithelial infectivity, and long-term persistence while simultaneously weakening mucosal immune surveillance and interferon-mediated antiviral defenses. These effects may create a permissive pulmonary microenvironment that supports persistent infection by candidate oncogenic viruses, including human papillomavirus (HPV), Epstein-Barr virus (EBV), Merkel cell polyomavirus (MCPyV), and other potentially tumour-promoting viruses. Convergent activation of pathways related to oxidative stress, NF-κB signalling, inflammasome activation, epithelial-mesenchymal transition, and defective tissue repair may amplify chronic airway inflammation, accelerate asthma progression, and promote malignant transformation. Although direct clinical evidence remains limited, accumulating mechanistic and experimental findings support a biologically plausible interaction between airborne microplastics and oncogenic viruses. We highlight key knowledge gaps regarding viral persistence, MP-mediated modulation of antiviral immunity, virus-particle interactions, and biomarkers of environmentally driven viral carcinogenesis. Improved understanding of these interactions may provide new insights into the virological basis of chronic airway disease and lung cancer development.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 4","pages":"e70181"},"PeriodicalIF":5.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}