Reviews in Medical Virology最新文献

{"title":"Comparative Effectiveness of High-Dose and Standard-Dose Influenza Vaccines for Hospitalisation and Mortality in Adults Aged 65 and Older: An Updated Systematic Review and Meta-Analysis.","authors":"Bilal Wazir Khan, Muhammad Huzaifa Khattak, Muhammad Maaz Amjad, Shahreena Athar Siddiqui, Tayyaba Ikram Qazi, Hamdullah Rehmat, Muhammad Faaz Khan, Haris Wazir Khan, Affan Masaud Mian, Mohsin Ullah, Umer Zaryab Khan, Muhammad Abdur Rafay, Sajjad Ghanim Al-Badri, Zaryab Bacha","doi":"10.1002/rmv.70158","DOIUrl":"https://doi.org/10.1002/rmv.70158","url":null,"abstract":"<p><p>This updated systematic review and meta-analysis evaluated the relative vaccine effectiveness (rVE) of high-dose inactivated influenza vaccine (HD-IV) versus standard-dose (SD-IV) in adults ≥ 65 years for key clinical outcomes, including hospitalisations and mortality. Conducted in accordance with PRISMA guidelines, PubMed, Embase, and the Cochrane Library were searched for randomised controlled trials. Primary outcomes were pneumonia and influenza (P&I) hospitalisation, all-cause hospitalisation, and all-cause mortality, while secondary outcomes included hospitalisation for cardiorespiratory disease, influenza-related hospitalisation, laboratory-confirmed influenza hospitalisation, and serious adverse events (SAEs). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using fixed-effect models. Across 586,188 participants, HD-IV reduced P&I hospitalisation (rVE 12.0%), increasing to 22.0% in sensitivity analysis. For all-cause hospitalisation (∼600,000 participants), rVE was 4.0%, while no significant reduction was observed for all-cause mortality (rVE = 2.0%). Subgroup analyses suggested greater benefits in individuals without cardiovascular disease and those aged 65-79 years. HD-IV also showed strong protection against influenza-specific outcomes (rVE 39% for influenza hospitalisation; 32% for laboratory-confirmed influenza hospitalisation), with no significant difference in SAEs between groups. Overall, HD-IV provides superior protection compared with SD-IV against P&I and all-cause hospitalisation in older adults, with the greatest benefits among younger seniors and those without cardiovascular disease. These findings support prioritising HD-IV to reduce influenza burden in the elderly, although benefits appear limited in adults aged > 80 years.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70158"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779754","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":"Human Cytomegalovirus Infection in Haematopoietic Stem Cell Transplant Recipients and CAR-T Cell Recipients-PART 2: Antiviral Therapy and Virus-Specific T Cell Therapy for HCMV in Allo-HSCT.","authors":"Gaurav Sutrave, Michelle K Yong, Danya Kaplan, David J Gottlieb, Allison Abendroth, Barry Slobedman, Emily Blyth, Lauren Stern","doi":"10.1002/rmv.70135","DOIUrl":"10.1002/rmv.70135","url":null,"abstract":"<p><p>Human cytomegalovirus (HCMV) reactivation is a common and significant complication after allogeneic haematopoietic stem cell transplantation (allo-HSCT), causing potentially life-threatening disease. Antiviral therapy approaches for HCMV are often limited by toxicities and the risk of developing antiviral drug resistance. This review article (Part 2) provides an overview of current antiviral pharmacotherapies for HCMV and the application of virus-specific adoptive T cell therapies for the prevention or treatment of HCMV reactivation in allo-HSCT recipients. The number of available antiviral drugs for HCMV is expanding, and letermovir primary prophylaxis is increasingly being adopted due to its favourable safety profile. Treatment resistant/refractory infections, end-organ disease, and late HCMV reactivations after antiviral therapy withdrawal continue to pose challenges. Adoptive HCMV-specific T cell therapies are a promising strategy for promoting immune-mediated control of HCMV reactivation in allo-HSCT recipients. The administration of HCMV-specific T cell products, generated through ex vivo expansion of donor-derived or partially HLA matched, third party HCMV-specific T cells, have demonstrated efficacy in combatting clinically significant HCMV infection in clinical trials. Adoptive HCMV-specific T cell therapies represent a powerful alternative approach for managing drug resistant HCMV infections in allo-HSCT recipients and reducing the reliance on antiviral pharmacotherapies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 3","pages":"e70135"},"PeriodicalIF":6.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13036708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582401","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":"Comparison of Azvudine and Nirmatrelvir-Ritonavir in Hospitalised Patients With COVID-19: A Systematic Review and Meta-Analysis.","authors":"Tahoora Mousavi, Mahmood Moosazadeh, Hossein Jalali","doi":"10.1002/rmv.70114","DOIUrl":"10.1002/rmv.70114","url":null,"abstract":"<p><p>Azvudine is a nucleoside reverse transcriptase inhibitor (NRTI) and belongs to the family of 2', 3'-dideoxynucleoside (ddNs) that can mimic natural nucleosides and block viral DNA or RNA chain synthesis and prevent viral replication. Since the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, Azvudine has been used to treat patients with COVID-19. Therefore, the objective of this meta-analysis study was to compare Azvudine and Nirmatrelvir-Ritonavir in hospitalised patients. The global online databases were used to identify relevant studies published between January 2019 and October 2024. The quality of all articles was determined using the Newcastle-Ottawa Scale (NOS) checklist. In this study, heterogeneity assay was assessed using the Cochran's Q-test and the I2 index, and STATA software version.14 (StataCorp) was used for statistical analysis. Egger's test, Begg's test, and funnel plot were performed to estimate of the publication bias, and the impact of each study on the overall estimate was assessed using sensitivity analysis. In this study, 19 studies were included in this meta-analysis. The results of the meta-analysis showed that the relative risk of death in the Azvudine treatment group compared with the Nirmatrelvir-Ritonavir treatment group was 0.64 (95% CI: 0. 44, 0. 93). These results suggest that treatment with Azvudine may provide significant clinical benefit in patients hospitalised with COVID-19.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70114"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776627","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":"Chandipura Virus: A Neglected Sandfly-Borne Neurotropic Virus in Children - Insights From Seven Decades of Evidence.","authors":"Ravi Rai Dangi, Vipin Vageriya, Anil Sharma, Pragna Dabhi","doi":"10.1002/rmv.70119","DOIUrl":"10.1002/rmv.70119","url":null,"abstract":"<p><p>Chandipura virus, a neurotropic RNA virus transmitted by Phlebotomus sandflies, remains an under-recognised cause of acute paediatric encephalitis in India. The 2024 outbreak, with 245 confirmed cases and 82 deaths, underscores its ongoing public health relevance. This review provides an integrated analysis of CHPV, encompassing its epidemiological distribution in India, host-agent-environment transmission dynamics, molecular and cellular pathogenesis, clinical presentation, diagnostic modalities, therapeutic options, and vaccine research. Evidence from 1950 to 2025, drawn from peer-reviewed studies, outbreak reports, and national surveillance databases, shows that CHPV primarily affects children younger than 15 years and causes abrupt fever, seizures, and coma within 24-48 h. The virus breaches the blood-brain barrier through cytokine-mediated permeability and induces neuronal apoptosis via Fas- and NF-κB-linked pathways, while genomic studies demonstrate overall stability across outbreaks. Diagnosis depends on RT-PCR and IgM ELISA, available only in reference laboratories. Experimental antivirals such as favipiravir and recombinant glycoprotein vaccines show promise in animal models but remain untested in humans. Strengthening molecular surveillance, integrating CHPV detection into India's Integrated Disease Surveillance Programme, and investing in antiviral and vaccine development are crucial to reducing the recurring burden of this neglected childhood neurotropic arbovirus.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70119"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326883","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":"The Impact of Study Size on COVID-19 Treatment Outcomes: A Meta-Epidemiological Study Comparing Large and Small Randomized Controlled Trials: A Systematic Review and Meta-Analyses.","authors":"Dong Hyun Kim, Soojin Lim, Michael Eisenhut, Andreas Kronbichler, Eunyoung Kim, Min Seo Kim, Stefania I Papatheodorou, Justin Stebbing, Yonghong Peng, Sarah Soyeon Oh, Jae Il Shin, Lee Smith","doi":"10.1002/rmv.70125","DOIUrl":"10.1002/rmv.70125","url":null,"abstract":"<p><p>Small randomized controlled trials (RCTs) in COVID-19 meta-analyses have been associated with more favourable treatment effects and reduced result stability. This study assessed how trial size impacts effect estimates, statistical stability, and risk of bias. Following PRISMA guidelines, we identified meta-analyses of COVID-19 treatments included in WHO, NIH, and the LIVING Project. Trials were classified by log-scale sample size, and separate pooled meta-analyses were conducted for large-only, small-only, and combined trials. Comparative metrics included the Ratio of Odds Ratios (ROR), Kappa statistics, Fragility Index (FI), Reverse Fragility Index (RFI), and Cochrane Risk of Bias assessments. Sensitivity analyses applied alternative size thresholds (≥ 1000 participants and median-based cutoffs) and stratified results by treatment and outcome type. Across 25 meta-analyses including 221 RCTs (46 large, 175 small), small trials produced more extreme estimates in 19 analyses and wider confidence intervals in 23. The pooled ROR was 0.85 (95% CI: 0.76-0.95; P = 0.004), decreasing to 0.81 (95% CI: 0.68-0.95; P = 0.011) when limited to small trials published before the first large trial. RORs remained below 1 across treatment and outcome types. Agreement between small and large trials was minimal, while large trials showed substantial agreement with overall estimates. Stability and bias profiles favoured large trials (FI: 14.0 vs. 4.0; RFI: 10.0 vs. 5.0). In conclusion, small RCTs tend to overestimate treatment effects and yield less precise, less stable results. Meta-analyses should prioritise large, high-quality trials and interpret small-study findings with caution, particularly in rapidly evolving research contexts.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70125"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370109","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":"An Update on Mpox: Focussing on Current and Emerging Antiviral Strategies.","authors":"Yizhuo Hou, Yu Su, Jixi Li, Jin Ding","doi":"10.1002/rmv.70116","DOIUrl":"10.1002/rmv.70116","url":null,"abstract":"<p><p>The 2022 global mpox outbreak and subsequent viral evolution have exposed critical limitations in current therapeutic strategies, which predominantly rely on repurposed smallpox drugs targeting a narrow range of viral proteins. This review provides a timely and comprehensive evaluation of the mpox antiviral landscape, spanning from established clinical agents to cutting-edge preclinical candidates. We critically analyse the 'clinical translation gap' observed in recent clinical trials (e.g., STOMP and PALM007), attributing the limited efficacy in mild cases to host immunopathological responses versus primary viral replication. Highlighting a strategic paradigm shift, we also discuss the 2025 breakthrough in covalent inhibitors targeting the conserved CorePro. Furthermore, we explore the integration of AI-assisted drug design and host-targeted therapies (HTTs) to elevate resistance barriers. By synthesising these emerging targets and multidimensional strategies, this review serves as a strategic roadmap for developing next-generation anti-mpox therapeutics with optimised efficacy and broader resistance profiles.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70116"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207581","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":"Advances in Rapid Nucleic Acid Diagnostics for Hepatitis B and C Viruses: A Comprehensive Review.","authors":"Hsin-Ying Ho, Chia-Yen Dai, I-Jung Feng, Yen-Hsu Chen, Ming-Lung Yu, Che-Hsin Lin, Ling-Shan Yu","doi":"10.1002/rmv.70110","DOIUrl":"10.1002/rmv.70110","url":null,"abstract":"<p><p>Chronic viral hepatitis, predominantly caused by HBV and HCV infections, remains a major global health burden and a leading cause of cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality. Achieving the World Health Organisation (WHO) target of diagnosing 90% of HBV and HCV infections by 2030 necessitates a fundamental transition from centralised laboratory-based testing towards rapid, accessible, and decentralised diagnostic solutions. This review provides a comprehensive and critical assessment of the current diagnostic landscape for viral hepatitis, spanning established commercial assays and emerging nucleic acid testing (NAT) technologies. We systematically examine recent advances in biosensor-enabled diagnostics, with particular emphasis on the integration of isothermal amplification and CRISPR-based molecular recognition into electrochemical and field-effect transistor (FET) platforms. These electronic sensing technologies enable label-free signal transduction, scalable miniaturisation, and seamless integration with point-of-care (POC) workflows, thereby addressing key limitations of conventional diagnostic pipelines. In addition, we discuss persistent challenges in sample preparation, signal amplification, and system integration, and highlight strategies that couple biochemical amplification with solid-state electronics to streamline diagnostic workflows. By synthesising the state of the art and identifying critical technological bottlenecks, this review describes the technological progression of next-generation diagnostic platforms required to accelerate the global elimination of viral hepatitis and to improve patient outcomes through earlier and more equitable access to diagnosis.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70110"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143465","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":"A Deep Dive Into Oncogenic Viruses Understanding Their Role in Cancer and Approaches for Prevention.","authors":"Neetesh Jindal, Bipin Bihari Mishra, Ashish Kumar, Sindhuprava Rana, Krishna Pandey, Ganesh Chandra Sahoo","doi":"10.1002/rmv.70121","DOIUrl":"10.1002/rmv.70121","url":null,"abstract":"<p><p>Oncogenic viruses, including Epstein-Barr virus (EBV), Human Papillomavirus (HPV), Kaposi's Sarcoma-Associated Herpesvirus (KSHV), Hepatitis B Virus (HBV), Merkel Cell Polyomavirus (MCPyV), Human T-cell Lymphotropic Virus (HTLV-1), and Hepatitis C Virus (HCV), are significant contributors to cancer development, each through distinct mechanisms. EBV is recognised for its association with cancers such as Burkitt lymphoma and nasopharyngeal carcinoma. High-risk types of HPV are primarily connected to cervical cancer. KSHV plays a crucial role in the development of Kaposi's sarcoma, especially among individuals with compromised immune systems. Both HBV and HCV are implicated in liver cancer due to chronic infections and resultant inflammation. MCPyV is linked to aggressive skin cancers, while HTLV-1 can lead to leukemia and various neurological complications. Collectively, these viruses account for approximately 20% of all cancers globally, providing valuable insights into cancer pathogenesis and potential treatment avenues. Effective management of these viruses includes the use of vaccines such as Gardasil for HPV and antiviral medications for HBV and HCV. Treatment options for cancers associated with EBV, KSHV, and MCPyV encompass targeted therapies and surgical interventions. Preventive measures emphasise vaccination, safe practices to curb virus transmission, routine screenings, and maintaining a healthy lifestyle. Ongoing research and public health initiatives are vital for enhancing prevention and treatment strategies, particularly in high-risk and resource-limited settings. By deepening our understanding of these viruses, we can improve the development of targeted therapies and strive to reduce the global burden of cancer.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70121"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276962","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":"Disruption of Signalling Pathways Induced by HBV HBx, HCV Core, and EBV LMP1 in Gastric Cancer.","authors":"Mengli Gao, Yanmin Wu, Yan Chen, Tongying Hao, Xiaojing Sun, Jing Ji","doi":"10.1002/rmv.70090","DOIUrl":"10.1002/rmv.70090","url":null,"abstract":"<p><p>Oncoviruses are a significant etiological factor in a substantial proportion of human cancers, with a particular impact on cancers of the digestive system. This review provides a comprehensive analysis of the complex molecular mechanisms through which viral oncoproteins, focusing on Hepatitis B Virus (HBV) HBx, Hepatitis C Virus (HCV) core protein, and Epstein-Barr Virus (EBV) latent membrane protein 1 (LMP1), hijack and disrupt host cell signalling networks to induce carcinogenesis. These disruptions include the inactivation of critical tumour suppressor proteins, such as p53 and the retinoblastoma protein (Rb), the constitutive activation of pro-proliferative and pro-survival pathways, including NF-κB and Akt, and the induction of chronic inflammation and metabolic dysregulation. A deeper understanding of these precise molecular interactions is essential to advancing precision oncology, enabling the development of next-generation targeted therapies and immunotherapies that can address the unique vulnerabilities of virus-associated cancers.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70090"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284841","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":"Insights Into Highly Associated Co-Factors on HPV-Related Cervical Cancer.","authors":"Liyuan Zheng, Guangwei Zhao, Lili Zheng, Yujie Zou, Shengshuo Zhang, Jinhua Dong","doi":"10.1002/rmv.70131","DOIUrl":"10.1002/rmv.70131","url":null,"abstract":"<p><p>Cervical cancer ranks among the most prevalent malignancies, representing a substantial threat to women's health. The incidence of cervical cancer is strongly correlated with persistent infections by high-risk human papillomavirus (HPV) types. Overall, the prevalence of HPV infection is high, with most cases being classified as recessive, latent, and subclinical. The predominant HPV types and overall infection rates exhibit variability across different tissue types, individuals, and regions. Numerous co-factors contribute to the processes underlying persistent HPV infection and carcinogenesis, including the microbiome, individual immune characteristics, and geographical population differences. Moreover, these factors affect the efficacy of chemotherapy and immunotherapy in cancer treatment. This review aims to summarise several key factors associated with HPV-related cervical cancer and discuss their mechanisms in promoting carcinogenesis in HPV-related malignancies. The insights gained may inform the development of more effective preventive and therapeutic strategies.</p>","PeriodicalId":21180,"journal":{"name":"Reviews in Medical Virology","volume":"36 2","pages":"e70131"},"PeriodicalIF":6.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370098","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}