In vitro comparison of currently available and investigational antiviral agents against pathogenic human double-stranded DNA viruses: A systematic literature review

• Published in: Antiviral research Vol. 163; pp. 50 - 58
• Main Authors: Chemaly, Roy F., Hill, Joshua A., Voigt, Sebastian, Peggs, Karl S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2019
• Subjects: Antiviral; Antiviral Agents - pharmacology; DNA Viruses - drug effects; DNA Viruses - pathogenicity; DNA, Viral; Drug Resistance, Viral; Drugs, Investigational - pharmacology; dsDNA virus; EC50; Humans; In vitro; dsDNA virus; Antiviral; EC50; In vitro; EC
• ISSN: 0166-3542; 1872-9096
• DOI: 10.1016/j.antiviral.2019.01.008

Double-stranded (ds) DNA virus infections often occur concomitantly in immunocompromised patients. We performed a systematic search of published in vitro activity for nine approved and investigational antivirals to understand the spectrum of in vitro activity against dsDNA viruses. A literature search was performed (PubMed and the WoS Core Collection) using keywords related to: 1) targeted approved/developmental antivirals (acyclovir, artesunate, brincidofovir, cidofovir, cyclopropavir (filociclovir), foscarnet, ganciclovir, letermovir, and maribavir); 2) pathogenic dsDNA viruses; 3) in vitro activity. We summarized data from 210 publications. Activity against ≤3 viruses was documented for maribavir (cytomegalovirus, Epstein-Barr virus), and letermovir, while activity against > 3 viruses was shown for ganciclovir, cidofovir, acyclovir, foscarnet, cyclopropavir, artesunate, and brincidofovir. The EC50 values of brincidofovir were the lowest, ranging from 0.001 to 0.27 μM, for all viruses except papillomaviruses. The next most potent agents included cidofovir, ganciclovir, foscarnet, and acyclovir with EC50 values between 0.1 μM and >10 μM for cytomegalovirus, herpes simplex virus, and adenovirus. Most of the identified antivirals had in vitro activity against more than one dsDNA virus. Brincidofovir and cidofovir have broad-spectrum activity, and brincidofovir has the lowest EC50 values. These findings could assist clinical practice and developmental research. •This is the first full summary of in vitro antiviral activity for 9 antivirals against human pathogenic dsDNA viruses.•Published in vitro activity often extended beyond the virus(es) covered by the labelled indication.•Most agents have good in vitro activity against individual or small subsets of dsDNA viruses that infect humans.•Based on an EC50 cut off of 10 μM, the spectrum of antiviral activity ranged from broadest to narrowest as follows:obrincidofovir > cidofovir > ganciclovir > artesunate > acyclovir > cyclopropavir (filociclovir) > maribavir > letermovir > foscarnet.