ReportEMERGING INFECTIONS

Remdesivir (GS-5734) protects African green monkeys from Nipah virus challenge

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Science Translational Medicine  29 May 2019:
Vol. 11, Issue 494, eaau9242
DOI: 10.1126/scitranslmed.aau9242

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Nipping Nipah virus infections in the bud

Human infection with Nipah virus is often fatal, and there are no approved therapeutics. Lo et al. tested the nucleotide prodrug remdesivir (GS-5734), which has shown activity against other pathogens such as Ebola virus, in a nonhuman primate model. Animals were administered a lethal dose of Nipah virus, and half were treated daily with remdesivir starting 24 hours later. All control animals had to be euthanized, and although treated animals had some mild symptoms, all survived. These results indicate that efficacy of remdesivir should be tested in human Nipah virus infection.

Abstract

Nipah virus is an emerging pathogen in the Paramyxoviridae family. Upon transmission of Nipah virus from its natural reservoir, Pteropus spp. fruit bats, to humans, it causes respiratory and neurological disease with a case-fatality rate about 70%. Human-to-human transmission has been observed during Nipah virus outbreaks in Bangladesh and India. A therapeutic treatment for Nipah virus disease is urgently needed. Here, we tested the efficacy of remdesivir (GS-5734), a broad-acting antiviral nucleotide prodrug, against Nipah virus Bangladesh genotype in African green monkeys. Animals were inoculated with a lethal dose of Nipah virus, and a once-daily intravenous remdesivir treatment was initiated 24 hours later and continued for 12 days. Mild respiratory signs were observed in two of four treated animals, whereas all control animals developed severe respiratory disease signs. In contrast to control animals, which all succumbed to the infection, all remsdesivir-treated animals survived the lethal challenge, indicating that remdesivir represents a promising antiviral treatment for Nipah virus infection.

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