Abstract
Alphaviruses are members of the Togaviridae family that are mainly transmitted by arthropods such as mosquitoes. In the last decades, several alphaviruses have re-emerged, causing outbreaks worldwide. One example is the re-emergence of chikungunya virus (CHIKV) in 2004, which caused massive epidemics in the Indian Ocean region after which the virus dramatically spread to the Americas in late 2013. Besides CHIKV, other alphaviruses, such as the Ross River virus (RRV), Mayaro virus (MAYV), and Venezuelan equine encephalitis virus (VEEV), have emerged and have become a serious public health concern in recent years. Infections with the Old World alphaviruses (e.g., CHIKV, RRV) are primarily associated with polyarthritis and myalgia that can persist for months to years. On the other hand, New World alphaviruses such as VEEV cause mainly neurological disease. Despite the worldwide (re-)emergence of these viruses, there are no antivirals or vaccines available for the treatment or prevention of infections with alphaviruses. It is therefore of utmost importance to develop antiviral strategies against these viruses. We here provided an overview of the reported antiviral strategies against arthritogenic alphaviruses. In addition, we highlighted the future perspectives for the development and the proper use of such antivirals.
Highlights
Alphaviruses are a group of human and animal viruses that belong to the family Togaviridae
Alphaviruses are divided into the New World and Old World alphaviruses based on their historical geographical abundance
Acute infections by arthritogenic alphaviruses are self-limiting, several patients suffer from a chronic polyarthritis that can severely incapacitate the patient for weeks and even up to several years after the acute stage [3]
Summary
Alphaviruses are a group of human and animal viruses that belong to the family Togaviridae. New World alphaviruses cause encephalitic diseases and include the Venezuelan and Western equine encephalitis viruses (VEEV and WEEV) [2]. Infections with Old World alphaviruses, such as the chikungunya virus (CHIKV) and Ross River virus (RRV), mainly result in rheumatic disease that causes debilitating pain in the joints [2]. The symptoms of acute disease caused by these viruses include fever, bilateral symmetrical arthritis, and sometimes skin rash. Acute infections by arthritogenic alphaviruses are self-limiting, several patients suffer from a chronic polyarthritis that can severely incapacitate the patient for weeks and even up to several years after the acute stage [3]. Recent outbreaks of arthritogenic alphaviruses such as CHIKV have been associated with neurological manifestations, e.g., myelopathy, Guillain-Barré syndrome, and meningoencephalitis, especially in elderly patients with comorbidities and neonates [4]. The current treatment depends on symptomatic relief using analgesics, antipyretics, nonsteroidal anti-inflammatory drugs, and, in severe cases, methotrexate [2]
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