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The use of antiviral drugs in children

Marco Antonio Motisi1, Agnese Tamborino1, Sara Parigi1

  • 1Department of Health Sciences, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy.

Journal of Chemotherapy (Florence, Italy)
|October 11, 2021
PubMed

Insights

Antiviral drugs treat various childhood viral infections, from mild to severe. While many options exist, pediatric approvals for some antivirals, like antiretrovirals, remain limited, impacting treatment accessibility.

Area of Science:

  • Pediatric infectious diseases
  • Antiviral pharmacology
  • Public health

Background:

  • Viral infections are common in children, ranging from mild to severe, potentially causing permanent disabilities.
  • Specific antiviral medications are available for certain viral infections, including herpes simplex virus, influenza, and congenital cytomegalovirus.
  • Antiretroviral therapy and prophylaxis are crucial for newborns exposed to HIV-1, with regimens adapted to risk categories.

Purpose of the Study:

  • To review the current landscape of antiviral drug treatments for various viral infections in pediatric populations.
  • To highlight the availability and limitations of approved antiviral therapies for children, including antiretrovirals and direct-acting antivirals for Hepatitis C.
  • To discuss emerging treatments like remdesivir for SARS-CoV-2 in the context of pediatric use.

Main Methods:

  • Review of existing literature and guidelines on antiviral drug use in children for various viral infections.
  • Analysis of drug approval status for pediatric populations, comparing adult and child indications.
  • Examination of specific treatment regimens for congenital infections, influenza, HIV-1, Hepatitis C, and SARS-CoV-2.

Main Results:

  • Established antiviral treatments exist for specific pediatric viral infections, with varying recommendations based on epidemiology (e.g., influenza).
  • Significant disparities exist in the approval of antiretroviral drugs for children compared to adults; only 38% of adult-approved drugs are available for those under two.
  • Direct-acting antivirals for Hepatitis C are approved for children over three, with genotype-specific regimens. Remdesivir shows potential for SARS-CoV-2 but has limited pediatric data.

Conclusions:

  • While several antiviral drugs are effective for pediatric viral infections, limited regulatory approval for children, particularly for antiretrovirals, poses a challenge.
  • Continued research and streamlined approval processes are necessary to expand treatment options for viral diseases in pediatric populations.
  • Personalized treatment strategies, considering viral genotype and individual risk, are essential for optimizing outcomes in children receiving antiviral therapy.

Keywords:
Antiviral drugsHIVSARS-CoV-2congenital cytomegalovirusfluherpes simplex virus

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