Vaccines
Various vaccines are in development, including purified inactivated viral particles, purified virus-like particles and viral subunit proteins, live-attenuated vaccines, chimeric vaccines, and viral and nonviral vectors encoding Zika virus structural proteins.[199]Poland GA, Kennedy RB, Ovsyannikova IG, et al. Development of vaccines against Zika virus. Lancet Infect Dis. 2018 Jul;18(7):e211-9.
https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(18)30063-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29396004?tool=bestpractice.com
[200]Barzon L, Palù G. Current views on Zika virus vaccine development. Expert Opin Biol Ther. 2017 Oct;17(10):1185-92.
https://www.tandfonline.com/doi/full/10.1080/14712598.2017.1346081
http://www.ncbi.nlm.nih.gov/pubmed/28644745?tool=bestpractice.com
[201]Marques ETA, Burke DS. Tradition and innovation in development of a Zika vaccine. Lancet. 2018 Feb 10;391(10120):516-7.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33107-0/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/29217377?tool=bestpractice.com
Zika purified inactivated virus (ZPIV) vaccine, an investigational vaccine, was found to be well tolerated in one phase I trial.[202]Modjarrad K, Lin L, George SL, et al. Preliminary aggregate safety and immunogenicity results from three trials of a purified inactivated Zika virus vaccine candidate: phase 1, randomised, double-blind, placebo-controlled clinical trials. Lancet. 2018 Feb 10;391(10120):563-71.
https://www.doi.org/10.1016/S0140-6736(17)33106-9
http://www.ncbi.nlm.nih.gov/pubmed/29217375?tool=bestpractice.com
A synthetic DNA vaccine (GLS-500) has shown promise in a phase I trial.[203]Tebas P, Roberts CC, Muthumani K, et al. Safety and immunogenicity of an anti-Zika virus DNA vaccine - preliminary report. N Engl J Med. 2021 Sep 16;385:e35.
http://www.nejm.org/doi/full/10.1056/NEJMoa1708120
http://www.ncbi.nlm.nih.gov/pubmed/28976850?tool=bestpractice.com
A live-attenuated vaccine has also shown promise in animal studies.[204]Shan C, Muruato AE, Nunes BTD, et al. A live-attenuated Zika virus vaccine candidate induces sterilizing immunity in mouse models. Nat Med. Nat Med. 2017 Jun;23(6):763-7.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276361
http://www.ncbi.nlm.nih.gov/pubmed/28394328?tool=bestpractice.com
Other vaccine candidates also show promise and are currently in clinical trials.[205]Pattnaik A, Sahoo BR, Pattnaik AK. Current status of Zika virus vaccines: successes and challenges. Vaccines (Basel). 2020 May 31;8(2):266.
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349928
http://www.ncbi.nlm.nih.gov/pubmed/32486368?tool=bestpractice.com
WHO: progress toward discovery of Zika virus vaccines and therapeutics
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Antiviral agents
While there are currently no specific antiviral treatments available for Zika virus infection, various candidates are being trialed in early-stage trials.[206]Eyer L, Nencka R, Huvarová I, et al. Nucleoside inhibitors of Zika virus. J Infect Dis. 2016 Sep 1;214(5):707-11.
http://jid.oxfordjournals.org/content/early/2016/05/26/infdis.jiw226.long
http://www.ncbi.nlm.nih.gov/pubmed/27234417?tool=bestpractice.com
[207]Julander JG, Siddharthan V, Evans J, et al. Efficacy of the broad-spectrum antiviral compound BCX4430 against Zika virus in cell culture and in a mouse model. Antiviral Res. 2017 Jan;137:14-22.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215849
http://www.ncbi.nlm.nih.gov/pubmed/27838352?tool=bestpractice.com
Antiviral agents effective against the hepatitis C virus are being tested and have shown activity against Zika virus polymerase.[208]Elfiky AA. Zika viral polymerase inhibition using anti-HCV drugs both in market and under clinical trials. J Med Virol. 2016 Dec;88(12):2044-51.
https://onlinelibrary.wiley.com/doi/10.1002/jmv.24678
http://www.ncbi.nlm.nih.gov/pubmed/27604059?tool=bestpractice.com
Selected antimalarial drugs have shown activity against Zika virus.[209]Balasubramanian A, Teramoto T, Kulkarni AA, et al. Antiviral activities of selected antimalarials against dengue virus type 2 and Zika virus. Antiviral Res. 2017 Jan;137:141-50.
http://www.ncbi.nlm.nih.gov/pubmed/27889529?tool=bestpractice.com
A new mouse model may help in exploring the potential activity of Zika virus vaccines and therapeutics.[210]Manangeeswaran M, Ireland DD, Verthelyi D. Zika (PRVABC59) infection is associated with T cell infiltration and neurodegeneration in CNS of immunocompetent neonatal C57Bl/6 mice. PLoS Pathog. 2016 Nov 17;12(11):e1006004.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113993
http://www.ncbi.nlm.nih.gov/pubmed/27855206?tool=bestpractice.com