Research Progress on Antiviral Drugs for Severe Fever with Thrombocytopenia Syndrome

doi:10.19803/j.1672-8629.20250663

Abstract

Abstract: Objective To review the research progress in drugs for Bandavirus dabieense (DBV) in recent years in order to provide a reference for related pharmaceutical research and clinical applications. Methods Based on the epidemiology of Severe Fever with Thrombocytopenia Syndrome (SFTS), studies on antiviral agents were summarized in terms of pharmacological mechanisms, in vitro experiments, animal experiments, and clinical studies. Results SFTS had been spreading from the initially reported five provinces to twenty-seven provinces in China, with an exponential increase in the number of cases. Experiments and clinical studies proved that favipiravir, ribavirin, and calcium channel blockers possessed antiviral activities against DBV. In addition, several potential anti-DBV compounds were identified via laboratory screening. Conclusion The incidence of SFTS has trended up year on year. Despite the lack of specific antiviral treatments, substantial progress has been made in recent years in the exploration and evaluation of anti-DBV agents, which can contribute to the development of effective therapies against SFTS.

Key words: Severe Fever with Thrombocytopenia Syndrome, Bandavirus Dabieense, Tick-Borne Infectious Disease, Antiviral Drugs, Treatment, Progress

CLC Number:

R978
R994.11

PENG Wan, JIANG Zhouling, CHEN Zhihai. Research Progress on Antiviral Drugs for Severe Fever with Thrombocytopenia Syndrome[J]. Chinese Journal of Pharmacovigilance, 2026, 23(1): 109-114.

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https://zgywjj.magtechjournal.com/EN/Y2026/V23/I1/109

References

[1] YU XJ, LIANG MF, ZHANG SY, et al.Fever with Thrombocytopenia Associated with a Novel Bunya Virus in China[J]. N Engl J Med, 2011, 364: 1523-1532.
[2] KIM YR, YUN Y, BAE SG, et al.Severe Fever with Thrombocytopenia Syndrome Virus Infection, South Korea, 2010[J]. Emerg Infect Dis, 2018, 24(11): 2103-2105.
[3] RATTANAKOMOL P, KHONGWICHIT S, LINSUWANON P, et al.Severe Fever with Thrombocytopenia Syndrome Virus Infection, Thailand, 2019-2020[J]. Emerg Infect Dis, 2022, 28(12): 2572-2574.
[4] TRAN XC, YUNY, VANAN L, et al.Endemic Severe Fever with Thrombocytopenia Syndrome, Vietnam[J]. Emerg Infect Dis, 2019, 25(5): 1029-1031.
[5] WIN AM, NGUYEN YTH, KIM Y, et al.Genotypic Heterogeneity of Orientia Tsutsugamushi in Scrub Typhus Patients and Thrombocy-topenia Syndrome Co-Infection, Myanmar[J]. Emerg Infect Dis, 2020, 26(8): 1878-1881.
[6] YUE YJ, REN DS, LUN XC.Epidemic Characteristics of Fatal Cases of Severe Fever with Thrombocytopenia Syndrome in China from 2010 to 2023[J]. Journal of Tropical Diseases and Parasitology(热带病与寄生虫学), 2024, 22(5): 257-300.
[7] CUI H, SHEN S, CHEN L, et al.Global Epidemiology of Severe Fever with Thrombocytopenia Syndrome Virus in Human and Animals: a Systematic Review and Meta-Analysis[J]. Lancet Reg Health West Pac, 2024, 48: 101133.
[8] LI H, LU QB, XING B, et al.Epidemiological and Clinical Features of Laboratory-Diagnosed Severe Fever with Thrombocytopenia Syndrome in China, 2011-17: a Prospective Observational Study[J]. Lancet Infect Dis, 2018, 18(10): 1127-1137.
[9] YU C, LIN Y, DAI Y, et al.Recent Research Advances in the Development of Dabie Banda Virus Vaccines[J]. PLoS Negl Trop Dis, 2024, 18(8): e0012411.
[10] FURUTA Y, KOMENO T, NAKAMURA T.Favipiravir (T-705), a Broad-Spectrum Inhibitor of Viral RNA Polymerase[J]. Proc JpnAcad Ser B Phys Biol Sci, 2017, 93(7): 449-463.
[11] BANG MS, KIM CM, KIM DM, et al.Effective Drugs against Severe Fever with Thrombocytopenia Syndrome Virus in an in vitro Model[J]. Front Med (Lausanne), 2022, 9: 839215.
[12] BABA M, TOYAMA M, SAKAKIBARA N, et al.Establishment of an Antiviral Assay System and Identification of Severe Fever with Thrombocytopenia Syndrome Virus Inhibitors[J]. Antivir Chem Chemother, 2017, 25(3): 83-89.
[13] GOWEN BB, WESTOVER JB, MIAO J, et al.Modeling Severe Fever with Thrombocytopenia Syndrome Virus Infection in Golden Syrian Hamsters: Importance of STAT2 in Preventing Disease and Effective Treatment with Favipiravir[J]. J Virol, 2017, 91(3): e01942-16.
[14] TANI H, KOMENO T, FUKUMA A, et al.Therapeutic Effects of Favipiravir against Severe Fever with Thrombocytopenia Syndrome Virus Infection in a Lethal Mouse Model: Dose-Efficacy Studies upon Oral Administration[J]. PLoS One, 2018, 13(10): e0206416.
[15] SUEMORI K, SAIJO M, YAMANAKA A, et al.A Multicenter Non-Randomized, Uncontrolled Single Arm Trial for Evaluation of the Efficacy and the Safety of the Treatment with Favipiravir for Patients with Severe Fever with Thrombocytopenia Syndrome[J]. PLoSNegl Trop Dis, 2021, 15(2): e0009103.
[16] YUAN Y, LU QB, YAO WS, et al.Clinical Efficacy and Safety Evaluation of Favipiravir in Treating Patients with Severe Fever with Thrombocytopenia Syndrome[J]. EBioMedicine, 2021, 72: 103591.
[17] LI H, JIANG XM, CUI N, et al.Clinical Effect and Antiviral Mechanism of T-705 in Treating Severe Fever with Thrombocytopenia Syndrome[J]. Signal Transduct Target Ther, 2021, 6(1): 145.
[18] SONG R, CHEN Z, LI W.Severe Fever with Thrombocytopenia Syndrome (SFTS) Treated with a Novel Antiviral Medication, Favipiravir (T-705)[J]. Infection, 2020, 48(2): 295-298.
[19] GRACI JD, CAMERON CE.Mechanisms of Action of Ribavirin against Distinct Viruses[J]. Rev Med Virol, 2006, 16(1): 37-48.
[20] SHIMOJIMA M, FUKUSHI S, TANI H, et al.Effects of Ribavirin on Severe Fever with Thrombocytopenia Syndrome Virus in vitro[J]. Jpn J Infect Dis, 2014, 67(6): 423-427.
[21] LEE MJ, KIM KH, YI J, et al.In vitro Antiviral Activity of Ribavirin against Severe Fever with Thrombocytopenia Syndrome Virus[J]. Korean J Intern Med, 2017, 32(4): 731-737.
[22] TANI H, FUKUMA A, FUKUSHI S, et al.Efficacy of T-705 (Favipiravir) in the Treatment of Infections with Lethal Severe Fever with Thrombocytopenia Syndrome Virus[J]. mSphere, 2016, 1(1): e00061-15.
[23] ZHANG Y, MIAO W, XU Y, et al.Severe Fever with Thrombocytopenia Syndrome in Hefei: Clinical Features, Risk Factors, and Ribavirin Therapeutic Efficacy[J]. J Med Virol, 2021, 93(6): 3516-3523.
[24] LIU W, LU QB, CUI N, et al.Case-Fatality Ratio and Effectiveness of Ribavirin Therapy among Hospitalized Patients in China Who Had Severe Fever with Thrombocytopenia Syndrome[J]. Clin Infect Dis, 2013, 57(9): 1292-1299.
[25] SONG X, XU X, REN X, et al.Therapeutic Plasma Exchange Combined with Ribavirin to Rescue Critical SFTS Patients[J]. J Clin Apher, 2024, 39(3): e22131.
[26] LI H, ZHANG LK, LI SF, et al.Calcium Channel Blockers Reduce Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) Related Fatality[J]. Cell Res, 2019, 29(9): 739-753.
[27] URATA S, YOSHIKAWA R, YASUDA J.Calcium Influx Regulates the Replication of Several Negative-Strand RNA Viruses Including Severe Fever with Thrombocytopenia Syndrome Virus[J]. J Virol, 2023, 97(3): e0001523.
[28] YAMAUCHI N, HONGO T, KAWAKAMI M, et al.Successful Recovery from Severe Fever with Thrombocytopenia Syndrome and Hemophagocytic Lymphohistiocytosis with Standard Treatment and a Calcium Channel Blocker of Nicardipine Hydrochloride[J]. Intern Med, 2023, 62(9): 1365-1369.
[29] GE Z, ZHAO C, XU Y, et al.Analysis of the Clinical Efficacy of CCBs in Patients with Severe Fever with Thrombocytopenia Syndrome Combined with Hypertension[J]. Virol J, 2025, 22(1): 184.
[30] JOHNSON CR, THACHER TD.Vitamin D: Immune Function, Inflammation, Infections and Auto-Immunity[J]. Paediatr Int Child Health, 2023, 43(4): 29-39.
[31] FERNANDEZ GJ, RAMIREZ-MEJIA JM, CASTILLO JA, et al.Vitamin D Modulates Expression of Antimicrobial Peptides and Proinflammatory Cytokines to Restrict Zika Virus Infection in Macro-phages[J]. Int Immunopharmacol, 2023, 119: 110232.
[32] SARTINI M, DEL PUENTE F, CARBONE A, et al.The Effect of Vitamin D Supplementation Post COVID-19 Infection and Related Outcomes: a Systematic Review and Meta-Analysis[J]. Nutrients, 2024, 16(22): 3794.
[33] YANG J, YAN Y, DAI Q, et al.Tilorone Confers Robust in vitro and in vivo Antiviral Effects against Severe Fever with Thrombocyto-penia Syndrome Virus[J]. Virol Sin, 2022, 37(1): 145-148.
[34] LUO C, YAN X, YANG S, et al.Antiviral Activity of Vitamin D Derivatives against Severe Fever with Thrombocytopenia Syndrome Virus in vitro and in vivo[J]. Virol Sin, 2024, 39(5): 802-811.
[35] LIU T, LIU J, WU J, et al.Clinical Diagnostic Value of Serum 25-Hydroxyvitamin D in Severe Fever with Thrombocytopenia Syndrome[J]. Infect Drug Resist, 2023, 16: 1715-1724.
[36] YAN X, LUO C, YANG J, et al.Antiviral Activity of Selective Estrogen Receptor Modulators against Severe Fever with Thrombocytopenia Syndrome Virus in vitro and in vivo[J]. Viruses, 2024, 16(8): 1332.
[37] EKINS S, LANE TR, MADRID PB.Correction to: Tilorone: a Broad-Spectrum Antiviral Invented in the USA and Commercialized in Russia and Beyond[J]. Pharm Res, 2020, 37(12): 239.
[38] CHENG Y, ZHENG W, DONG X, et al.Design and Development of a Novel Oral 4’-Fluorouridine Double Prodrug VV261 against SFTSV[J]. J Med Chem, 2025, 68(9): 9811-9826.
[39] SHEN S, ZHANG Y, YIN Z, et al.Antiviral Activity and Mechanism of the Antifungal Drug, Anidulafungin, Suggesting Its Potential to Promote Treatment of Viral Diseases[J]. BMC Med, 2022, 20(1): 359.
[40] QU B, QI X, WU X, et al.Suppression of the Interferon and NF-κB Responses by Severe Fever with Thrombocytopenia Syndrome Virus[J]. J Virol, 2012, 86(16): 8388-8401.
[41] CHENG T, XIAO Q, CUI J, et al.Identification of Lurasidone as a Potent Inhibitor of Severe Fever with Thrombocytopenia Syndrome Virus by Targeting the Viral Nucleoprotein[J]. Front Microbiol, 2025, 16: 1578844.
[42] JIANG N, HE Y, WU J, et al.6-Thioguanine Inhibits Severe Fever with Thrombocytopenia Syndrome Virus through Suppression of EGR1[J]. Antiviral Res, 2024, 227: 105916.
[43] WU B, YU C, LIN Y, et al.Verteporfin Inhibits Severe Fever with Thrombocytopenia Syndrome Virus Infection via Inducing the Degradation of the Viral Gn Protein[J]. Pharmaceutics, 2025, 17(4): 434.
[44] BABA M, OKAMOTO M, TOYAMA M, et al.Amodiaquine Derivatives as Inhibitors of Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) Replication[J]. Antiviral Res, 2023, 210: 105479.
[45] HAN M, LEE YJ, AHN SM, et al.Efficacy of CP-COV03 (a Niclos-amide-Based Inorganic Nanohybrid Product) against Severe Fever with Thrombocytopenia Syndrome Virus in an in vitro Model[J]. Microbiol Spectr, 2024, 12(11): e0139924.
[46] YAMADA H, TANIGUCHI S, SHIMOJIMA M, et al.M Segment-Based Minigenome System of Severe Fever with Thrombocytopenia Syndrome Virus as a Tool for Antiviral Drug Screening[J]. Viruses, 2021, 13(6): 1061.