Preventive and therapeutic strategies for respiratory syncytial virus infection

Respiratory syncytial virus (RSV) remains an important cause of pneumonitis in infants and in the elderly and immunosuppressed. Passive immunoprophylaxis of high-risk infants with the humanised monoclonal antibody palivizumab reduces RSV-related hospitalisation and admission to intensive care units by about 50%, although optimal and cost-effective use of this agent remains undefined. The development of an RSV vaccine is the focus of much research and recent advances with live attenuated vaccines are promising — several agents are in clinical trials. The value of the only therapeutic agent available to treat established infection, the antiviral ribavirin, is now seriously doubted and the agent is little used. New RSV chemotherapeutics are just entering clinical trials.