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ABSTRACT
Introduction
Herpes simplex keratitis stands as a prominent factor contributing to infectious blindness among developed nations. On a global scale, over 60% of the population tests positive for herpes simplex virus type-1 (HSV-1). Despite these statistics, there is currently no vaccine available for the virus. Moreover, the conventional nucleoside drugs prescribed to patients are proving ineffective in addressing issues related to drug resistance, recurrence, latency, and the escalating risk of vision loss. Hence, it is imperative to continually explore all potential avenues to restrict the virus. This review article centers on the present treatment methods for HSV-1 keratitis (HSK), highlighting the ongoing clinical trials. It delves into the emerging drugs, their mode-of-action and future therapeutics.
Areas covered
The review focuses on the significance of a variety of small molecules targeting HSV-1 lifecycle at multiple steps. Peer-reviewed articles and abstracts were searched in MEDLINE, PubMed, Embase, and clinical trial websites.
Expert opinion
The exploration of small molecules that target specific pathways within the herpes lifecycle holds the potential for substantial impact on the antiviral pharmaceutical market. Simultaneously, the pursuit of disease-specific biomarkers has the capacity to usher in a transformative era in diagnostics within the field.
Article highlights
HSV-1 infects the human eye causing HSK.
HSK is a prominent cause of infection-related blindness, globally.
Despite the high seropositivity, there is currently no vaccine available for HSK.
New drugs are needed to more effectively treat HSK.
The current pipeline includes future drugs that target new steps in the HSV-1 lifecycle.
Abbreviations
| HSK | = | Herpes Simplex Keratitis |
| HSV-1 | = | Herpes Simplex Virus-1 |
| ACV | = | Acyclovir |
| AAO | = | American Academy of Ophthalmology |
| HEDS | = | Herpes Eye Disease Study |
| TFT | = | Trifluorothymidine or trifluridine |
| AVP | = | Antiviral Prophylaxis |
| VACV | = | Valacyclovir |
| ACVR | = | ACV-resistant |
| TK | = | Thymidine Kinase |
| DNA pol | = | DNA polymerase |
| GCV | = | Ganciclovir |
| FDA | = | Food and Drug Administration |
| WHO | = | World Health organization |
| NSAIDs | = | Non-steroidal anti-inflammatory drugs |
| dGTP | = | Deoxyguanosine triphosphate |
| PED | = | Persistent Corneal Epithelial Defects |
| PCED | = | Primary congenital glaucoma Defects |
| DNA | = | Deoxyribose Nucleic Acid |
| RNA | = | Ribose Nucleic Acid |
| AVP | = | Antiviral prophylaxis |
| NICE | = | National Institute for Health and Clinical Excellence |
| EMA | = | European Medicines Agency |
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, patents received or pending, or royalties.
Reviewer disclosures
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.