Medical prevention of respiratory-synchitic viral infection in the present and future

Respiratory syncytial virus (RSV) is one of the most common respiratory viral agents and the main cause of lower respiratory tract infections in children and the elderly that have an unfavorable outcome. Unfortunately, current national recommendations for the treatment of patients with RSV infection (RSVI) are limited mainly to pathogenetic and symptomatic therapy. Instead, scientists are focusing on the development of new drugs that inhibit the activity of various viral proteins and surface receptor molecules of respiratory tract epithelial cells. Aim - to provide an overview of the main current and future strategies for RSVI prevention. The drug prophylaxis of RSVI, which is recommended in the form of passive and active immunization, is highly effective. Passive immunization is recommended for children, while vaccination is mainly indicated for pregnant women and the elderly. For passive immunization in children, medications containing recombinant monoclonal RSV-neutralizing antibodies, such as palivizumab and nircevimab, are used. Palivizumab is administered intramuscularly once a month throughout the RSV season. At the same time, nirsevimab requires only a single injection to achieve the preventive effect. The duration of the preventive effect of nirsevimab is due to the modification of the mAb molecule, which significantly increases the half-life of the mAb. For children in the first six months of life whose mothers were vaccinated during pregnancy, it is recommended to be vaccinated with Abrisvo vaccine during the period of increased incidence of RSVI. For the prevention of RSVI in the elderly, it is recommended to use Arexvie and Abrisvo vaccines, and for pregnant women - the bivalent subunit Abrisvo vaccine. It is believed that the introduction of new RSVI preventive strategies will significantly reduce both the incidence of the disease and the risk of adverse outcomes from this infection. The authors declare no conflict of interest.