Evaluating antiviral candidates for dengue virus infection: A review

Dengue virus (DENV) infection poses a significant global health threat, affecting millions worldwide. The virus is transmitted through the bite of infected mosquitoes, leading to a range of symptoms from mild fever to severe dengue hemorrhagic fever and dengue shock syndrome. Effective treatment strategies are urgently needed to combat this growing public health concern. Several compounds, including chloroquine, favipiravir, ribavirin, ST-148, NITD-008, interferon β, curcumin, papaya leaf extracts, artemisinin, nanocurcumin, balapiravir, and andrographolide, exhibited antiviral activity against DENV in different cell lines. In vivo studies demonstrated the effectiveness of celgosivir, ST-148, NITD-008, and 2’- C -methylcytidine in reducing viral load and improving survival rates in mice. However, clinical trials on Balapiravir, celgosivir, chloroquine, and ribavirin showed limited efficacy in humans. Further investigations, including those on non-human primates, suggest the potential for chloroquine in reducing viremia. Studies involving intravenous immunoglobulin, Freeze-dried carica papaya leaves juice (FCPLJ), and IFNα/β highlight the complex interplay between the immune system and DENV infection. The findings suggest that some treatments may exacerbate disease symptoms while others, such as FCPLJ, exhibit potential for enhancing immune responses. This review highlights promising antiviral candidates for DENV treatment, emphasizing the need for further research to optimize efficacy and safety in human populations. The dengue virus impacts various organs in the body, resulting in a range of clinical symptoms. Each type of organ damage requires its specific management approach. • Chloroquine, Favipiravir, and Celgosivir show antiviral activity in vitro. • Papaya leaf extract reduces DENV load and enhances immune responses. • 2CMC and NITD-008 reduce viral load and improve survival in mice. • Interferon-β boosts immune response and inhibits DENV replication. • Clinical trials show limited efficacy of Balapiravir, Celgosivir, and Ribavirin.