By Ana Espino | Published on
May 11, 2026 | 4 min read
Hantaviruses are zoonotic,
single-stranded, segmented, negative-sense RNA viruses belonging to the Hantaviridae
family. They are primarily transmitted to humans by rodents through inhalation
of aerosols contaminated with urine, feces, or saliva. These viruses cause two
major syndromes: hemorrhagic fever with renal syndrome (HFRS) and hantavirus
pulmonary or cardiopulmonary syndrome (HPS/HCPS). These infections represent an
emerging public health threat, with more than 200,000 cases reported worldwide
each year.
Current management mainly relies
on supportive care: hospitalization, intensive care, oxygen therapy, mechanical
ventilation, hemofiltration, dialysis, and correction of fluid and electrolyte
imbalances depending on pulmonary or renal involvement. Ribavirin is one of the
few antivirals used, but its effectiveness appears to depend largely on very
early administration. To date, there is no globally approved specific antiviral
treatment or vaccine against hantavirus infections.
An additional challenge lies in
the diversity of hantaviruses, their zoonotic transmission, the variability of
clinical presentations, and the potential severity of pulmonary or renal forms.
Another major challenge is therapeutic. Several approaches have shown promise
in laboratory or animal studies, but their effectiveness in humans remains
insufficiently demonstrated. Strategies such as siRNA therapies, neutralizing
antibodies, and certain antivirals still face limitations related to stability,
in vivo targeting, safety, standardization, and large-scale production.
The aim of this review is to
present current knowledge on hantavirus infections and summarize recent
therapeutic advances. The authors focus particularly on antivirals, therapies
targeting viral entry or replication, RNA interference approaches, immunotherapy,
and vaccine candidates capable of reducing disease progression and the risk of
severe forms.
Hantavirus: Focus on Innovation
This article examined several
dimensions of hantavirus infection: epidemiology, viral structure,
pathogenesis, diagnosis, clinical management, antiviral treatments,
immunotherapy, and vaccines under development. The data discussed come from in
vitro studies, animal models, preclinical research, clinical trials, human
observations, and multicenter epidemiological data.
The article shows that
hantaviruses primarily infect endothelial cells, which line blood vessels,
especially in the lungs and kidneys. This infection triggers a strong
inflammatory response and disrupts vascular permeability. Fluids leak more
easily into tissues, contributing to pulmonary edema, renal injury, and severe
forms of the disease.
Several therapeutic strategies
were investigated. A first approach consists of preventing the virus from
entering cells. Molecules such as lactoferrin, griffithsin, or certain peptides
may block viral attachment or penetration into host cells. However, these
treatments appear to be most effective when administered very early, before the
infection becomes advanced.
Another strategy aims to limit
viral replication. Molecules such as ribavirin, favipiravir, ETAR, or baloxavir
acid act on viral replication or on enzymes required for the viral life cycle.
These treatments have shown encouraging results in experimental models, but
their efficacy appears more limited once infection is advanced.
RNA interference therapies (siRNA)
have also been investigated. These molecules directly target parts of the viral
genome in order to reduce viral RNA production and replication. Although
promising, this approach remains difficult to apply in humans, particularly
because of the poor stability of siRNA molecules and the difficulty of
targeting infected tissues.
Some strategies do not only aim to
block the virus but also to limit the consequences of infection on the body.
For example, vandetanib or icatibant may help reduce vascular
hyperpermeability, which plays a central role in severe hantavirus
complications.
Finally, immunotherapy and
vaccination appear to be major avenues of research.
Neutralizing antibodies have
demonstrated protective effects in several animal models. Likewise, several
vaccine candidates are under development. These approaches are promising but
still require robust clinical studies to confirm their safety, efficacy, and
usefulness in humans.
Toward defeating Hantaviruses ?
Hantaviruses are zoonotic viruses
transmitted mainly by rodents and responsible for severe syndromes affecting
the kidneys or lungs. The major challenges in managing this disease include the
absence of a validated specific treatment, the lack of an available vaccine,
the need for very early intervention during infection, and the difficulty of
translating preclinical findings into effective clinical solutions.
In this context, the objective of
this study was to review therapeutic advances against hantavirus infections,
including antivirals, immunological approaches, siRNA therapies, host-targeted
treatments, and vaccine candidates. The data suggest that combined strategies
appear to be the most promising. Effective management may involve a combination
of early antiviral therapy, neutralizing antibodies, immunomodulatory
approaches, and vaccines capable of preventing infection in high-risk areas.
Experimental results are
encouraging, but they still need to be confirmed in humans.
Future perspectives include the
development of more effective and longer-lasting vaccines, improved siRNA
delivery systems, clinical validation of monoclonal or polyclonal antibodies,
and investigation of treatments combining antivirals with immunomodulators. The
authors also highlight the importance of better targeting the inflammatory and
vascular mechanisms responsible for the severity of HFRS and HPS/HCPS.
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About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap
between research and real-world impact. With expertise in immunology, virology,
oncology, and clinical studies, she makes complex science clear and accessible.
Her mission: to accelerate knowledge sharing and empower evidence-based
decisions 
