A potential first for the treatment of henipaviruses

In a potential first, a phase I study of an antibody used in the treatment of henipaviruses has found it to be effective in neutralising the virus. The results, published in The Lancet Infectious Diseases, has opened up the potential for future testing in what could become the first known treatment for the group of viruses — inclusive of the Nipah virus, which has been a notable threat in India in recent years.

“Given the high death rate from infection by henipaviruses, their ability to cause infection in multiple organs including the brain, and their unique ability to spread to humans from bats via a wide range of animal species including horses and dogs, doctors need a safe way to neutralise them,” says Dr Elliott Geoffrey Playford from Princess Alexandra Hospital, Australia.

The monoclonal antibody m102.4 was tested in forty individuals aged eighteen to fifty and was overall well tolerated with no serious side effects. The most common treatment-related adverse events were headaches, which were reported by twelve out of thirty volunteers in those receiving the antibody and three out of ten volunteers who received the placebo.

The antibody was found to neutralise both the Hendra and Nipah viruses. The potential treatment of the Nipah virus comes as a major benefit to India, given the numerous outbreaks over the previous few years – particularly in the state of Kerala. 

“Twenty years have passed since its discovery, but the world is still not adequately equipped to tackle the global health threat posed by Nipah virus,” said Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations (CEPI). While rare, the Nipah virus is a worrying prospect due to the disease having a seventy percent mortality rate, making the threat to life – especially in a large-scale outbreak – considerable. More troubling still is that there is no known vaccine for the disease, making fears of large outbreaks more pronounced due to the absence of immunisation as a prevention tool.

India has witnessed several isolated outbreaks of the Nipah virus in just the last few years. These outbreaks have, however, been rapidly attended to by health authorities, controlling and isolating the situation to prevent escalation. A lack of medications or vaccination means containment efforts are limited to quarantine measures. The potential development of a treatment that has thus far showed the capacity to neutralise henipaviruses therefore comes as a major hope in preventing the disease from becoming a major pandemic.