Zika virus outbreaks and treatment in pregnant women in Ho Chi Minh City, Vietnam

ABSTRACT Arthropod-borne viruses represent a significant public health threat worldwide, yet there are few antiviral therapies or prophylaxes targeting these pathogens. In particular, the development of novel antivirals for high-risk populations such as pregnant women is essential to prevent devastating disease such as that which was experienced with the recent outbreak of Zika virus (ZIKV) in the Americas. One potential avenue to identify new and pregnancy-acceptable antiviral compounds is to repurpose well-known and widely used FDA-approved drugs. In this study, we addressed the antiviral role of atovaquone, an FDA Pregnancy Category C drug and pyrimidine biosynthesis inhibitor used for the prevention and treatment of parasitic infections. We found that atovaquone was able to inhibit ZIKV and chikungunya virus virion production in human cells and that this antiviral effect occurred early during infection at the initial steps of viral RNA replication. Moreover, we were able to complement viral replication and virion production with the addition of exogenous pyrimidine nucleosides, indicating that atovaquone functions through the inhibition of the pyrimidine biosynthesis pathway to inhibit viral replication. Finally, using an ex vivo human placental tissue model, we found that atovaquone could limit ZIKV infection in a dose-dependent manner, providing evidence that atovaquone may function as an antiviral in humans. Taken together, these studies suggest that atovaquone could be a broad-spectrum antiviral drug and a potential attractive candidate for the prophylaxis or treatment of arbovirus infection in vulnerable populations, such as pregnant women and children. IMPORTANCE The ability to protect vulnerable populations such as pregnant women and children from Zika virus and other arbovirus infections is essential to preventing the devastating complications induced by these viruses. One class of antiviral therapies may lie in known pregnancy-acceptable drugs that have the potential to mitigate arbovirus infections and disease, yet this has not been explored in detail. In this study, we show that the common antiparasitic drug atovaquone inhibits arbovirus replication through intracellular nucleotide depletion and can impair ZIKV infection in an ex vivo human placental explant model. Our study provides a novel function for atovaquone and highlights that the rediscovery of pregnancy-acceptable drugs with potential antiviral effects can be the key to better addressing the immediate need for treating viral infections and preventing potential birth complications and future disease.

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The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic

The American Journal of Bioethics ◽

10.1080/15265161.2016.1177367 ◽

2016 ◽

Vol 16 (5) ◽

pp. 1-4 ◽

Cited By ~ 23

Author(s):

Lisa H. Harris ◽

Neil S. Silverman ◽

Mary Faith Marshall

Keyword(s):

Pregnant Women ◽

Zika Virus

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694: Middle cerebral artery Dopplers and adverse neonatal outcomes among pregnant women with Zika virus infection

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2019.11.708 ◽

2020 ◽

Vol 222 (1) ◽

pp. S439

Author(s):

Thalia Wong ◽

Jose Paulo Pereira ◽

Nasim Sobhani ◽

Renan Fonseca Cardozo ◽

Helena Abreu Valle ◽

...

Keyword(s):

Virus Infection ◽

Pregnant Women ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Zika Virus ◽

Neonatal Outcomes ◽

Zika Virus Infection ◽

Adverse Neonatal Outcomes

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Personal protective measures of pregnant women against Zika virus infection

Revista de Saúde Pública ◽

10.11606/s1518-8787.2019053001146 ◽

2019 ◽

Vol 53 ◽

pp. 72

Author(s):

Vladimir Antonio Dantas Melo ◽

José Rodrigo Santos Silva ◽

Roseli La Corte

Keyword(s):

Pregnant Women ◽

Urban Area ◽

Zika Virus ◽

Rural Areas ◽

Education Level ◽

Ministry Of Health ◽

Chi Square ◽

Protective Measures ◽

Exact Test ◽

Mosquito Nets

OBJECTIVE: To evaluate the adherence of pregnant women to personal protective measures against mosquito bites, recommended by the Ministry of Health, and to investigate the factors associated with the non-adoption of these measures. METHODS: We interviewed 177 pregnant women between November 2016 and February 2017 in the 10 basic health units of the municipality of Propriá, state of Sergipe, two located in the rural area and eight in the urban area, during prenatal appointments, to raise information about the use of preventive measures against the vector transmission of Zika virus. Data were analyzed using descriptive statistical methods, chi-square test or Fisher’s exact test, and the odds ratio was calculated. The independent variables were grouped by the analysis of principal components, and the dependents (the use of repellent, mosquito nets, garments, screens and insecticides) were analyzed using the logistic regression method. RESULTS: Among the measures recommended by the Ministry of Health, mosquito nets were the most used by pregnant women living in rural areas and with low education level, while the repellents were more used by women in the urban area and with higher education level. Women in a vulnerable socio-economic situation presented a risk 2.4 times higher for not using screens in their homes, 1.9 times higher for not changing clothes and 2.5 times higher for not using repellent than pregnant women in better economic conditions. CONCLUSIONS: The socioeconomic status of pregnant women, especially among the less privileged, influenced the use of protective measures against Zika virus, from the purchase of repellent, clothing, insecticides to other resources in the municipality of Propriá, SE.

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Maternal-fetal Transmission and Adverse Perinatal Outcomes in Pregnant Women Infected With Zika Virus

Obstetric Anesthesia Digest ◽

10.1097/01.aoa.0000557676.45720.85 ◽

2019 ◽

Vol 39 (2) ◽

pp. 89-90

Author(s):

L. Pomar ◽

M. Vouga ◽

V. Lambert ◽

C. Pomar ◽

N. Hcini ◽

...

Keyword(s):

Pregnant Women ◽

Zika Virus ◽

Perinatal Outcomes ◽

Adverse Perinatal Outcomes ◽

Maternal Fetal Transmission

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Perception of the Zika virus infection and its influence on Zika prevention practices by pregnant women at the Region 5 Health Promotion Center in Thailand

Medical Journal of Indonesia ◽

10.13181/mji.v27i3.2424 ◽

2018 ◽

Vol 27 (3) ◽

pp. 201-8

Author(s):

Issara Siramaneerat

Keyword(s):

Health Promotion ◽

Pregnant Women ◽

Zika Virus ◽

Smoking Behavior ◽

Cross Sectional Study ◽

Survey Method ◽

Attitudes And Beliefs ◽

Brain Disorder ◽

Cross Sectional ◽

Virus Zika

Background: The Zika virus (ZIKA) infection in pregnant women causes microcephaly, a brain disorder resulting in severe birth defects. The objective of this study was to identify the factors that influence Zika prevention practices by pregnant women at the Region 5 Health Promotion Center in Thailand.Methods: A cross-sectional study applied a survey method to collect data from pregnant women between 18 and 45 years of age. The sampling method used multistage random sampling. The data were analyzed using descriptive statistics and multiple linear regression analysis.Results: The findings indicated that 5 of 12 factors could significantly predict Zika prevention practices of pregnant women at the Health Promotion Center Region 5 in Thailand: education, smoking behavior, check-up status during pregnancy, perception of susceptibility, and perception of benefit.Conclusion: The results show a direct correlation between the perception of susceptibility and benefit and Zika prevention practices. Policies for promoting Zika knowledge and preventive behavior by providing information about Zika should focus on changing the thoughts, attitudes, and beliefs of pregnant women and their families.

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