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At a glance

How it is written

Every virus chapter is written at three altitudes, marked in the text:

1. Molecular virology — genome class, the precise enzymatic or structural step inhibited, the biochemistry of inhibition, and the structural basis of escape.
2. Clinical virology — which assay on which specimen in which units, how to read a viral load, when to order genotypic or phenotypic resistance testing, and the pre-analytical traps.
3. Bedside — indication, regimen, dose, duration, renal and hepatic adjustment, interactions, monitoring, and what to do when first-line fails.

Recommendations carry IDSA/USPHS two-part evidence grades (A–E for strength, I–III for quality), with an explicit warning that most inpatient antiviral practice rests at B-II or C-III rather than A-I.

Contents

1. The druggable virus: why antivirals are few, narrow and hard
2. Molecular pharmacology: activation, inhibition, exposure
3. Antiviral resistance: evolutionary and molecular principles
4. Resistance testing: history, methods, scientific principles
5. Clinical virology measurement and decision-making
6. Dose adjustment and special populations
7. Antiviral stewardship
8. Herpes simplex virus and varicella zoster virus
9. Cytomegalovirus
10. Epstein–Barr virus, HHV-6, HHV-7 and HHV-8
11. Hepatitis B and hepatitis D
12. Hepatitis C
13. Hepatitis A and hepatitis E
14. Human immunodeficiency virus (and HIV-2, HTLV)
15. Influenza
16. Coronaviruses
17. RSV, metapneumovirus, parainfluenza, measles, Nipah
18. Enteroviruses, rhinoviruses and parechoviruses
19. Adenovirus, polyoma-, papilloma- and parvoviruses
20. Poxviruses
21. Rabies, arboviral flaviviruses and alphaviruses
22. Viral haemorrhagic fevers
23. Viral gastroenteritis
24. Drug interactions
25. Toxicity and monitoring
26. The immunocompromised host
27. Where the field is going

Appendices: an antiviral spectrum matrix; viruses for which there is no effective antiviral, with what does change outcome; a resistance-mutation quick reference; and abbreviations.

Licence and use

© 2026 Saranga Sumathipala. Published under the Creative Commons Attribution 4.0 International License (CC BY 4.0). You may share and adapt it for any purpose with appropriate credit.

Suggested citation: Sumathipala S. Antiviral Therapeutics: An Encyclopaedic Reference Across the Human Virome. Reference edition, 2026. Open access, CC BY 4.0.

Prepared with the assistance of an AI tool (Claude, Anthropic), used to draft text and produce the figures; the author directed the work and is responsible for it. For education only — doses, thresholds and licensed indications change and differ between countries. Verify against current national labelling and local guidelines before prescribing.