In July 2022 China’s drug regulator gave conditional approval for Azvduine, an HIV drug developed by Genuine Biotech, to be used in the treatment of Covid-19. Specific data from clinical trials were not released but the company announced that in a Phase III clinical trial around 40% of participants showed “improved clinical symptoms”.  Safety and further efficacy information remain unpublished.  

Despite this absence, experts are confident that Azvudine’s status as an approved HIV treatment enabled a fast-tracked application. They say that Azvudine will “trick the virus’ polymerase into incorporating the drug into its RNA”. This prevents viral replication.  

The need for Covid-19 therapies is growing, and until the approval of Azvudine China had only authorised one other oral antiviral: Paxlovid. This was developed by Pfizer and is highly effective. However, it is accompanied by suggestions of a “rebound” in symptoms following course completion. Despite this, it reduces the risk of hospitalisation and death by almost 89%, and was the treatment recommended by White House doctors for President Joe Biden in his recent recovery from the virus. 

Another Chinese oral antiviral (VV116) is currently in final development stages. It is “a pill version of the intravenous drug remdesivir”, which is produced by Gilead Sciences. The developers, Shanghai Junshi Biosciences, intend to apply for regulatory approval shortly. They suggest that Phase III trials demonstrated faster and more effective results when compared with Paxlovid. Again, detailed data is yet to be released and it is “unclear whether it will outperform Paxlovid”. All of these antivirals work best when administered as close to infection as possible.

With these antiviral developments we might expect to see an alleviation of China’s meticulous “zero-Covid” policy. This policy involves rigorous testing and quarantine regulations.  However, Dr Jun Wang of Rutgers University suggests that the lifting of regulations is unlikely, certainly while access to these treatments is limited. With more treatments moving along the pipeline towards approval, will we see increased availability to the Chinese public?

To participate in a discussion of Antivirals and Vaccines at the World Vaccine Congress in Europe 2022, click here.