Therapeutic intervention strategies for Nipah virus infection: a scoping review

Introduction Nipah virus (NiV) infection, a zoonotic disease, has caused recurrent outbreaks in South and Southeast Asia, with case fatality rates ranging from 38% to 75%. The clinical management of NiV disease (NiVD) relies on supportive care, with unapproved antiviral therapies and no licensed vaccines currently available.Objectives This scoping review aims to synthesise and map the available evidence on therapeutic strategies for NiV infection.Methods A systematic search was conducted in PubMed and Scopus for studies published from 1 January 1999 to 1 February 2026, focusing on clinical studies, animal experiments, in vitro investigations and in silico analyses evaluating NiV therapies. Eligible studies were selected based on their population or experimental model, therapeutic intervention, evaluation methods, efficacy outcomes, safety findings and proposed molecular mechanisms.Results Of 1703 articles screened, 16 studies were included, covering clinical reports, animal models, in vitro experiments and in silico analyses. Therapeutic interventions evaluated included antivirals (ribavirin, favipiravir, remdesivir and RdRp-targeted candidates), passive immunotherapy (monoclonal antibodies targeting viral glycoproteins) and computationally prioritised compounds (e.g. phytochemicals, bioisosteres and repurposed drugs). Most interventions targeted viral entry, RNA replication or multiple stages of the NiV life cycle. However, a substantial gap exists between the urgent clinical need for effective treatments and the limited availability of clinically validated therapies.Conclusion Effective, clinically validated therapies for NiV infection are still lacking. Translational research, outbreak-ready clinical trial frameworks and prioritisation of promising therapeutic candidates are crucial for improving preparedness and clinical outcomes in future NiV outbreaks.