Herbal Antiviral Agents in Clinical Practice

Abstract

Viral infections span a wide clinical spectrum from self-limiting upper respiratory tract infections to chronic viral hepatitis and recurrent herpetic conditions that together represent substantial European healthcare burden. Conventional antiviral pharmacology has made remarkable progress for specific viral conditions (direct-acting antivirals for hepatitis C, specific neuraminidase inhibitors for influenza, effective antiretroviral therapy for HIV) while remaining limited for many common viral conditions including most common-cold causative viruses, many respiratory viral infections, and some chronic viral conditions. Herbal antiviral agents have accumulated clinical evidence in the intermediate space where conventional options are limited or tolerability-concerning. Ayurvedic medicine has documented interventions for what classical practice recognised as Jvara (febrile viral-syndrome-like presentations) and related viral illness categories, with Guduchi (Tinospora cordifolia), Andrographis paniculata, Tulsi (Ocimum sanctum), and specific polyherbal preparations as the best-characterised agents. This study reviews 52 primary clinical studies published between 2012 and 2022, grouped under five frames: HV1 (respiratory viral infection management), HV2 (herpetic and HSV-related conditions), HV3 (chronic viral hepatitis adjunctive therapy), HV4 (general immunomodulatory antiviral herbs), and HV5 (integrated clinical deployment in European integrative-medicine practice). Each frame was scored with the Herbal Antiviral Clinical Index (HACI). Integrated clinical deployment (HV5) scored highest at HACI 0.812, with respiratory viral infection management (HV1) at 0.796 and general immunomodulatory antiviral (HV4) at 0.774.