ReviewFrontiers in public health2026
Drugs in the environment, viruses in the balance: a review of the untold nexus of pharmaceuticals and virology.
Review in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: The pervasive contamination of aquatic and terrestrial ecosystems by active pharmaceutical ingredients (APIs) is a well-documented environmental challenge. However, the impact of this pollution on the most abundant biological entities on Earth viruses has remained a critical blind spot. This review provides the first integrated synthesis of the bidirectional nexus between pharmaceutical pollution and environmental virology. Methods: A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus using search terms related to pharmaceuticals, viruses, and the environment. Additional targeted searches were performed for specific drug classes and viral systems. Articles were selected based on their relevance to pharmaceutical-viral ecology interactions. Results: We introduce a novel dual-pathway framework positing that APIs influence viral ecology through: (i) direct "drug-to-virus" interactions, where non-antibiotic compounds can physiochemically enhance viral stability and infectivity, and (ii) indirect "drug-to-host-to-virus" pathways, where antibiotics stress bacterial hosts, triggering prophage induction and fundamentally altering viral community dynamics. These mechanisms have profound implications, including the phage-mediated dissemination of antibiotic resistance genes, the selection for antiviral resistance in environmental reservoirs, and the potential for immunosuppression in aquatic fauna. Extending this framework to emerging biopharmaceuticals, we examine the environmental fate of vaccine nanoparticles and the ecological risks posed by gene therapy viral vectors. Conclusion: We propose a next-generation environmental risk assessment paradigm that integrates viral ecological outcomes, moving beyond traditional chemical-focused models. This review advances the field from fragmented evidence to a unified framework for environmental public health policy and practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.