Human astroviruses: molecular virology

Abstract

SUMMARY Human astroviruses (HAstVs) are important etiologic agents of pediatric gastroenteritis and are increasingly recognized as pathogens associated with extraintestinal disease, including encephalitis and meningitis, particularly in immunocompromised individuals. Despite their clinical relevance, widespread prevalence, and expanding genetic diversity, no approved vaccines or antiviral therapies are available. Progress toward effective interventions requires a comprehensive understanding of HAstV molecular biology, including mechanisms of cell entry, viral replication, and immune recognition. In this review, we summarize current knowledge of HAstV epidemiology, clinical manifestations, evolution, and taxonomy, emphasizing recent advances in molecular and structural virology. We examine the HAstV replication cycle, including emerging insights into receptor usage, double-membrane vesicle biogenesis, protease-driven maturation, the capsid’s membrane-lytic activity, and virion uncoating. Recent advances in determining high-resolution structures of the capsid core and spike of classical and non-classical HAstVs are highlighted, providing a framework for understanding virion assembly, maturation, and antibody neutralization. These molecular and structural insights highlight conserved and clade-specific vulnerabilities, refine current models of HAstV biology, and identify key molecular determinants that may serve as targets for antiviral development and vaccine design. We also outline critical unresolved questions that define priorities for future research.