ABSTRACT

Although the use of antiviral drugs has improved, human viral infections are still a serious health problem in the world, as they have the capacity to evade host immunity, to persist and to not be completely eliminated. The methylation of RNA at the N6 position of adenine (N6-methyladenosine or m6A) is the most common internal modification of eukaryotic messenger RNAs, and recent findings have shown that m6A plays an important role in regulating the expression of both host and viral genes. The involvement of m6A writers, erasers and readers in regulating RNA stability, translation, splicing and degradation has been shown to regulate multiple stages of the viral life cycle. Previous studies have shown that persistent viruses, such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomavirus (HPV), Epstein–Barr virus (EBV), cytomegalovirus (CMV) and Kaposi’s sarcoma-associated herpesvirus (KSHV), hijack host m6A machinery to amplify viral replication, control latency and inhibit antiviral immune responses. Moreover, m6A remodeling of epitranscriptomes plays a role in immune escape, including by dampening innate immune sensing, blocking interferon signaling, decreasing antigen presentation, and driving immune tolerance, which all enable chronic infection. The results have revealed m6A regulatory processes as potential targets for novel antiviral therapies. There are, however, significant challenges to clinical translation due to the context-dependent functions of m6A, the virus-specific regulatory mechanisms, and the possibility of off-target effects. This review highlights the present understanding on the molecular machinery of m6A modification, how m6A modification is involved in viral replication and immune evasion, how it is involved in the regulation of persistent human viruses, and emerging therapeutic strategies targeting m6A modification. Lastly, the paper explores the potential for personalized antiviral therapies based on epitranscriptomic profiling, multi-omics technologies, and AI to improve long-term clinical outcomes and overcome the limitations of existing treatment strategies in persistent viral infections.

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Cite this article

Mohammed, Z. B., & Mahdi, E. I. (2026). Viral Immune Escape: The Role of RNA M6a Modifications in Persistent Human Viral Infections and Precision Antiviral Therapy Limitations. INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH, 5(7), 616-623. https://doi.org/10.58806/ijhmr.2026.v5i7n06