The epidemiology and spread of drug resistant human influenza viruses
The epidemiology and spread of drug resistant human influenza viruses
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DOI：
10.1016/j.coviro.2014.04.009
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发表时间：
2014-10-01
影响因子：
5.9
通讯作者：
Hurt, Aeron C.
中科院分区：
文献类型：
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作者：
Hurt, Aeron C.
在过去的十年里，抗病毒耐药流感病毒的传播发生了重大变化。金刚烷抗药性A(H3N2)和A(H1N1)pdm09病毒的出现和持续传播意味着金刚烷不再被推荐使用。对神经氨酸酶抑制剂这类较新药物的耐药性通常与较差的病毒复制和传播有关。但在2007/2008年间补偿了甲型H1N1流感病毒功能损害的“容许性”突变，使它们能够获得H275Y NA抗性突变，而不会失去适合度，导致它们在全球迅速传播。现在似乎在甲型H1N1流感pdm09病毒中存在允许的突变，从而增加了耐奥司他韦的甲型H1N1 pdm09病毒也可能在全球传播的风险，考虑到奥司他韦是最广泛使用的流感抗病毒药物，这是一个令人担忧的情况。
Significant changes in the circulation of antiviral-resistant influenza viruses have occurred over the last decade. The emergence and continued circulation of adamantane-resistant A(H3N2) and A(H1N1)pdm09 viruses mean that the adamantanes are no longer recommended for use. Resistance to the newer class of drugs, the neuraminidase inhibitors, is typically associated with poorer viral replication and transmission. But 'permissive' mutations, that compensated for impairment of viral function in A(H1N1) viruses during 2007/2008, enabled them to acquire the H275Y NA resistance mutation without fitness loss, resulting in their rapid global spread. Permissive mutations now appear to be present in A(H1N1)pdm09 viruses thereby increasing the risk that oseltamivir-resistant A(H1N1)pdm09 viruses may also spread globally, a concerning scenario given that oseltamivir is the most widely used influenza antiviral.