RESISTANCE OF INFLUENZA-A VIRUS TO AMANTADINE AND RIMANTADINE - RESULTS OF ONE DECADE OF SURVEILLANCE
RESISTANCE OF INFLUENZA-A VIRUS TO AMANTADINE AND RIMANTADINE - RESULTS OF ONE DECADE OF SURVEILLANCE
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DOI：
10.1093/infdis/159.3.430
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发表时间：
1989-03-01
影响因子：
6.4
通讯作者：
SIM, IS
中科院分区：
文献类型：
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作者：
BELSHE, RB;BURK, B;SIM, IS
对美国西弗吉尼亚州亨廷顿市1978-1988年间所有临床分离的甲型流感病毒进行了检测，65株H1N1病毒和181株H3N2病毒中有65株对金刚烷胺和金刚乙胺的抗病毒作用敏感。这五种耐药病毒是从一个正在接受金刚乙胺治疗或预防的家庭的三名成员中获得的。金刚乙胺治疗期间出现耐药流感，并传播给两个家庭接触者，引起典型流感，伴有发烧、肌痛和咳嗽，持续时间不超过5天。抗性病毒的遗传特征与从指示病例中分离的易感病毒相比，显示M2蛋白跨膜部分的一个氨基酸发生了变化。体外研究表明，金刚烷胺对H1N1和H3N2病毒的活性明显高于金刚烷胺。虽然这种耐药流感是在一个家庭中传播并引起疾病的，但没有自然产生的耐药病毒表明，每隔几年出现新的甲型流感毒株可能会防止耐药甲型流感病毒的广泛出现。
All clinical isolates of influenza A viruses from patients in Huntington, West Virginia, USA, during the decade 1978-1988 were tested, and 65 of 65 H1N1 and 176 of 181 H3N2 viruses were susceptible to the antiviral action of amantadine and rimantadine. The five resistant viruses were obtained from three members of a family undergoing therapy or prophylaxis with rimantadine. Resistant influenza emerged during treatment with rimantadine and spread to two family contacts, causing typical influenza with fever, myalgia, and cough of 5 days'' or less duration. Genetic characterization of the resistant viruses when compared to the susceptible virus isolated on day 1 from the index case revealed a single amino acid change in the transmembrane portion of the M2 protein. In vitro studies showed that rimantadine was significantly more active than amantadine against both H1N1 and H3N2 viruses. Although this resistant influenza was transmitted and caused illness in one family, the absence of naturally occurring resistant viruses suggests that the emergence of new strains of influenza A each few years may prevent the widespread emergence of resistant influenza A virus.