[The molecular basis of resistance to anti-influenza drugs]

Influenza A viruses resistant to adamantanes(amantadine and rimantadine) have drastically increased in the last few years. Moreover, these adamantane-resistant viruses have acquired resistance without compromising viral pathogenicity and transmissibility. Viruses resistant to the other anti-influenza drugs, neuraminidase (NA) inhibitors, have also been shown to emerge at a rate higher than previously thought. In addition, several recent observations suggest that human-to-human transmission of variants resistant to NA inhibitors may have occurred, contrary to earlier predictions that such variants were much less likely to be transmitted. Although the prevalence of NA inhibitor resistants remains low, surveillance of drug-resistant influenza viruses in communities is essential. Here, we review antiviral resistance in influenza viruses and the molecular mechanisms of the acquisition of resistance to these drugs.