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Early Viral Entry Assays for the Identification and Evaluation of Antiviral Compounds
09:29

Early Viral Entry Assays for the Identification and Evaluation of Antiviral Compounds

Published on: October 29, 2015

Antiviral prophylaxis during pandemic influenza may increase drug resistance

Martin Eichner1, Markus Schwehm, Hans-Peter Duerr

  • 1Department of Medical Biometry, University of Tübingen, Tübingen, Germany. martin.eichner@uni-tuebingen.de

BMC Infectious Diseases
|January 22, 2009
PubMed
Abstract

Insights

Neuraminidase inhibitors (NI) can promote drug-resistant influenza strains. Limiting NI prophylaxis is crucial to prevent increased hospitalizations and deaths during pandemics.

Area of Science:

  • Epidemiology
  • Virology
  • Computational Biology

Background:

  • Neuraminidase inhibitors (NI) and social distancing are key strategies for mitigating influenza pandemics.
  • The emergence and spread of NI-resistant influenza strains pose a significant threat to public health.

Purpose of the Study:

  • To investigate the extent to which NI treatment and prophylaxis contribute to the emergence and transmission of NI-resistant influenza strains.
  • To model the impact of NI resistance on pandemic outcomes using the InfluSim program.

Main Methods:

  • Utilized the InfluSim simulation program to model influenza transmission dynamics.
  • Assessed the conditions under which NI-resistant strains can spread, considering transmissibility (fitness) relative to drug-sensitive strains.
  • Evaluated the impact of NI treatment and prophylaxis on the prevalence of resistant strains.

Main Results:

  • A NI-resistant strain requires at least 40% of the fitness of the drug-sensitive strain to spread when R0=2.5.
  • Resistant strains can rapidly become prevalent if their fitness is high, even if resistance emerges late in infection.
  • Antiviral prophylaxis increases selection pressure, favoring resistant strains and potentially increasing influenza cases and deaths.

Conclusions:

  • High-fitness NI-resistant strains, when combined with prophylaxis, can lead to increased hospitalizations and deaths.
  • Restricting NI use to treatment and minimizing prophylaxis is recommended to curb the spread of resistant strains.

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