Clinical Implications of Antiviral Resistance in Influenza
Timothy C M Li1, Martin C W Chan2, Nelson Lee3
1Division of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, 9/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China. liman1986@gmail.com.
Abstract:
Influenza is a major cause of severe respiratory infections leading to excessive hospitalizations and deaths globally; annual epidemics, pandemics, and sporadic/endemic avian virus infections occur as a result of rapid, continuous evolution of influenza viruses. Emergence of antiviral resistance is of great clinical and public health concern. Currently available antiviral treatments include four neuraminidase inhibitors (oseltamivir, zanamivir, peramivir, laninamivir), M2-inibitors (amantadine, rimantadine), and a polymerase inhibitor (favipiravir). In this review, we focus on resistance issues related to the use of neuraminidase inhibitors (NAIs). Data on primary resistance, as well as secondary resistance related to NAI exposure will be presented. Their clinical implications, detection, and novel therapeutic options undergoing clinical trials are discussed.
Insights
Influenza virus evolution drives antiviral resistance, particularly to neuraminidase inhibitors (NAIs). This review examines NAI resistance, its clinical impact, detection, and emerging treatments for influenza.
Area of Science:
- Virology
- Infectious Diseases
- Pharmacology
Background:
- Influenza viruses constantly evolve, causing global epidemics and pandemics.
- Antiviral resistance in influenza is a significant clinical and public health challenge.
- Current influenza treatments include neuraminidase inhibitors (NAIs), M2 inhibitors, and favipiravir.
Purpose of the Study:
- To review resistance issues associated with neuraminidase inhibitors (NAIs) for influenza treatment.
- To discuss primary and secondary NAI resistance, including clinical implications and detection methods.
- To explore novel therapeutic options for influenza currently in clinical trials.
Main Methods:
- Literature review focusing on scientific publications and clinical data regarding NAI resistance.
- Analysis of data on primary and secondary resistance mechanisms and prevalence.
- Examination of diagnostic methods for detecting NAI resistance.
- Review of ongoing clinical trials for new influenza therapeutics.
Main Results:
- Data on primary and secondary resistance to NAIs will be presented.
- Clinical implications of NAI resistance will be discussed.
- Current detection methods and emerging therapeutic strategies will be outlined.
Conclusions:
- Understanding and monitoring NAI resistance is crucial for effective influenza management.
- Development of novel antiviral strategies is essential to combat evolving influenza strains.
- Continued research into influenza virus evolution and drug resistance is vital for public health.
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