Hungnes Olav, Dudman Susanne Gjeruldsen
Avdeling for virologi, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo.
Tidsskr Nor Laegeforen. 2008 Nov 20;128(22):2601-6.
Influenza virus infection can be prevented and treated with antiviral drugs. The usage of such drugs in Norway has been infrequent, however, they are an important component in our pandemic preparedness planning, as it will probably be difficult to get access to the appropriate vaccine in time before the pandemic reaches the country. The first generation of influenza drugs acquired resistance to a large degree, in contrast to the modern neuraminidase inhibitors that until recently have had minor problems with resistance.
This review is based on research found in relevant published literature, together with experience from a virology reference laboratory and participation in a national and international surveillance including susceptibility testing.
While resistance has been a longstanding problem with the use of the "old" influenza drugs amantadine and rimantadine, only during the winter 2007/2008 did it become clear, that a certain type of virus acquired widespread resistance against the neuraminidase inhibitor oseltamivir. Resistance surveillance is crucial for the correct choice of empiric treatment for influenza infection, and will be one of the most important tasks at the National Influenza Centre in certain phases of a pandemic. The current situation with an increasing resistance problem strengthens the need to conduct continuous monitoring of antiviral susceptibility, as well as development of new antiviral drugs and treatment regimes.
流感病毒感染可用抗病毒药物预防和治疗。然而，此类药物在挪威的使用并不频繁，不过它们是我们大流行防范计划的重要组成部分，因为在大流行蔓延至该国之前，可能难以及时获得合适的疫苗。第一代流感药物在很大程度上产生了耐药性，而现代神经氨酸酶抑制剂直到最近耐药问题都较小。
本综述基于相关已发表文献中的研究，以及病毒学参考实验室的经验和参与包括药敏试验在内的国家及国际监测的情况。
虽然使用“老”流感药物金刚烷胺和金刚乙胺一直存在耐药问题，但直到2007/2008年冬季才明确，某类病毒对神经氨酸酶抑制剂奥司他韦产生了广泛耐药性。耐药性监测对于正确选择流感感染的经验性治疗至关重要，并且在大流行的某些阶段将是国家流感中心最重要的任务之一。耐药问题日益严重的现状强化了持续监测抗病毒药敏性以及研发新抗病毒药物和治疗方案的必要性。
