Research Center in Infectious Diseases, Centre hospitalier Univeritaire de Quebec and Laval University, Québec City, Québec, Canada.
Semin Respir Crit Care Med. 2011 Aug;32(4):409-22. doi: 10.1055/s-0031-1283281. Epub 2011 Aug 19.
Influenza viruses are major human pathogens with a global distribution, accounting for more than 500,000 annual deaths worldwide and with considerable impact on the quality of life and productivity of the society. Due to the limited efficacy of vaccination, antiviral drugs constitute a complementary approach in the control and prevention of influenza infections and thus play an important role in the management of influenza outbreaks and pandemics. Currently, adamantanes and neuraminidase inhibitors (NAIs) are the only two classes of anti-influenza agents approved for clinical use. However, the worldwide emergence and high prevalence of adamantane-resistant virus variants has discouraged the use of the former drugs. NAIs have proved to be very effective against influenza A and B viruses. Nevertheless, oseltamivir-resistant strains have also been reported quite frequently, as in the case of seasonal H1N1 viruses that circulated between 2007 and 2009. Indeed, the emergence of drug-resistant virus variants is always a matter of concern because it could significantly compromise the usefulness of such intervention. This highlights the need for continuous monitoring of resistance markers, as well as the development of new anti-influenza drugs and combination therapies.
流感病毒是具有全球分布的主要人类病原体，每年造成全球超过 50 万人死亡，对社会的生活质量和生产力有重大影响。由于疫苗的效果有限，抗病毒药物是控制和预防流感感染的补充方法，因此在流感爆发和大流行的管理中发挥着重要作用。目前，金刚烷胺和神经氨酸酶抑制剂（NAIs）是仅有的两种获准临床使用的抗流感药物。然而，全球范围内出现的和高流行的金刚烷胺耐药病毒变异株已经抑制了对前一种药物的使用。NAIs 已被证明对甲型和乙型流感病毒非常有效。然而，也经常有报道称奥司他韦耐药株的出现，如 2007 年至 2009 年期间流行的季节性 H1N1 病毒。事实上，耐药病毒变异株的出现一直是人们关注的问题，因为这可能会严重影响此类干预措施的有效性。这凸显了持续监测耐药标志物以及开发新的抗流感药物和联合疗法的必要性。
