Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
Curr Opin Virol. 2011 Dec;1(6):574-81. doi: 10.1016/j.coviro.2011.08.006. Epub 2011 Oct 1.
Antiviral drugs are important components for the control of influenza. The key question is whether antiviral use or natural virus evolution will lead to the emergence of drug-resistant virus with comparable or superior fitness to drug-susceptible counterpart. Currently, neuraminidase (NA) inhibitors (NAIs) are the first choice for influenza prevention and treatment. In this article we will review complex process of the risk assessment for the fitness of NAIs-resistant seasonal H1N1 and H3N2, pandemic 2009 H1N1, and highly pathogenic H5N1 influenza A viruses: identification of antiviral susceptibility, degree of functional NA loss, molecular markers of resistance, and evaluation of replicative ability in vivo, virulence and transmissibility in animal studies (mouse, ferret, and guinea pig models).
抗病毒药物是流感防控的重要组成部分。关键问题是抗病毒药物的使用或病毒自然进化是否会导致耐药病毒的出现,这些耐药病毒具有与敏感病毒相当或更优的适应性。目前,神经氨酸酶(NA)抑制剂(NAIs)是流感预防和治疗的首选药物。本文将综述季节性 H1N1 和 H3N2、大流行 2009 年 H1N1 和高致病性 H5N1 甲型流感病毒对 NAI 耐药性的适应性风险评估的复杂过程:抗病毒药物敏感性鉴定、功能性 NA 丧失程度、耐药分子标记物以及体内复制能力评估、动物研究(小鼠、雪貂和豚鼠模型)中的毒力和传播性。