Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA.
J Infect Dis. 2012 Jun;205(11):1642-5. doi: 10.1093/infdis/jis265. Epub 2012 Mar 23.
Emergence of resistance is a major concern in influenza antiviral treatment and prophylaxis. Combination antiviral therapy might overcome this problem. Here, we estimate that all possible single mutants and a sizeable fraction of double mutants are generated during an uncomplicated influenza infection. While most of them may sustain a fitness cost, some variants may confer drug resistance and be selected during therapy. We argue that a triple combination regimen would markedly reduce the risk of antiviral resistance emergence in seasonal and pandemic influenza viruses, especially in seriously ill or immunocompromised hosts.
耐药性的出现是流感抗病毒治疗和预防的主要关注点。联合抗病毒治疗可能会克服这个问题。在这里，我们估计在一次简单的流感感染过程中会产生所有可能的单突变体和相当一部分的双突变体。虽然它们中的大多数可能会维持一定的适应性成本，但一些变体可能会产生耐药性，并在治疗过程中被选择。我们认为，三联疗法将显著降低季节性和大流行性流感病毒出现抗病毒耐药性的风险，特别是在重病或免疫功能低下的宿主中。
