Hurt Aeron C
WHO Collaborating Centre for Reference and Research on Influenza, North Melbourne, Victoria 3051, Australia.
Curr Opin Virol. 2014 Oct;8:22-9. doi: 10.1016/j.coviro.2014.04.009. Epub 2014 May 24.
Significant changes in the circulation of antiviral-resistant influenza viruses have occurred over the last decade. The emergence and continued circulation of adamantane-resistant A(H3N2) and A(H1N1)pdm09 viruses mean that the adamantanes are no longer recommended for use. Resistance to the newer class of drugs, the neuraminidase inhibitors, is typically associated with poorer viral replication and transmission. But 'permissive' mutations, that compensated for impairment of viral function in A(H1N1) viruses during 2007/2008, enabled them to acquire the H275Y NA resistance mutation without fitness loss, resulting in their rapid global spread. Permissive mutations now appear to be present in A(H1N1)pdm09 viruses thereby increasing the risk that oseltamivir-resistant A(H1N1)pdm09 viruses may also spread globally, a concerning scenario given that oseltamivir is the most widely used influenza antiviral.
在过去十年中，对抗病毒耐药的流感病毒的传播情况发生了显著变化。对金刚烷耐药的A(H3N2)和A(H1N1)pdm09病毒的出现及持续传播意味着不再推荐使用金刚烷类药物。对新型药物神经氨酸酶抑制剂的耐药性通常与病毒复制和传播能力较差有关。但是，在2007/2008年期间，A(H1N1)病毒中出现的“允许性”突变弥补了病毒功能的损害，使它们能够获得H275Y神经氨酸酶耐药突变且不损失适应性，从而导致其在全球迅速传播。现在，A(H1N1)pdm09病毒中似乎也存在允许性突变，这增加了对奥司他韦耐药的A(H1N1)pdm09病毒也可能在全球传播的风险，鉴于奥司他韦是使用最广泛的流感抗病毒药物，这是一个令人担忧的情况。
