Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Leidos, Reston, Virginia, USA.
Clin Infect Dis. 2022 Feb 11;74(3):532-540. doi: 10.1093/cid/ciab625.
Prompt antiviral treatment has the potential to reduce influenza virus transmission to close contacts, but rigorous data on the magnitude of treatment effects on transmission are limited. Animal model data indicate that rapid reductions in viral replication after antiviral treatment reduce the risk of transmission. Observational and clinical trial data with oseltamivir and other neuraminidase inhibitors indicate that prompt treatment of household index patients seems to reduce the risk of illness in contacts, although the magnitude of the reported effects has varied widely across studies. In addition, the potential risk of transmitting drug-resistant variants exists with all approved classes of influenza antivirals. A controlled trial examining baloxavir treatment efficacy to reduce transmission, including the risk of transmitting virus with reduced baloxavir susceptibility, is currently in progress. If reduced transmission risk is confirmed, modeling studies indicate that early treatment could have major epidemiologic benefits in seasonal and pandemic influenza.
抗病毒治疗有可能降低流感病毒向密切接触者的传播，但关于治疗对传播影响的严格数据有限。动物模型数据表明，抗病毒治疗后病毒复制的迅速减少降低了传播的风险。奥司他韦和其他神经氨酸酶抑制剂的观察性和临床试验数据表明，迅速治疗家庭指数患者似乎可以降低接触者患病的风险，尽管报告的效果大小在不同的研究中差异很大。此外，所有批准的流感抗病毒药物类别都存在传播耐药变异体的潜在风险。目前正在进行一项临床试验，以评估巴洛沙韦治疗减少传播的疗效，包括传播对巴洛沙韦敏感性降低的病毒的风险。如果降低传播风险得到证实，模型研究表明，季节性和大流行性流感的早期治疗可能具有重大的流行病学益处。
