Emergence of drug-resistant influenza virus: population dynamical considerations.
Given the considerable challenges to the rapid development of an effective vaccine against influenza, antiviral agents will play an important role as a first-line defense if a new pandemic occurs. The large-scale use of drugs for chemoprophylaxis and treatment will impose strong selection for the evolution of drug-resistant strains. The ensuing transmission of those strains could substantially limit the effectiveness of the drugs as a first-line defense. Summarizing recent data on the rate at which the treatment of influenza infection generates resistance de novo and on the transmission fitness of resistant virus, we discuss possible implications for the epidemiological spread of drug resistance in the context of an established population dynamic model.
Regoes
Roland R
RR
Institute of Integrative Biology, ETH Zürich, ETH Zentrum CHN K12.1, Universitätsstrasse 16, CH 8092 Zürich, Switzerland.
Bonhoeffer
Sebastian
S
D000081:Acetamides / Q000494:pharmacology / Q000627:therapeutic use; D000547:Amantadine / Q000494:pharmacology / Q000627:therapeutic use; D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D003198:Computer Simulation; D004196:Disease Outbreaks; D024882:Drug Resistance, Viral / Q000235:genetics; D006801:Humans; D009980:Influenza A virus / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D007251:Influenza, Human / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D008433:Mathematics; D008954:Models, Biological; D009154:Mutation; D009439:Neuraminidase / Q000037:antagonists & inhibitors; D009975:Orthomyxoviridae / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D053139:Oseltamivir; D011157:Population Dynamics
D000081:Acetamides; D000998:Antiviral Agents; D053139:Oseltamivir; D000547:Amantadine; D009439:Neuraminidase