title: Clinical Implications of Antiviral Resistance in Influenza.
abstract: Influenza is a major cause of severe respiratory infections leading to excessive hospitalizations and deaths globally; annual epidemics, pandemics, and sporadic/endemic avian virus infections occur as a result of rapid, continuous evolution of influenza viruses. Emergence of antiviral resistance is of great clinical and public health concern. Currently available antiviral treatments include four neuraminidase inhibitors (oseltamivir, zanamivir, peramivir, laninamivir), M2-inibitors (amantadine, rimantadine), and a polymerase inhibitor (favipiravir). In this review, we focus on resistance issues related to the use of neuraminidase inhibitors (NAIs). Data on primary resistance, as well as secondary resistance related to NAI exposure will be presented. Their clinical implications, detection, and novel therapeutic options undergoing clinical trials are discussed.
authors.affiliation: Division of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, 9/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China. liman1986@gmail.com.
authors.forename: Timothy C M
authors.initials: TC
authors.lastname: Li
authors.affiliation: Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, 1/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China. martin.chan@cuhk.edu.hk.
authors.forename: Martin C W
authors.initials: MC
authors.lastname: Chan
authors.affiliation: Division of Infectious Diseases, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, 9/F, Clinical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China. leelsn@cuhk.edu.hk.
authors.forename: Nelson
authors.initials: N
authors.lastname: Lee
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024882:Drug Resistance, Viral; D006801:Humans; D007251:Influenza, Human / Q000188:drug therapy* / Q000821:virology*; D009439:Neuraminidase / Q000037:antagonists & inhibitors*; D009975:Orthomyxoviridae / Q000187:drug effects* / Q000201:enzymology; D014764:Viral Proteins / Q000037:antagonists & inhibitors*
chemical_list: D000998:Antiviral Agents; D014764:Viral Proteins; C487630:NA protein, influenza A virus; C541223:NA protein, influenza B virus; D009439:Neuraminidase
keywords: antiviral resistance; influenza viruses; neuraminidase inhibitors