Global update on the susceptibility of human influenza viruses to neuraminidase inhibitors and status of novel antivirals, 2016-2017.

Abstract

A total of 13672 viruses, collected by World Health Organization recognised National Influenza Centres between May 2016 and May 2017, were assessed for neuraminidase inhibitor susceptibility by four WHO Collaborating Centres for Reference and Research on Influenza and one WHO Collaborating Centre for the Surveillance Epidemiology and Control of Influenza. The 50% inhibitory concentration (IC50) was determined for oseltamivir and zanamivir for all viruses, and for peramivir and laninamivir in a subset (n = 8457). Of the viruses tested, 94% were obtained from the Western Pacific, Americas and European WHO regions, while limited viruses were available from the Eastern Mediterranean, African and South East Asian regions. Reduced inhibition (RI) by one or more neuraminidase inhibitor was exhibited by 0.2% of viruses tested (n = 32). The frequency of viruses with RI has remained low since this global analysis began (2015/16: 0.8%, 2014/15: 0.5%; 2013/14: 1.9%; 2012/13: 0.6%) but 2016/17 has the lowest frequency observed to date. Analysis of 13581 neuraminidase sequences retrieved from public databases, of which 5243 sequences were from viruses not included in the phenotypic analyses, identified 58 further viruses (29 without phenotypic analyses) with amino acid substitutions associated with RI by at least one neuraminidase inhibitor. Bringing the total proportion to 0.5% (90/18915). This 2016/17 analysis demonstrates that neuraminidase inhibitors remain suitable for treatment and prophylaxis of influenza virus infections, but continued monitoring is important. An expansion of surveillance testing is paramount since several novel influenza antivirals are in late stage clinical trials with some resistance already having been identified.

• Authors: Angie Lackenby, Terry G Besselaar, Rod S Daniels, Alicia Fry, Vicki Gregory, Larisa V Gubareva, Weijuan Huang, Aeron C Hurt, Sook-Kwan Leang, Raphael T C Lee, Janice Lo, Lori Lollis, Sebastian Maurer-Stroh, Takato Odagiri, Dmitriy Pereyaslov, Emi Takashita, Dayan Wang, Wenqing Zhang, Adam Meijer
• Journal: Antiviral research (Antiviral Res) Vol. 157 Pg. 38-46 (09 2018) ISSN: 1872-9096 [Electronic] Netherlands
• PMID: 29981793 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Chemical References

• Antiviral Agents
• Enzyme Inhibitors
• Neuraminidase

Topics

• Amino Acid Substitution
• Antiviral Agents (pharmacology)
• Drug Resistance, Viral
• Enzyme Inhibitors (pharmacology)
• Global Health
• Humans
• Influenza, Human (epidemiology, virology)
• Inhibitory Concentration 50
• Microbial Sensitivity Tests
• Mutation, Missense
• Neuraminidase (antagonists & inhibitors, genetics)
• Orthomyxoviridae (drug effects, enzymology, isolation & purification)
• Prevalence
• Sequence Analysis, DNA