Current and future antiviral therapy of severe seasonal and avian influenza.

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Beigel J, Bray M

Current and future antiviral therapy of severe seasonal and avian influenza.

Antiviral Res. 2008 Apr;78(1):91-102. doi: 10.1016/j.antiviral.2008.01.003. Epub 2008 Feb 4.

PubMed ID

18328578 [ View in PubMed

]

Abstract

The currently circulating H3N2 and H1N1 subtypes of influenza A virus cause a transient, febrile upper respiratory illness in most adults and children ("seasonal influenza"), but infants, the elderly, immunodeficient and chronically ill persons may develop life-threatening primary viral pneumonia or complications such as bacterial pneumonia. By contrast, avian influenza viruses such as the H5N1 virus that recently emerged in Southeast Asia can cause severe disease when transferred from domestic poultry to previously healthy people ("avian influenza"). Most H5N1 patients present with fever, cough and shortness of breath that progress rapidly to adult respiratory distress syndrome. In seasonal influenza, viral replication remains confined to the respiratory tract, but limited studies indicate that H5N1 infections are characterized by systemic viral dissemination, high cytokine levels and multiorgan failure. Gastrointestinal infection and encephalitis also occur. The licensed anti-influenza drugs (the M2 ion channel blockers, amantadine and rimantadine, and the neuraminidase inhibitors, oseltamivir and zanamivir) are beneficial for uncomplicated seasonal influenza, but appropriate dosing regimens for severe seasonal or H5N1 viral infections have not been defined. Treatment options may be limited by the rapid emergence of drug-resistant viruses. Ribavirin has also been used to a limited extent to treat influenza. This article reviews licensed drugs and treatments under development, including high-dose oseltamivir; parenterally administered neuraminidase inhibitors, peramivir and zanamivir; dimeric forms of zanamivir; the RNA polymerase inhibitor T-705; a ribavirin prodrug, viramidine; polyvalent and monoclonal antibodies; and combination therapies.

DrugBank Data that Cites this Article

Drugs

Favipiravir

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Amantadine	Matrix protein 2	Protein	Influenza A virus (strain A/Ann Arbor/6/1960 H2N2)	Yes	Inhibitor	Details

Drug Interactions

Drugs	Interaction
Integrate drug-drug interactions in your software
Adenovirus type 7 vaccine live Rimantadine	The therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Rimantadine.
Adenovirus type 7 vaccine live Amantadine	The therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Amantadine.
Anthrax vaccine Rimantadine	The therapeutic efficacy of Anthrax vaccine can be decreased when used in combination with Rimantadine.
Anthrax vaccine Amantadine	The therapeutic efficacy of Anthrax vaccine can be decreased when used in combination with Amantadine.
Bacillus calmette-guerin substrain connaught live antigen Rimantadine	The therapeutic efficacy of Bacillus calmette-guerin substrain connaught live antigen can be decreased when used in combination with Rimantadine.