Influenza and antiviral agents

Abstract

Neuraminidase inhibitors, including oseltamivir and zanamivir are the recommended licensed anti-influenza drugs. However, the emergence in 2007 of oseltamivir-resistant and in 2009 of pandemic A(H1N1) influenza viruses highlighted the need for more efficient antiviral agents for influenza treatment. In this article, we review the advances in knowledge, based on experience from the last pandemic in particular, for patients admitted to the intensive care unit for severe influenza infection. We also focus on undergoing trials evaluating the efficiency of parenteral administration of oseltamivir, zanamivir or peramivir, the associations of antiviral agents, as well as laninamivir, a new long-acting neuraminidase inhibitor. Favipiravir, a polymerase inhibitor and DAS181, a sialidase removing the sialic acids within the host epithelial respiratory tract, are also undergoing clinical trials. In vitro studies showed that small interfering RNAs are able to inhibit the expression of influenza viral RNA and nitazoxide to block the terminal glycosylation of haemagglutinins. To date, new drugs are being actively developed to improve influenza treatment.