Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 205, Issue 11, Pages 1642-1645Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jis265
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Funding
- US Department of Energy [DE-AC52-06NA25396]
- National Institutes of Health [P30-EB011339, HHSN272201000055C, OD011095]
- Los Alamos National Laboratory LDRD
- National Science Foundation [DMS-1122290, PHY05-51164]
- GSK
- Roche
- Direct For Mathematical & Physical Scien
- Division Of Mathematical Sciences [1122290] Funding Source: National Science Foundation
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Emergence of resistance is a major concern in influenza antiviral treatment and prophylaxis. Combination antiviral therapy might overcome this problem. Here, we estimate that all possible single mutants and a sizeable fraction of double mutants are generated during an uncomplicated influenza infection. While most of them may sustain a fitness cost, some variants may confer drug resistance and be selected during therapy. We argue that a triple combination regimen would markedly reduce the risk of antiviral resistance emergence in seasonal and pandemic influenza viruses, especially in seriously ill or immunocompromised hosts.
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