Abstract
Drug resistance in antiviral therapy is a major public health challenge. This resistance can occur among immunocompromised patients where persistent viral replication and protracted drug exposure result in selection of resistant strains. Consequences of drug resistance range from toxicity inherent in the use of second-line antiviral agents, severe disease, and even death (from progressive viral infection when no effective alternative treatment is available). Although scientific technology has identified a number of these proximal mechanisms of antiviral resistance, bigger evolutionary trends of the viruses remain obscure. New metrics for evaluating mutations, recombination rates, demographic histories of transmission, and selective forces during viral adaptation to antiviral drug treatment have been developed. Understanding levels of resistance and cross-resistance conferred by diverse mutations is required for accurate interpretation of genotypic assays. Identification of viral resistance to drug therapy is possible by linking distinctive viral alterations (phenotypic resistance) to a number of antiviral drugs. To reduce antiviral resistance, there is the need to optimize drug administration, select alternate therapy based on knowledge of resistance mechanisms, and develop novel antivirals. Experimental drugs with various viral targets are being investigated, and these agents may offer better treatment options. In this chapter, we delve into the mechanisms of viral resistance, manifestation of antiviral resistance, detection of antiviral resistance, and clinical implications of drug resistance in viruses.
Original language | English |
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Title of host publication | Viral Drug Delivery Systems |
Subtitle of host publication | Advances in Treatment of Infectious Diseases |
Publisher | Springer International Publishing |
Pages | 17-26 |
Number of pages | 10 |
ISBN (Electronic) | 9783031205378 |
ISBN (Print) | 9783031205361 |
DOIs | |
Publication status | Published - 1 Jan 2023 |
Keywords
- DNA polymerase
- Famciclovir
- Hepatitis B virus
- Lamivudine
- Resistance
- Varicella-zoster virus