Opinion Article - Virology Research Journal (2023) Volume 7, Issue 2
Antiviral resistance: implications for drug development and clinical practice
Chou Pacheco*
Department of Infectious Diseases, Oregon Health & Science University, Portland, USA
- Corresponding Author:
- Chou Pacheco
Department of Infectious Diseases
Oregon Health & Science
University Portland, USA
E-mail: chou@ohsu.edu
Received: 30-Dec-2022, Manuscript No. AAVRJ-23-90736; Editor assigned: 03-Jan-2023, PreQC No. AAVRJ-23-90736 (PQ); Reviewed: 17-Jan-2023, QC No. AAVRJ-23-90736; Revised: 23-Jan-2023, Manuscript No. AAVRJ-23-90736(R); Published: 30-Jan-2023, DOI:10.35841/AAVRJ-7.2.136
Citation: Pacheco C. Antiviral resistance: implications for drug development and clinical practice. Virol Res J. 2023;7(2):136
Introduction
Antiviral resistance is a phenomenon in which viruses develop resistance to antiviral agents, making the drugs less effective or completely ineffective. This poses a significant challenge for drug development and clinical practice, as the effectiveness of antiviral agents is crucial for the treatment and prevention of viral infections. In this essay, we will discuss the implications of antiviral resistance for drug development and clinical practice [1].
Antiviral resistance is a major concern for the development of new antiviral drugs. This is because viruses can develop resistance to drugs through various mechanisms, including mutations in their genes, alterations in the target site of the drug, and the acquisition of resistance genes from other viruses. As a result, it is essential to design antiviral agents that can overcome these resistance mechanisms.
One approach to developing antiviral agents that are less susceptible to resistance is to target multiple stages of the viral life cycle. For example, the drug combination therapy, which involves using two or more drugs that target different stages of the viral life cycle, has been effective in treating HIV and hepatitis C virus infections. By targeting multiple stages of the viral life cycle, it becomes more difficult for the virus to develop resistance to the drugs. Another approach to combating antiviral resistance is to use drugs that target host factors that are essential for viral replication. For example, some antiviral drugs target the host cell enzymes that the virus requires for replication, rather than targeting the virus directly. These drugs are less likely to be affected by viral mutations and can reduce the likelihood of resistance.
The development of new antiviral drugs is also influenced by the potential for resistance. Drug developers must take into account the potential for resistance when designing new drugs and must test them against different strains of the virus to ensure their effectiveness. They must also consider the potential for cross-resistance, where resistance to one drug can lead to resistance to another drug in the same class. Antiviral resistance also has significant implications for clinical practice [2]. In many cases, the development of antiviral resistance can lead to treatment failure, making it difficult to control viral infections. This is particularly true for chronic viral infections such as HIV and hepatitis C virus, where the long-term use of antiviral drugs can lead to the emergence of drug-resistant strains.
In the case of HIV, drug resistance is a significant problem due to the high mutation rate of the virus and the fact that the virus can replicate rapidly, leading to the emergence of drug-resistant strains. This has led to the development of new classes of drugs, such as integrase inhibitors and entry inhibitors, that target different stages of the viral life cycle and are less susceptible to resistance. However, the emergence of drug-resistant strains remains a significant challenge in the management of HIV.
Similarly, the development of drug resistance is also a significant problem in the treatment of hepatitis C virus infections. This is due to the fact that the virus can rapidly evolve and develop resistance to drugs, particularly when the drugs are used as monotherapy. The use of combination therapy has been effective in reducing the incidence of drug resistance in hepatitis C virus infections.In addition to the development of new drugs, clinical practice also involves the monitoring of antiviral resistance. This involves the regular testing of viral loads and resistance mutations to ensure that the treatment is effective and to detect the emergence of drugresistant strains. This information is used to guide treatment decisions and to adjust treatment regimens as necessary [3-5].
In conclusion, antiviral resistance is a significant challenge for drug development and clinical practice. The development of new antiviral drugs that are less susceptible to resistance and the use of combination therapy can help to overcome this challenge. However, the monitoring of antiviral resistance is also essential to ensure that treatment is effective and to detect the emergence of drug-resistant strains.
References
- Villet S, Ollivet A, Pichoud C, et al. Stepwise process for the development of entecavir resistance in a chronic hepatitis B virus infected patient. J Hepatol. 2007;46(3):531–8.
- Trojan J. Treatment of patients with lamivudine-resistant and adefovir dipivoxil-resistant chronic hepatitis B virus infection: is tenofovir the answer. Gut. 2007;56(3):436–7.
- Yim HJ. Evolution of multi-drug resistant hepatitis B virus during sequential therapy. Hepatology. 2006;44(3):703–12.
- Van Bommel F, Wunsche T. Comparison of adefovir and tenofovir in the treatment of lamivudine-resistant hepatitis B virus infection. Hepatology. 2004;40(6):1421–5.
- Tenney DJ, Rose RE. Two-year assessment of entecavir resistance in Lamivudine-refractory hepatitis B virus patients reveals different clinical outcomes depending on the resistance substitutions present. Antimicrob Agents Chemother. 2007;51(3):902–11.
Indexed at, Google Scholar, Cross Ref
Indexed at, Google Scholar, Cross Ref
Indexed at, Google Scholar, Cross Ref
Indexed at, Google Scholar, Cross Ref