25. Antivirals: Targets and use

  1. Robert G. Webster PhD, FRS3,
  2. Arnold S. Monto MD4,
  3. Thomas J. Braciale MD, PhD5 and
  4. Robert A. Lamb PhD, ScD6
  1. Michael G. Ison1 and
  2. Alan Hay2

Published Online: 16 AUG 2013

DOI: 10.1002/9781118636817.ch25

Textbook of Influenza, 2nd Edition

Textbook of Influenza, 2nd Edition

How to Cite

Ison, M. G. and Hay, A. (2013) Antivirals: Targets and use, in Textbook of Influenza, 2nd Edition (eds R. G. Webster, A. S. Monto, T. J. Braciale and R. A. Lamb), John Wiley & Sons, Ltd, Oxford, UK. doi: 10.1002/9781118636817.ch25

Editor Information

  1. 3

    Rose Marie Thomas Chair, Division of Virology, Department of Infectious Diseases, St Jude Children's Research Hospital, Memphis, TN, USA

  2. 4

    Thomas Francis, Jr. Collegiate Professor of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA

  3. 5

    Director, Beirne B. Carter Center for Immunology Research, Beirne B. Carter Professor in Immunology, Professor of Pathology and Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 6

    John Evans Professor of Molecular and Cellular Biology, Howard Hughes Medical Institute, Department of Molecular Biosciences, Northwestern University, Evanston, IL, USA

Author Information

  1. 1

    Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

  2. 2

    Virology Division, MRC National Institute for Medical Research, London, UK

Publication History

  1. Published Online: 16 AUG 2013
  2. Published Print: 16 SEP 2013

ISBN Information

Print ISBN: 9780470670484

Online ISBN: 9781118636817



  • neuraminidase inhibitor;
  • M2 inhibitor;
  • aminoamantadine;
  • influenza;
  • antiviral therapy


The two principal classes of antivirals, which target the virus M2 proton channel or the virus neuraminidase (NA), have been licensed widely for use against influenza. Arbidol, which targets the fusion activity of the hemagglutinin, is also available in Russia and China. The usefulness of amantadine and rimantadine, which are effective only against influenza A viruses, has been largely abrogated by the emergence of resistance in currently circulating viruses. Of the NA inhibitors, oral oseltamivir has been most widely used, in contrast to the inhaled zanamivir and laninamivir and intravenous peramivir. While the incidence of resistance to zanamivir has been low, resistance to oseltamivir, usually due to a His275Tyr mutation in N1 viruses, has been seen more frequently and became established in seasonal influenza globally in 2008–2009 before being replaced by the susceptible pandemic strain. Several new classes of antivirals are under development to expand our armamentarium against influenza.