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Emergence of Oseltamivir-Resistant H7N9 Influenza Viruses in Immunosuppressed Cynomolgus Macaques

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  • Emergence of Oseltamivir-Resistant H7N9 Influenza Viruses in Immunosuppressed Cynomolgus Macaques

    J Infect Dis. 2017 Sep 1;216(5):582-593. doi: 10.1093/infdis/jix296.
    Emergence of Oseltamivir-Resistant H7N9 Influenza Viruses in Immunosuppressed Cynomolgus Macaques.

    Kiso M1, Iwatsuki-Horimoto K1, Yamayoshi S1, Uraki R1, Ito M1, Nakajima N2, Yamada S1, Imai M1, Kawakami E3, Tomita Y1, Fukuyama S1,4, Itoh Y5, Ogasawara K5, Lopes TJS1,6, Watanabe T1,4, Moncla LH6,7, Hasegawa H2, Friedrich TC6,7, Neumann G6, Kawaoka Y1,4,6.
    Author information

    Abstract

    Antiviral compounds (eg, the neuraminidase inhibitor oseltamivir) are invaluable for the treatment of individuals infected with influenza A viruses of the H7N9 subtype (A[H7N9]), which have infected and killed hundreds of persons. However, oseltamivir treatment often leads to the emergence of resistant viruses in immunocompromised individuals. To better understand the emergence and properties of oseltamivir-resistant A(H7N9) viruses in immunosuppressed individuals, we infected immunosuppressed cynomolgus macaques with an A(H7N9) virus and treated them with oseltamivir. Disease severity and mortality were higher in immunosuppressed than in immunocompetent animals. Oseltamivir treatment at 2 different doses reduced A(H7N9) viral titers in infected animals, but even high-dose oseltamivir did not block viral replication sufficiently to suppress the emergence of resistant variants. Some resistant variants were not appreciably attenuated in cultured cells, but an oseltamivir-resistant A(H7N9) virus did not transmit among ferrets. These findings are useful for the control of A(H7N9) virus infections in clinical settings.
    ? The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.


    KEYWORDS:

    Influenza virus; immunosuppression; nonhuman primates; oseltamivir resistance

    PMID: 28931216 DOI: 10.1093/infdis/jix296
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