Giuseppe
Emeritus
[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]
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J Infect Dis. 2012 Aug 20. [Epub ahead of print]
Determinants of Antiviral Effectiveness in H5N1 Avian Influenza.
Chan PK, Lee N, Zaman M, Adisasmito W, Coker R, Hanshaoworakul W, Gasimov V, Oner AF, Dogan N, Tsang O, Phommasack B, Touch S, Swenson A, Toovey S, Dreyer NA.
Source: Faculty of Medicine, The Chinese University of Hong Kong.
Abstract
Background.
Oseltamivir is widely used as treatment for H5N1 infection, but like any intervention, is not always effective.
Methods.
Using Avian Influenza Registry data from ten countries (www.avianfluregistry.org), the risk of death in 215 patients with confirmed H5N1 infections and treated with oseltamivir is examined according to viral clade, age, respiratory failure, and adjunctive treatment with corticosteroids or antibiotics.
Results.
The median age of cases was 18 years, and 50% were male. The highest fatality rate occurred in a country with clade 2.1 virus circulation, and the lowest, in countries with clade 2.2 (p<0.001). In univariate analyses, youth (≤5 years) and treatment within 2 days of symptom onset were protective against fatality. When accounting for all risk factors, early oseltamivir is particularly effective when initiated in the absence of respiratory failure (OR 0.17, p=0.04) . Patients already suffering from advanced respiratory failure requiring ventilatory support at the time of oseltamivir initiation were more likely to die than patients who did not (p<0.001 ). Adjunctive therapy did not improve survival.
Conclusions.
Oseltamivir is especially effective for treating human H5N1 infection when given early and before onset of respiratory failure. Effect of viral clade on fatality and treatment response deserves further investigation.
PMID: 22927451 [PubMed - as supplied by publisher]
-Determinants of Antiviral Effectiveness in H5N1 Avian Influenza.
Chan PK, Lee N, Zaman M, Adisasmito W, Coker R, Hanshaoworakul W, Gasimov V, Oner AF, Dogan N, Tsang O, Phommasack B, Touch S, Swenson A, Toovey S, Dreyer NA.
Source: Faculty of Medicine, The Chinese University of Hong Kong.
Abstract
Background.
Oseltamivir is widely used as treatment for H5N1 infection, but like any intervention, is not always effective.
Methods.
Using Avian Influenza Registry data from ten countries (www.avianfluregistry.org), the risk of death in 215 patients with confirmed H5N1 infections and treated with oseltamivir is examined according to viral clade, age, respiratory failure, and adjunctive treatment with corticosteroids or antibiotics.
Results.
The median age of cases was 18 years, and 50% were male. The highest fatality rate occurred in a country with clade 2.1 virus circulation, and the lowest, in countries with clade 2.2 (p<0.001). In univariate analyses, youth (≤5 years) and treatment within 2 days of symptom onset were protective against fatality. When accounting for all risk factors, early oseltamivir is particularly effective when initiated in the absence of respiratory failure (OR 0.17, p=0.04) . Patients already suffering from advanced respiratory failure requiring ventilatory support at the time of oseltamivir initiation were more likely to die than patients who did not (p<0.001 ). Adjunctive therapy did not improve survival.
Conclusions.
Oseltamivir is especially effective for treating human H5N1 infection when given early and before onset of respiratory failure. Effect of viral clade on fatality and treatment response deserves further investigation.
PMID: 22927451 [PubMed - as supplied by publisher]
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