tetano
Editor, Senior Moderator
Antivir Ther. 2015 Apr 7. doi: 10.3851/IMP2957. [Epub ahead of print]
[h=1]Viral shedding and susceptibility to oseltamivir in hospitalized immunocompromized patients with influenza in the Influenza Resistance Information Study (IRIS).[/h] Fraaij P[SUP]1[/SUP], Schutten M, Javouhey E, Burleigh L, Outlaw R, Kumar D, Boucher CA.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Immunocompromised patients are at greater risk of complicated influenza and may be more likely to develop antiviral resistance. This observational sub-study of the Influenza Resistance Information Study (NCT00884117) aimed to study antiviral resistance in immunocompromised patients with influenza, and characterize its effect on clinical and virological outcomes.
[h=4]METHODS:[/h] Eligible immunocompromised patients were aged ≥1 year with a local rapid diagnostic or PCR test positive for influenza ≤96 hours after diagnosis, and with influenza symptoms. Nasal and throat swabs were taken for RT-PCR analysis on Day 1, then every 3 days until patients were virus-free. Resistance was assessed by mutation-specific RT-PCR, phenotypic susceptibility analysis and Sanger sequencing.
[h=4]RESULTS:[/h] Of 42 patients enrolled, 29 (69%) were influenza-positive (RT-PCR) on Day 1: 18 adults and 11 children aged 1-12 years. Six patients were severely immunocompromised. On Days 3, 6 and 9, most patients tested (18/24, 9/15 and 6/9, respectively) had not cleared the virus. Two of five patients assessed after Day 9 continued shedding virus until Day 15. H1N1pdm09 viruses harbouring H275Y mutations were detected in post-baseline samples from four patients (aged 52-61 years), one of whom had prolonged viral shedding. No genotypic antiviral resistance was detected in the other 20 treated patients (prevalence of resistance, 17%). Correlation between level of immune compromise and resistance or outcomes could not be assessed. Ten patients (seven influenza-positive) were admitted to intensive care and three died.
[h=4]CONCLUSIONS:[/h] In these patients with mild/moderate immune compromised, emergence of oseltamivir-resistant viruses was not common. Severity of influenza symptoms ranged from mild to moderate, but correlation with level of compromise could not be determined.
PMID: 25849228 [PubMed - as supplied by publisher]
[h=1]Viral shedding and susceptibility to oseltamivir in hospitalized immunocompromized patients with influenza in the Influenza Resistance Information Study (IRIS).[/h] Fraaij P[SUP]1[/SUP], Schutten M, Javouhey E, Burleigh L, Outlaw R, Kumar D, Boucher CA.
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Immunocompromised patients are at greater risk of complicated influenza and may be more likely to develop antiviral resistance. This observational sub-study of the Influenza Resistance Information Study (NCT00884117) aimed to study antiviral resistance in immunocompromised patients with influenza, and characterize its effect on clinical and virological outcomes.
[h=4]METHODS:[/h] Eligible immunocompromised patients were aged ≥1 year with a local rapid diagnostic or PCR test positive for influenza ≤96 hours after diagnosis, and with influenza symptoms. Nasal and throat swabs were taken for RT-PCR analysis on Day 1, then every 3 days until patients were virus-free. Resistance was assessed by mutation-specific RT-PCR, phenotypic susceptibility analysis and Sanger sequencing.
[h=4]RESULTS:[/h] Of 42 patients enrolled, 29 (69%) were influenza-positive (RT-PCR) on Day 1: 18 adults and 11 children aged 1-12 years. Six patients were severely immunocompromised. On Days 3, 6 and 9, most patients tested (18/24, 9/15 and 6/9, respectively) had not cleared the virus. Two of five patients assessed after Day 9 continued shedding virus until Day 15. H1N1pdm09 viruses harbouring H275Y mutations were detected in post-baseline samples from four patients (aged 52-61 years), one of whom had prolonged viral shedding. No genotypic antiviral resistance was detected in the other 20 treated patients (prevalence of resistance, 17%). Correlation between level of immune compromise and resistance or outcomes could not be assessed. Ten patients (seven influenza-positive) were admitted to intensive care and three died.
[h=4]CONCLUSIONS:[/h] In these patients with mild/moderate immune compromised, emergence of oseltamivir-resistant viruses was not common. Severity of influenza symptoms ranged from mild to moderate, but correlation with level of compromise could not be determined.
PMID: 25849228 [PubMed - as supplied by publisher]