First case in Italy of acquired resistance to oseltamivir in an immunocompromised patient with influenza A/H1N1v infection.
J Clin Virol, 2010/7;48(3):220-2.
Campanini G[1], Piralla A, Rovida F, Puzelli S, Facchini M, Locatelli F, Minoli L, Percivalle E, Donatelli I, Baldanti F, Surveillance Group for New Influenza A/H1N1v Investigation in Italy
Affiliations
PMID: 20447860DOI: 10.1016/j.jcv.2010.03.027
Impact factor: 14.481
Abstract
A pandemic influenza A/H1N1v strain with the neuraminidase H274Y mutation was detected in nasal secretions of a 2-year-old leukemic patient with influenza-like illness after 18 days of treatment with oseltamivir. At baseline, no drug-resistant virus was found, while 4 days after treatment initiation a mixture of wild-type and mutated virus was detected. After treatment interruption, the wild type influenza virus re-emerged and became prevalent in nasal secretions after a few days, suggesting the lower fitness of the mutated virus strain. The patient slowly improved concurrently with a decrease in virus load, which resulted negative 42 days after diagnosis. No other drug-resistant influenza A/H1N1v virus strains have been detected in Italy (up to the end of November 2009) since the first case of the novel A/H1N1v virus was identified in the country (May 2009).
MeSH terms
Amino Acid Substitution; Antiviral Agents; Bodily Secretions; Child, Preschool; Drug Resistance, Viral; Female; Humans; Immunocompromised Host; Influenza A Virus, H1N1 Subtype; Influenza, Human; Italy; Molecular Sequence Data; Mutation, Missense; Neuraminidase; Nose; Oseltamivir; RNA, Viral; Sequence Analysis, DNA; Treatment Outcome; Viral Load; Viral Proteins; Withholding Treatment
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