Oseltamivir resistance during treatment of influenza A (H5N1) infection.
Influenza A (H5N1) virus with an amino acid substitution in neuraminidase conferring high-level resistance to oseltamivir was isolated from two of eight Vietnamese patients during oseltamivir treatment. Both patients died of influenza A (H5N1) virus infection, despite early initiation of treatment in one patient. Surviving patients had rapid declines in the viral load to undetectable levels during treatment. These observations suggest that resistance can emerge during the currently recommended regimen of oseltamivir therapy and may be associated with clinical deterioration and that the strategy for the treatment of influenza A (H5N1) virus infection should include additional antiviral agents.
de Jong
Menno D
MD
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. mddejong@hcm.vnn.vn
Tran
Tan Thanh
TT
Truong
Huu Khanh
HK
Vo
Minh Hien
MH
Smith
Gavin J D
GJ
Nguyen
Vinh Chau
VC
Bach
Van Cam
VC
Phan
Tu Qui
TQ
Do
Quang Ha
QH
Guan
Yi
Y
Peiris
J S Malik
JS
Tran
Tinh Hien
TH
Farrar
Jeremy
J
D000081:Acetamides / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D019943:Amino Acid Substitution; D000998:Antiviral Agents / Q000627:therapeutic use*; D001483:Base Sequence; D002648:Child; D024882:Drug Resistance, Viral; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000235:genetics / Q000302:isolation & purification; D007251:Influenza, Human / Q000188:drug therapy* / Q000821:virology; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D009439:Neuraminidase / Q000037:antagonists & inhibitors* / Q000235:genetics; D053139:Oseltamivir; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging / Q000821:virology; D011859:Radiography; D017422:Sequence Analysis, DNA; D019562:Viral Load
D000081:Acetamides; D000998:Antiviral Agents; D053139:Oseltamivir; D009439:Neuraminidase