Recovery of drug-resistant influenza virus from immunocompromised patients: a case series.
Influenza virus with resistance to antiviral drugs emerges with increased frequency in immunocompromised patients and can limit the benefit of M2 and neuraminidase (NA) inhibitors. We document 3 cases of influenza in severely immunocompromised patients from whom virus variants with molecular markers of resistance to anti-influenza drugs were recovered. Virus variants recovered from 2 patients had mutations in the M2, NA (with a previously recognized Glu119Val NA substitution), and hemagglutinin genes. We describe a novel Asp198Asn NA mutation in an influenza B virus and its decreased susceptibility to both oseltamivir and zanamivir.
Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, 22908, USA.
Michael G
MG
Ison
Larisa V
LV
Gubareva
Robert L
RL
Atmar
John
J
Treanor
Frederick G
FG
Hayden
D000998:Antiviral Agents / Q000494:pharmacology; D002460:Cell Line; D024882:Drug Resistance, Viral / Q000235:genetics*; D004791:Enzyme Inhibitors / Q000494:pharmacology*; D006801:Humans; D016867:Immunocompromised Host; D009980:Influenza A virus / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D009981:Influenza B virus / Q000187:drug effects* / Q000235:genetics; D009154:Mutation; D009439:Neuraminidase / Q000037:antagonists & inhibitors / Q000235:genetics*
D000998:Antiviral Agents; D004791:Enzyme Inhibitors; D009439:Neuraminidase