title: Progressive emergence of an oseltamivir-resistant A(H3N2) virus over two courses of oseltamivir treatment in an immunocompromised paediatric patient.
abstract: A minor viral population of oseltamivir-resistant A(H3N2) viruses (E119V neuraminidase mutation) was selected and maintained in a continually infected immunocompromised child following initial oseltamivir treatment. A subsequent course of oseltamivir given 7 weeks later rapidly selected for the E119V variant resulting in a near-pure population of the resistant virus. The study highlights the challenges of oseltamivir treatment of immunocompromised patients that are continually shedding virus and demonstrates the ability of the E119V oseltamivir-resistant virus to be maintained for prolonged periods even in the absence of drug-selective pressure.
authors.affiliation: WHO Collaborating Centre for Reference and Research on Influenza, North Melbourne, Vic., Australia; School of Applied Sciences, Monash University, Churchill, Vic., Australia.
authors.forename: Aeron C
authors.initials: AC
authors.lastname: Hurt
authors.forename: Sook Kwan
authors.initials: SK
authors.lastname: Leang
authors.forename: Karin
authors.initials: K
authors.lastname: Tiedemann
authors.forename: Jeff
authors.initials: J
authors.lastname: Butler
authors.forename: Francoise
authors.initials: F
authors.lastname: Mechinaud
authors.forename: Anne
authors.initials: A
authors.lastname: Kelso
authors.forename: Peter
authors.initials: P
authors.lastname: Downie
authors.forename: Ian G
authors.initials: IG
authors.lastname: Barr
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002675:Child, Preschool; D024882:Drug Resistance, Viral; D006801:Humans; D016867:Immunocompromised Host; D053122:Influenza A Virus, H3N2 Subtype / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D007251:Influenza, Human / Q000188:drug therapy* / Q000821:virology*; D008297:Male; D020125:Mutation, Missense; D053139:Oseltamivir / Q000494:pharmacology / Q000627:therapeutic use*; D012641:Selection, Genetic
chemical_list: D000998:Antiviral Agents; D053139:Oseltamivir
keywords: E119V NA mutation; immunocompromised; influenza; oseltamivir resistance
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