6533b821fe1ef96bd127afda
RESEARCH PRODUCT
First case in Italy of acquired resistance to oseltamivir in an immunocompromised patient with influenza A/H1N1v infection
Campanini GPiralla ARovida FPuzelli SFacchini MLocatelli FMinoli LPercivalle EDonatelli IBaldanti FSurveillance Group For New Influenza A/h1n1v Investigation In ItalyPierlanfranco D'agarosubject
Bodily SecretionsvirusesResistanceDrug ResistanceSettore MED/42 - Igiene Generale E Applicatamedicine.disease_causePandemic H1N1v Oseltamivir Resistancechemistry.chemical_compoundInfluenza A Virus H1N1 SubtypePandemicInfluenza A virusInfluenza A VirusViralChildViral LoadTreatment OutcomeInfectious DiseasesItalyChild PreschoolRNA ViralFemaleViral diseaseViral loadH1N1vSequence AnalysisH1N1v; Oseltamivir; Pandemic; Resistance; Amino Acid Substitution; Antiviral Agents; Bodily Secretions; Child Preschool; 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; Drug Resistance Viral; Virology; Infectious DiseasesHumanOseltamivirMolecular Sequence DataMutation MissenseNeuraminidaseBiologyNoseAntiviral AgentsVirusresistanceImmunocompromised HostViral ProteinsOseltamivirVirologyDrug Resistance ViralInfluenza HumanmedicineHumansH1N1 SubtypePreschoolInfluenza-like illnessPandemicSequence Analysis DNADNAVirologyInfluenzaInfluenza; A/H1N1v; Oseltamivir; resistancechemistryAmino Acid SubstitutionWithholding TreatmentMutationbiology.proteinRNAA/H1N1vMissenseNeuraminidasedescription
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 mix- ture 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).
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2010-01-01 |