H275Y Mutant Pandemic (H1N1) 2009 Virus in Immunocompromised Patients
Published Date:Apr 2011
Source:Emerg Infect Dis. 17(4):653-660.
Antiviral Drug Resistance
Drug Resistance, Viral
Influenza A Virus, H1N1 Subtype
Respiratory Tract Infections
Funding:CA15704/CA/NCI NIH HHS/United States
CA18029/CA/NCI NIH HHS/United States
HL93294/HL/NHLBI NIH HHS/United States
Description:Most oseltamivir-resistant pandemic (H1N1) 2009 viruses have been isolated from immunocompromised patients. To describe the clinical features, treatment, outcomes, and virologic data associated with infection from pandemic (H1N1) 2009 virus with H275Y mutation in immunocompromised patients, we retrospectively identified 49 hematology-oncology patients infected with pandemic (H1N1) 2009 virus. Samples from 33 of those patients were tested for H275Y genotype by allele-specific real-time PCR. Of the 8 patients in whom H275Y mutations was identified, 1 had severe pneumonia; 3 had mild pneumonia with prolonged virus shedding; and 4 had upper respiratory tract infection, of whom 3 had prolonged virus shedding. All patients had received oseltamivir before the H275Y mutation was detected; 1 had received antiviral prophylaxis. Three patients excreted resistant virus for >60 days. Emergence of oseltamivir resistance is frequent in immunocompromised patients infected with pandemic (H1N1) 2009 virus and can be associated with a wide range of clinical disease and viral kinetics.
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