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. Atbaseline, no drug-resistant virus was found, while 4 days after treatment initiation a mixture 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). (C) 2010 Elsevier B.V. All rights reserved.
Campanini, G., Piralla, A., Rovida, F., Puzelli, S., Facchini, M., Locatelli, F., Minoli, L., Percivalle, E., Donatelli, I., Baldanti, F., First case in Italy of acquired resistance to oseltamivir in an immunocompromised patient with influenza A/H1N1v infection, <<JOURNAL OF CLINICAL VIROLOGY>>, 2010; 48 (3): 220-222. [doi:10.1016/j.jcv.2010.03.027] [https://hdl.handle.net/10807/250576]
First case in Italy of acquired resistance to oseltamivir in an immunocompromised patient with influenza A/H1N1v infection
Locatelli, Franco;
2010
Abstract
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. Atbaseline, no drug-resistant virus was found, while 4 days after treatment initiation a mixture 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). (C) 2010 Elsevier B.V. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.