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Oseltamivir Resistance during Treatment of Influenza A (H5N1) Infection

2005; Massachusetts Medical Society; Volume: 353; Issue: 25 Linguagem: Inglês

10.1056/nejmoa054512

1533-4406

M.C.M. de Jong, Tran Tan Thanh, Truong Huu Khanh, Vo Minh Hien, Gavin J. D. Smith, Nguyen Vinh Chau, Bach Van Cam, Phan Tu Qui, Do Quang Ha, Yi Guan, Malik Peiris, Tran Tinh Hien, Jeremy Farrar,

Respiratory viral infections research

Influenza A (H5N1) virus with an amino acid substitution in neuraminidase conferring high-level resistance to oseltamivir was isolated from two of eight Vietnamese patients during oseltamivir treatment. Both patients died of influenza A (H5N1) virus infection, despite early initiation of treatment in one patient. Surviving patients had rapid declines in the viral load to undetectable levels during treatment. These observations suggest that resistance can emerge during the currently recommended regimen of oseltamivir therapy and may be associated with clinical deterioration and that the strategy for the treatment of influenza A (H5N1) virus infection should include additional antiviral agents.