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Resistance profile of H7N9 requires close monitoring
Antiviral resistance emerges with “ease” in the novel A/H7N9 influenza virus, which is “concerning,” according to results of a recent study.
Zhenghong Yuan, PhD, of the Key Lab of Medical Molecular Virology, School of Basic Medical Science, Shanghai Medical College of Fudan University, and colleagues reviewed viral load data on 14 patients with H7N9 infection who had been admitted to the Shanghai Public Health Clinical Centre in China during a 2-week period in April.
All of the patients developed pneumonia, and seven of those required mechanical ventilation. Three patients became dependent upon extracorporeal membrane oxygenation, and two of those patients died.
The researchers said treating patients quickly with oseltamivir (Tamiflu, Roche) — within 2 days of disease onset — effectively reduced their viral load, but a mutation appeared in two patients, and that mutation helped lead to a viral rebound. Viral load was investigated sequentially in patients’ throat, stool, serum and urine specimens.
Yuan and colleagues said corticosteroids may have contributed to the neuraminidase Arg292Lys mutation, and may have even affected viral load.
The researchers also said the “the fitness and stability of the Arg292Lys mutation in A/H7N9 needs to be investigated.”
Disclosure: Yuan reports no relevant financial disclosures.