학술논문

Replacement of neuraminidase inhibitor‐susceptible influenza A(H1N1) with resistant phenotype in 2008 and circulation of susceptible influenza A and B viruses during 2009‐2013, South Africa
Document Type
Academic Journal
Source
Influenza and Other Respiratory Viruses. September 14, 2018, Vol. 13 Issue 1, p54, 10 p.
Subject
Drug therapy
Analysis
Genetic aspects
Health aspects
Influenza viruses -- Genetic aspects -- Health aspects -- Analysis
Medical research -- Analysis -- Health aspects
Influenza -- Genetic aspects -- Drug therapy
Neuraminidase inhibitors -- Genetic aspects -- Health aspects -- Analysis
Drug approval -- Health aspects -- Analysis
Medicine, Experimental -- Analysis -- Health aspects
Language
English
ISSN
1750-2640
Abstract
INTRODUCTION Annually, influenza virus infections account for an estimated 3‐5 million cases globally, with 250 000‐500 000 deaths. During the 2009 pandemic, an estimated 200 million infections occurred globally and [...]
Background: Data on the susceptibility of influenza viruses from South Africa to neuraminidase inhibitors (NAIs) are scarce, and no extensive analysis was done. Objectives: We aimed to determine oseltamivir and zanamivir susceptibility of influenza A and B virus neuraminidases (NAs), 2007‐2013, South Africa. Patients/Methods: We enrolled participants through national influenza‐like illness surveillance, 2007‐2013. Influenza diagnosis was by virus isolation and quantitative polymerase chain reaction (qPCR). Drug susceptibility was determined by chemiluminescence‐based NA‐STAR/NA‐XTD assay. Sanger sequencing was used to determine molecular markers of NAI resistance. Results: Forty percent (6341/15 985) of participants were positive for influenza viruses using virus isolation (2007‐2009) and qPCR (2009‐2013) methods. A total of 1236/6341 (19.5%) virus isolates were generated of which 307/1236 (25%) were tested for drug susceptibility. During 2007‐2008, the median 50% inhibitory concentration (IC[sub.50]) of oseltamivir for seasonal influenza A(H1N1) increased from of 0.08 nmol/L (range 0.01‐3.60) in 2007 to 73 nmol/L (range 1.56‐305 nmol/L) in 2008. Influenza A isolates from 2009 to 2013 were susceptible to oseltamivir [A(H3N2) median IC[sub.50] = 0.05 nmol/L (range 0.01‐0.08); A(H1N1)pdm09 = 0.11 nmol/L (range 0.01‐0.78)] and zanamivir [A(H3N2) median IC[sub.50] = 0.56 nmol/L (range 0.47‐0.66); A(H1N1)pdm09 = 0.35 nmol/L (range 0.27‐0.533)]. Influenza B viruses were susceptible to both NAIs. NAI resistance‐associated substitutions H275Y, E119V, and R150K (N1 numbering) were not detected in influenza A viruses that circulated in 2009‐2013. Conclusions: We confirm replacement of NAI susceptible by resistant phenotype influenza A(H1N1) in 2008. Influenza A and B viruses (2009‐2013) remained susceptible to NAIs; therefore, these drugs are useful for treating influenza‐infected patients.