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Recovery of drug-resistant influenza virus from immunocompromised patients: a case series

Michael G Ison1, Larisa V Gubareva, Robert L Atmar

  • 1Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, 22908, USA.

The Journal of Infectious Diseases
|February 16, 2006
PubMed

Insights

Antiviral-resistant influenza emerges in immunocompromised patients. Novel mutations in influenza B virus decrease susceptibility to oseltamivir and zanamivir, impacting treatment options.

Area of Science:

  • Virology
  • Immunology
  • Infectious Diseases

Background:

  • Antiviral resistance in influenza viruses, particularly M2 and neuraminidase (NA) inhibitors, poses a significant challenge in treating immunocompromised patients.
  • The emergence of drug-resistant influenza strains can limit therapeutic options and impact patient outcomes.

Observation:

  • Three cases of influenza in severely immunocompromised patients were documented.
  • Virus variants exhibiting molecular markers of resistance to anti-influenza drugs were recovered from these patients.

Findings:

  • Virus variants from two patients displayed mutations in the M2, hemagglutinin, and NA genes, including a known Glu119Val NA substitution.
  • A novel Asp198Asn mutation in the NA gene of an influenza B virus was identified, correlating with decreased susceptibility to oseltamivir and zanamivir.

Implications:

  • The emergence of novel drug-resistant influenza variants, such as the Asp198Asn mutation, highlights the need for continuous surveillance of antiviral resistance in immunocompromised populations.
  • Understanding these resistance mechanisms is crucial for developing effective treatment strategies and new antiviral therapies against influenza.
  • This study underscores the clinical significance of monitoring influenza virus evolution in vulnerable patient groups to ensure treatment efficacy.

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