Abstract
Prolonged treatment of an immunocompromised child with oseltamivir and zanamivir for A(H1N1)pdm09 virus infection led to the emergence of viruses carrying H275Y and/or E119G in the neuraminidase (NA). When phenotypically evaluated by NA inhibition, the dual H275Y-E119G substitution caused highly reduced inhibition by 4 NA inhibitors: oseltamivir, zanamivir, peramivir, and laninamivir.
Keywords:
drug resistance; neuraminidase; oseltamivir; pyrosequencing; zanamivir.
Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Acids, Carbocyclic
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Amino Acid Substitution
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Antiviral Agents / therapeutic use*
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Cyclopentanes / therapeutic use
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Drug Resistance, Viral / genetics*
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Enzyme Inhibitors / therapeutic use*
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Guanidines / therapeutic use
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Humans
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Immunocompromised Host
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Infant
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Influenza A Virus, H1N1 Subtype / drug effects
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Influenza A Virus, H1N1 Subtype / genetics*
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Influenza, Human / drug therapy
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Influenza, Human / virology*
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Male
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Mutation, Missense
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Neuraminidase / genetics*
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Oseltamivir / therapeutic use
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Pyrans
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Sialic Acids
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Viral Proteins / genetics
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Zanamivir / analogs & derivatives
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Zanamivir / therapeutic use
Substances
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Acids, Carbocyclic
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Antiviral Agents
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Cyclopentanes
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Enzyme Inhibitors
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Guanidines
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Pyrans
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Sialic Acids
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Viral Proteins
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Oseltamivir
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laninamivir
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Neuraminidase
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Zanamivir
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peramivir