FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 353:2667-2672 December 22, 2005 Number 25 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Moscona, A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

SUMMARY

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.

Source Information

From the Oxford University Clinical Research Unit, Hospital for Tropical Diseases (M.D.J., T.T.T., D.Q.H., J.F.), Pediatric Hospital Number One (T.H.K., B.V.C., P.T.Q.), and the Hospital for Tropical Diseases (V.M.H., N.V.C., T.T.H.)— all in Ho Chi Minh City, Vietnam; and the Department of Microbiology, University of Hong Kong, Queen Mary Hospital, Hong Kong Special Administrative Region, China (G.J.D.S., Y.G., J.S.M.P.).

Address reprint requests to Dr. de Jong at the Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Vietnam, or at mddejong{at}hcm.vnn.vn.

Full Text of this Article

Related Letters:

Oseltamivir Resistance in Influenza A (H5N1) Infection
Gupta R. K., Nguyen-Van-Tam J. S., de Jong M. D., Hien T. T., Farrar J.
Extract | Full Text | PDF  
N Engl J Med 2006; 354:1423-1424, Mar 30, 2006. Correspondence

This article has been cited by other articles:

• Thomas, Y., Vogel, G., Wunderli, W., Suter, P., Witschi, M., Koch, D., Tapparel, C., Kaiser, L. (2008). Survival of Influenza Virus on Banknotes. Appl. Environ. Microbiol. 74: 3002-3007 [Abstract] [Full Text]  
• Sandrock, C., Stollenwerk, N. (2008). Acute Febrile Respiratory Illness in the ICU: Reducing Disease Transmission. Chest 133: 1221-1231 [Abstract] [Full Text]  
• Christian, M. D., Devereaux, A. V., Dichter, J. R., Geiling, J. A., Rubinson, L. (2008). Definitive Care for the Critically Ill During a Disaster: Current Capabilities and Limitations: From a Task Force for Mass Critical Care Summit Meeting, January 26-27, 2007, Chicago, IL. Chest 133: 8S-17S [Abstract] [Full Text]  
• Korteweg, C., Gu, J. (2008). Pathology, Molecular Biology, and Pathogenesis of Avian Influenza A (H5N1) Infection in Humans. Am. J. Pathol. 172: 1155-1170 [Abstract] [Full Text]  
• Gabriel, G., Nordmann, A., Stein, D. A., Iversen, P. L., Klenk, H.-D. (2008). Morpholino oligomers targeting the PB1 and NP genes enhance the survival of mice infected with highly pathogenic influenza A H7N7 virus. J. Gen. Virol. 89: 939-948 [Abstract] [Full Text]  
• Watanabe, T., Watanabe, S., Kim, J. H., Hatta, M., Kawaoka, Y. (2008). Novel Approach to the Development of Effective H5N1 Influenza A Virus Vaccines: Use of M2 Cytoplasmic Tail Mutants. J. Virol. 82: 2486-2492 [Abstract] [Full Text]  
• Ruat, C., Caillet, C., Bidaut, A., Simon, J., Osterhaus, A. D. M. E. (2008). Vaccination of Macaques with Adjuvanted Formalin-Inactivated Influenza A Virus (H5N1) Vaccines: Protection against H5N1 Challenge without Disease Enhancement. J. Virol. 82: 2565-2569 [Abstract] [Full Text]  
• Writing Committee of the Second World Health Organ, (2008). Update on Avian Influenza A (H5N1) Virus Infection in Humans. NEJM 358: 261-273 [Full Text]  
• Yen, H.-L., Ilyushina, N. A., Salomon, R., Hoffmann, E., Webster, R. G., Govorkova, E. A. (2007). Neuraminidase Inhibitor-Resistant Recombinant A/Vietnam/1203/04 (H5N1) Influenza Viruses Retain Their Replication Efficiency and Pathogenicity In Vitro and In Vivo. J. Virol. 81: 12418-12426 [Abstract] [Full Text]  
• Zhou, B., Zhong, N., Guan, Y. (2007). Treatment with Convalescent Plasma for Influenza A (H5N1) Infection. NEJM 357: 1450-1451 [Full Text]  
• Ducatez, M. F., Olinger, C. M., Owoade, A. A., Tarnagda, Z., Tahita, M. C., Sow, A., De Landtsheer, S., Ammerlaan, W., Ouedraogo, J. B., Osterhaus, A. D. M. E., Fouchier, R. A. M., Muller, C. P. (2007). Molecular and antigenic evolution and geographical spread of H5N1 highly pathogenic avian influenza viruses in western Africa. J. Gen. Virol. 88: 2297-2306 [Abstract] [Full Text]  
• Yin, C., Khan, J. A., Swapna, G. V. T., Ertekin, A., Krug, R. M., Tong, L., Montelione, G. T. (2007). Conserved Surface Features Form the Double-stranded RNA Binding Site of Non-structural Protein 1 (NS1) from Influenza A and B Viruses. J. Biol. Chem. 282: 20584-20592 [Abstract] [Full Text]  
• Yen, H.-L., Lipatov, A. S., Ilyushina, N. A., Govorkova, E. A., Franks, J., Yilmaz, N., Douglas, A., Hay, A., Krauss, S., Rehg, J. E., Hoffmann, E., Webster, R. G. (2007). Inefficient Transmission of H5N1 Influenza Viruses in a Ferret Contact Model. J. Virol. 81: 6890-6898 [Abstract] [Full Text]  
• Lindegardh, N., Davies, G. R., Hien, T. T., Farrar, J., Singhasivanon, P., Day, N. P. J., White, N. J. (2007). Importance of Collection Tube during Clinical Studies of Oseltamivir. Antimicrob. Agents Chemother. 51: 1835-1836 [Abstract] [Full Text]  
• Hatakeyama, S., Sugaya, N., Ito, M., Yamazaki, M., Ichikawa, M., Kimura, K., Kiso, M., Shimizu, H., Kawakami, C., Koike, K., Mitamura, K., Kawaoka, Y. (2007). Emergence of Influenza B Viruses With Reduced Sensitivity to Neuraminidase Inhibitors. JAMA 297: 1435-1442 [Abstract] [Full Text]  
• Peiris, J. S. M., de Jong, M. D., Guan, Y. (2007). Avian Influenza Virus (H5N1): a Threat to Human Health. Clin. Microbiol. Rev. 20: 243-267 [Abstract] [Full Text]  
• Govorkova, E. A., Ilyushina, N. A., Boltz, D. A., Douglas, A., Yilmaz, N., Webster, R. G. (2007). Efficacy of Oseltamivir Therapy in Ferrets Inoculated with Different Clades of H5N1 Influenza Virus. Antimicrob. Agents Chemother. 51: 1414-1424 [Abstract] [Full Text]  
• Tsiodras, S., Mooney, J. D, Hatzakis, A. (2007). Role of combination antiviral therapy in pandemic influenza and stockpiling implications. BMJ 334: 293-294 [Full Text]  
• Thomas, J. K., Noppenberger, J. (2007). Avian influenza: A review. Am J Health Syst Pharm 64: 149-165 [Abstract] [Full Text]  
• Jones, J. C., Turpin, E. A., Bultmann, H., Brandt, C. R., Schultz-Cherry, S. (2006). Inhibition of Influenza Virus Infection by a Novel Antiviral Peptide That Targets Viral Attachment to Cells. J. Virol. 80: 11960-11967 [Abstract] [Full Text]  
• Karie, S., Launay-Vacher, V., Janus, N., Izzedine, H., Deray, G. (2006). Pharmacokinetics and dosage adjustment of oseltamivir and zanamivir in patients with renal failure. Nephrol Dial Transplant 21: 3606-3608 [Full Text]  
• Kandun, I. N., Wibisono, H., Sedyaningsih, E. R., Yusharmen, , Hadisoedarsuno, W., Purba, W., Santoso, H., Septiawati, C., Tresnaningsih, E., Heriyanto, B., Yuwono, D., Harun, S., Soeroso, S., Giriputra, S., Blair, P. J., Jeremijenko, A., Kosasih, H., Putnam, S. D., Samaan, G., Silitonga, M., Chan, K.H., Poon, L. L.M., Lim, W., Klimov, A., Lindstrom, S., Guan, Y., Donis, R., Katz, J., Cox, N., Peiris, M., Uyeki, T. M. (2006). Three Indonesian Clusters of H5N1 Virus Infection in 2005.. NEJM 355: 2186-2194 [Abstract] [Full Text]  
• Democratis, J., Pareek, M., Stephenson, I. (2006). Use of neuraminidase inhibitors to combat pandemic influenza. J Antimicrob Chemother 58: 911-915 [Abstract] [Full Text]  
• Rameix-Welti, M. A., Agou, F., Buchy, P., Mardy, S., Aubin, J. T., Veron, M., van der Werf, S., Naffakh, N. (2006). Natural Variation Can Significantly Alter the Sensitivity of Influenza A (H5N1) Viruses to Oseltamivir. Antimicrob. Agents Chemother. 50: 3809-3815 [Abstract] [Full Text]  
• Lindegardh, N., Davies, G. R., Hien, T. T., Farrar, J., Singhasivanon, P., Day, N. P. J., White, N. J. (2006). Rapid degradation of oseltamivir phosphate in clinical samples by plasma esterases.. Antimicrob. Agents Chemother. 50: 3197-3199 [Abstract] [Full Text]  
• Bartlett, J. G. (2006). Planning for Avian Influenza. ANN INTERN MED 145: 141-144 [Abstract] [Full Text]  
• Monto, A. S., McKimm-Breschkin, J. L., Macken, C., Hampson, A. W., Hay, A., Klimov, A., Tashiro, M., Webster, R. G., Aymard, M., Hayden, F. G., Zambon, M. (2006). Detection of Influenza Viruses Resistant to Neuraminidase Inhibitors in Global Surveillance during the First 3 Years of Their Use.. Antimicrob. Agents Chemother. 50: 2395-2402 [Abstract] [Full Text]  
• Stephenson, I., Democratis, J. (2006). Influenza: current threat from avian influenza. Br Med Bull 75-76: 63-80 [Abstract] [Full Text]  
• Granados, A., Goodman, C., Eklund, L. (2006). Pandemic influenza: using evidence on vaccines and antivirals for clinical decisions and policy making.. Eur Respir J 27: 661-663 [Full Text]  
• Treanor, J. J., Campbell, J. D., Zangwill, K. M., Rowe, T., Wolff, M. (2006). Safety and immunogenicity of an inactivated subvirion influenza A (H5N1) vaccine.. NEJM 354: 1343-1351 [Abstract] [Full Text]  
• Poland, G. A. (2006). Vaccines against avian influenza--a race against time.. NEJM 354: 1411-1413 [Full Text]  
• Gupta, R. K., Nguyen-Van-Tam, J. S., de Jong, M. D., Hien, T. T., Farrar, J. (2006). Oseltamivir resistance in influenza A (H5N1) infection.. NEJM 354: 1423-1424 [Full Text]  
• (2006). Two More Cases of Oseltamivir-Resistant Avian Influenza. JWatch Pediatrics 2006: 7-7 [Full Text]  
• Hayden, F. G. (2006). Antiviral resistance in influenza viruses--implications for management and pandemic response.. NEJM 354: 785-788 [Full Text]  
• Weinstock, D. M., Zuccotti, G. (2006). Adamantane Resistance in Influenza A. JAMA 295: 934-936 [Full Text]  
• Bonten, M. J M, Prins, J. M (2006). Antibiotics in pandemic flu. BMJ 332: 248-249 [Full Text]  
• (2006). Oseltamivir-Resistant Influenza A (H5N1) Infections in Humans. JWatch Infect. Diseases 2006: 3-3 [Full Text]  
• (2006). Two More Cases of Oseltamivir-Resistant Avian Influenza. JWatch General 2006: 2-2 [Full Text]  
• Parry, J. (2006). Uncertainty still surrounds oseltamivir after 13 year old dies. BMJ 332: 5-5 [Full Text]  
• Mudur, G. (2006). Indian firm to produce oseltamivir for developing countries. BMJ 332: 5-5 [Full Text]