Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 216, Issue 5, Pages 582-593Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jix296
Keywords
Influenza virus; oseltamivir resistance; immunosuppression; nonhuman primates
Categories
Funding
- Japan Initiative for Global Research Network on Infectious Diseases from the Ministry of Education, Culture, Sports, Science and Technology, Japan
- Japan Agency for Medical Research and Development (AMED)
- Leading Advanced Projects for medical innovation (LEAP)
- Japan Initiative for Global Research Network on Infectious Diseases (J-GRID)
- Ministry of Health, Labour and Welfare, Japan
- ERATO
- Japan Science and Technology Agency
- AMED
- Ministry of Education, Culture, Science, Sports, and Technology (MEXT) of Japan [16H06429, 16K21723, 16H06434]
- Grants-in-Aid for Scientific Research [16H06429, 16H06434, 16KT0196] Funding Source: KAKEN
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Antiviral compounds (eg, the neuraminidase inhibitor oseltamivir) are invaluable for the treatment of individuals infected with influenza A viruses of the H7N9 subtype (A[H7N9]), which have infected and killed hundreds of persons. However, oseltamivir treatment often leads to the emergence of resistant viruses in immunocompromised individuals. To better understand the emergence and properties of oseltamivir-resistant A(H7N9) viruses in immunosuppressed individuals, we infected immunosuppressed cynomolgus macaques with an A(H7N9) virus and treated them with oseltamivir. Disease severity and mortality were higher in immunosuppressed than in immunocompetent animals. Oseltamivir treatment at 2 different doses reduced A(H7N9) viral titers in infected animals, but even high-dose oseltamivir did not block viral replication sufficiently to suppress the emergence of resistant variants. Some resistant variants were not appreciably attenuated in cultured cells, but an oseltamivir-resistant A(H7N9) virus did not transmit among ferrets. These findings are useful for the control of A(H7N9) virus infections in clinical settings.
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