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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.

Original publication

DOI

10.1056/NEJMoa054512

Type

Journal article

Journal

N Engl J Med

Publication Date

22/12/2005

Volume

353

Pages

2667 - 2672

Keywords

Acetamides, Adolescent, Adult, Amino Acid Substitution, Antiviral Agents, Base Sequence, Child, Drug Resistance, Viral, Fatal Outcome, Female, Humans, Influenza A Virus, H5N1 Subtype, Influenza, Human, Lung, Male, Neuraminidase, Oseltamivir, Pneumonia, Viral, Radiography, Sequence Analysis, DNA, Viral Load