Another study from last month...published in Chicago from Infectious Diseases Society of America....re study undertaken by Japan Physicians Association.
Note the conclusion reached and this comment made in the study.....this did not come from some small University research team, but the Japan Physicians Association.
---- CONCLUSION: The effectiveness of oseltamivir, but not that of zanamivir, decreased significantly for H1N1 virus infection during the 20082009 season. ---
CDC and WHO have access to a whole range of research around the world, but this study and the other publication presented tonight would be of concern to these authorities.
Any modification of views by WHO or CDC would have major significance for Relenza and Lani -----------------------------------------------
> Clinical Infectious Diseases > 15 December 2009 > Drug Efficacy for H274Y‐Mutated H1N1 Virus
Published for the Infectious Diseases Society of America By Author Naoki KawaiHideyuki IkematsuNobuo HirotsuTetsunari MaedaTakashi KawashimaOsame TanakaSatoshi YamauchiKenichi KawamuraShinro MatsuuraMika NishimuraNorio IwakiSeizaburo Kashiwagi Search In CrossRefGoogle Scholar..Announcements 2009 by the Infectious Diseases Society of America. All rights reserved. 1058-4838/2009/4912-0008$15.00 DOI: 10.1086/648424 MAJOR ARTICLE
Clinical Effectiveness of Oseltamivir and Zanamivir for Treatment of Influenza A Virus Subtype H1N1 with the H274Y Mutation: A Japanese, Multicenter Study of the 20072008 and 20082009 Influenza SeasonsNaoki Kawai,1,a Hideyuki Ikematsu,1,2,a Nobuo Hirotsu,1 Tetsunari Maeda,1 Takashi Kawashima,1 Osame Tanaka,1 Satoshi Yamauchi,1 Kenichi Kawamura,1 Shinro Matsuura,1 Mika Nishimura,2 Norio Iwaki,1 and Seizaburo Kashiwagi1
1Japan Physicians Association, Tokyo, and 2Department of Clinical Research, Hara‐doi Hospital, Fukuoka, Japan
Background.Influenza A virus subtype H1N1 with the H274Y mutation emerged and spread worldwide. However, the clinical effectiveness of the neuraminidase inhibitors, oseltamivir and zanamivir, has not been adequately reevaluated.
Methods.Data from 164 patients with H1N1 virus infection and 59 patients with H3N2 virus infection during the 20082009 influenza season and 68 patients with H1N1 virus infection during the 20072008 influenza season who received a neuraminidase inhibitor were analyzed. The duration of fever (body temperature 37.5C) after the first dose of oseltamivir or zanamivir and from onset of symptoms was calculated from patient reports. The influenza virus was isolated, and its subtype was determined by hemagglutinin inhibition assay and polymerase chain reaction. The H274Y neuraminidase mutation status was determined by sequencing the neuraminidase segment.
Results.Of 68 patients with H1N1 virus infection during the 20072008 season, 41 were treated with oseltamivir, and 27 were treated with zanamivir. During the 20082009 season, 77 patients with H1N1 virus infection were treated with oseltamivir, and 87 were treated with zanamivir; 31 and 28 patients with H3N2 virus infection were treated with oseltamivir and zanamivir, respectively. All 49 analyzed H1N1 virus isolates obtained during the 20082009 season, but none of the isolates obtained during the 20072008 season, contained the H274Y mutation. The mean standard deviation duration of fever after the start of oseltamivir therapy was significantly longer for patients with H1N1 virus infection ( h) than it was for patients with H3N2 virus infection ( h; ) during the 20082009 season and patients with H1N1 virus infection during the 20072008 season ( h; ). The duration of fever was significantly longer after the first dose of oseltamivir than it was after the first dose of zanamivir for patients with H1N1 virus infection during the 20082009 season ( ). The duration of fever from onset of H1N1 virus infection was significantly longer for children 15 years of age during 20082009 ( h) than it was for such children during 20072008 ( h).
Conclusion.The effectiveness of oseltamivir, but not that of zanamivir, decreased significantly for H1N1 virus infection during the 20082009 season.
Received 17 May 2009; accepted 31 July 2009; electronically published 13 November 2009.
(See the editorial commentary by Baum, on pages 18367.)
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