Kawai Naoki, Ikematsu Hideyuki, Iwaki Norio, Maeda Tetsunari, Satoh Ietaka, Hirotsu Nobuo, Kashiwagi Seizaburo
Japan Physicians Association, Tokyo, Japan.
Clin Infect Dis. 2006 Aug 15;43(4):439-44. doi: 10.1086/505868. Epub 2006 Jun 26.
To compare the effectiveness of oseltamivir for treatment of influenza A and influenza B, we conducted a prospective, multicenter study of the 2003-2004 and 2004-2005 influenza seasons. The study included 3351 patients in whom influenza had been diagnosed by use of an antigen detection test kit.
Oseltamivir was administered to 1818 patients with influenza A and 1485 patients with influenza B. No anti-influenza drugs were administered to 21 patients with influenza A or to 27 patients with influenza B. Patients receiving oseltamivir therapy were divided into 4 groups according to the time between the onset of fever (temperature, > or = 37.5 degrees C) and administration of the first dose of oseltamivir (0-12 h, 13-24 h, 25-36 h, and 37-48 h). The patients were also divided into 4 subgroups on the basis of age (0-6 years, 7-15 years, 16-64 years, and >64 years). Virus isolation was performed after completion of oseltamivir therapy for 44 patients with influenza A and 31 patients with influenza B.
The duration of fever was significantly shorter for patients with influenza A and B who were treated with oseltamivir than for patients who were not treated with an anti-influenza drug (P<.001 for both). The time until the patient became afebrile after the initial administration of oseltamivir and the duration of fever were significantly longer for patients with influenza B than for patients with influenza A for the 0-12 h, 13-24 h, 25-36 h, and 37-48 h groups (P<.001) and for all age groups (P<.001). After 4-6 days of oseltamivir therapy, the influenza B virus reisolation rate (51.6%) was significantly higher than the influenza A virus reisolation rate (15.9%) (P<.001).
Oseltamivir is less effective for influenza B than for influenza A with regard to duration of fever and virus persistence, irrespective of patient age or the timing of administration of the first dose.
为比较奥司他韦治疗甲型流感和乙型流感的有效性，我们在2003 - 2004年和2004 - 2005年流感季节进行了一项前瞻性多中心研究。该研究纳入了3351例使用抗原检测试剂盒确诊为流感的患者。
对1818例甲型流感患者和1485例乙型流感患者给予奥司他韦治疗。21例甲型流感患者和27例乙型流感患者未使用抗流感药物。接受奥司他韦治疗的患者根据发热（体温≥37.5℃）开始至给予首剂奥司他韦的时间分为4组（0 - 12小时、13 - 24小时、25 - 36小时和37 - 48小时）。患者还根据年龄分为4个亚组（0 - 6岁、7 - 15岁、16 - 64岁和>64岁）。对44例甲型流感患者和31例乙型流感患者在奥司他韦治疗结束后进行病毒分离。
接受奥司他韦治疗的甲型和乙型流感患者发热持续时间显著短于未使用抗流感药物治疗的患者（两者P<0.001）。在0 - 12小时、13 - 24小时、25 - 36小时和37 - 48小时组以及所有年龄组中，乙型流感患者在首次给予奥司他韦后退热时间和发热持续时间均显著长于甲型流感患者（P<0.001）。奥司他韦治疗4 - 6天后，乙型流感病毒重新分离率（51.6%）显著高于甲型流感病毒重新分离率（15.9%）（P<0.001）。
无论患者年龄或首剂给药时间如何，在发热持续时间和病毒持续存在方面，奥司他韦治疗乙型流感的效果不如甲型流感。
