Sugaya Norio, Sakai-Tagawa Yuko, Bamba Masahiro, Yasuhara Rieko, Yamazaki Masahiko, Kawakami Chiharu, Yamaguchi Yoshio, Ide Yoshiaki, Ichikawa Masataka, Mitamura Keiko, Kawaoka Yoshihiro
Department of Pediatrics, Keiyu Hospital, Yokohama, Japan.
Antivir Ther. 2015;20(1):49-55. doi: 10.3851/IMP2798. Epub 2014 May 16.
Shedding of the pandemic virus during an influenza pandemic is thought to persist longer than shedding of influenza viruses during annual influenza seasons, because people have much less immunity against a pandemic influenza. A correlation is thought to exist between the length of virus shedding and the clinical severity of influenza illness.
We compared the virus isolation rates of children with pandemic A H1N1/09 influenza infection and children with A H3N2 influenza infection after the patients had been treated with one of three neuraminidase inhibitors (NAI) such as peramivir, laninamivir and oseltamivir. The clinical effectiveness of each NAI was assessed on the basis of the duration of the febrile period after the start of treatment.
Influenza viruses were isolated from 15 of the 34 patients in the A H3N2 group (mean age 6.2 years) and from 4 of the 25 patients in the A H1N1/09 (mean age 5.6 years) virus group (44.1% versus 16.0%; P<0.05). However, the differences between the duration of fever in the patients in the A H3N2 group and A H1N1/09 group after treatment with the NAIs were not significant.
The virus isolation rates after treatment with each of the NAIs were significantly lower in the A H1N1/09 group, suggesting that the pandemic A H1N1/09 virus was more sensitive to the NAIs than the seasonal A H3N2 virus was. Clinically, there were no significant differences in the effectiveness of the NAIs between the H1N1/09 infected group and H3N2 infected group.
在流感大流行期间，大流行病毒的排出被认为比在年度流感季节期间流感病毒的排出持续时间更长，因为人们对大流行性流感的免疫力要低得多。病毒排出的持续时间与流感疾病的临床严重程度之间被认为存在关联。
我们比较了甲型H1N1/09流感大流行感染儿童和甲型H3N2流感感染儿童在接受三种神经氨酸酶抑制剂（NAI）之一（如帕拉米韦、拉尼米韦和奥司他韦）治疗后的病毒分离率。根据治疗开始后发热期的持续时间评估每种NAI的临床疗效。
在甲型H3N2组（平均年龄6.2岁）的34例患者中有15例分离出流感病毒，在甲型H1N1/09病毒组（平均年龄5.6岁）的25例患者中有4例分离出流感病毒（44.1%对16.0%；P<0.05）。然而，在接受NAI治疗后，甲型H3N2组和甲型H1N1/09组患者的发热持续时间差异不显著。
甲型H1N1/09组在接受每种NAI治疗后的病毒分离率显著较低，这表明甲型H1N1/09大流行病毒比季节性甲型H3N2病毒对NAI更敏感。临床上，甲型H1N1/09感染组和甲型H3N2感染组在NAI的疗效方面没有显著差异。
