Cellular Therapy and Immunology, Manashi Chakrabarti Foundation, Kolkata, India.
Department of Blood and Marrow Transplantation & Hematology, Dharamshila Narayana Superspeciality Hospital and Research Centre, New Delhi, India.
Transpl Infect Dis. 2020 Oct;22(5):e13309. doi: 10.1111/tid.13309. Epub 2020 Jun 8.
Following a major seasonal outbreak of H1N1 influenza in 2018 September, prophylactic oseltamivir for six months was initiated in children undergoing haploidentical HCT with regular monitoring for influenza and other respiratory virus infections. Influenza was not detected in 22 children undergoing prophylaxis, compared to 8 H1N1 infections in 21 adults without prophylaxis (P = .01). Four children on prophylaxis were detected to have other respiratory viruses, compared to 8 in those without prophylaxis. Invasive pulmonary aspergillosis (IPA) was observed only in association with H1N1 (4/8 with H1N1 vs 0/35 without H1N1, P = .001) and was thus lower in the prophylaxis group (P = .04). The overall incidence of episodes of respiratory illness and hospital stay were also lower in those on prophylaxis (P = .001). There were no untoward side effects associated with prophylactic oseltamivir. Prophylactic oseltamivir was safe and effective in prevention of H1N1 infection and subsequent IPA in children at-risk, early after haploidentical HCT.
在 2018 年 9 月甲型 H1N1 流感的一次大规模季节性暴发后，我们对接受单倍体相合造血干细胞移植的患儿进行为期 6 个月的奥司他韦预防，并定期监测流感和其他呼吸道病毒感染情况。接受预防治疗的 22 名患儿中未发现流感，而未接受预防治疗的 21 名成人中有 8 例感染 H1N1（P=.01）。接受预防治疗的 4 名患儿被检出有其他呼吸道病毒，而未接受预防治疗的患儿中有 8 例。仅在甲型 H1N1 感染时观察到侵袭性肺曲霉病（IPA）（H1N1 感染 4/8 例，无 H1N1 感染 0/35 例，P=.001），且预防组的 IPA 发生率较低（P=.04）。预防组的呼吸道疾病发作和住院总发生率也较低（P=.001）。奥司他韦预防无不良副作用。在单倍体相合造血干细胞移植后早期，对高危患儿进行奥司他韦预防可安全、有效地预防甲型 H1N1 感染和随后的 IPA。
