Influenza A H5N1 Clade 2.3.4 Virus with a Different Antiviral Susceptibility Profile Replaced Clade 1 Virus in Humans in Northern Vietnam
2008

H5N1 Virus Changes in Northern Vietnam

Sample size: 8 publication 10 minutes Evidence: moderate

Author Information

Author(s): Le Mai T. Q., Wertheim Heiman F. L., Nguyen Hien D., Taylor Walter, Hoang Phuong V. M., Vuong Cuong D., Nguyen Hang L. K., Nguyen Ha H., Nguyen Thai Q., Nguyen Trung V., Van Trang D., Ngoc Bich T., Bui Thinh N., Nguyen Binh G., Nguyen Liem T., Luong San T., Phan Phuc H., Pham Hung V., Nguyen Tung, Fox Annette, Nguyen Cam V., Do Ha Q., Crusat Martin, Farrar Jeremy, Nguyen Hien T., de Jong Menno D., Horby Peter

Primary Institution: National Institute of Hygiene and Epidemiology, Hanoi, Vietnam

Hypothesis

What are the characteristics and antiviral susceptibility profiles of H5N1 viruses infecting humans in northern Vietnam in 2007?

Conclusion

In 2007, H5N1 clade 2.3.4 viruses replaced clade 1 viruses in northern Vietnam and were susceptible to amantadine but showed reduced susceptibility to oseltamivir.

Supporting Evidence

  • Eight patients were diagnosed with H5N1 in 2007, and five of them died.
  • Phylogenetic analysis showed that clade 2.3.4 H5N1 viruses replaced clade 1 viruses in northern Vietnam.
  • Four human H5N1 strains had eight-fold reduced in-vitro susceptibility to oseltamivir compared to clade 1 viruses.
  • All patients presented with fever, cough, and dyspnea.
  • Seven patients required mechanical ventilation early after admission.

Takeaway

Some sick people in Vietnam got a new type of bird flu virus that was harder to treat with one medicine but could still be treated with another.

Methodology

Patients suspected of H5N1 infection were tested using RT-PCR and virus isolates were characterized by genome sequencing and drug susceptibility testing.

Potential Biases

Potential bias due to the limited geographical area and the specific patient demographics.

Limitations

The study was limited to a small sample size of eight patients and may not represent the broader population.

Participant Demographics

Six males and two females, median age 23 years, with exposure to poultry.

Statistical Information

P-Value

0.021

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0003339

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