Systematic review of influenza A(H1N1)pdm09 virus shedding: duration is affected by severity, but not age.
Systematic review of influenza A(H1N1)pdm09 virus shedding: duration is affected by severity, but not age.
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DOI：
10.1111/irv.12216
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发表时间：
2014-03
影响因子：
4.4
通讯作者：
Glass K
中科院分区：
文献类型：
--
作者：
Fielding JE;Kelly HA;Mercer GN;Glass K
感染后病毒脱落的持续时间是疾病传播的重要决定因素，为控制政策和疾病建模提供信息。我们对甲型H1N1流感pdm09病毒脱落的持续时间进行了系统的文献综述，以检查年龄、疾病严重程度和接受抗病毒治疗的影响。通过使用关键词“H1N1”、“pandemic”、"pandemics“、”shed“和”shedding“检索PubMed数据库来识别研究。任何具有病毒脱落结果指标的人类研究都有资格纳入审查。年龄，严重程度和抗病毒治疗进行了比较与森林地块。检索返回了214篇文章，其中22篇符合审查条件。研究之间的显著统计异质性排除了荟萃分析。平均排毒持续时间通常随临床表现的严重程度而增加，但我们没有发现儿童中甲型H1N1流感pdm09排毒持续时间长于成人的证据。在发病后48小时内给予奥司他韦治疗时，观察到病毒脱落持续时间较短。病毒排毒研究的设计和分析存在相当大的差异，这限制了它们的比较，并强调了标准化方法的必要性。这些见解不仅对大流行规划有影响，而且对现在A（H1N1）pdm09病毒已被确定为季节性H1N1流感病毒的季节性流感的响应和研究也有影响。
Duration of viral shedding following infection is an important determinant of disease transmission, informing both control policies and disease modelling. We undertook a systematic literature review of the duration of influenza A(H1N1)pdm09 virus shedding to examine the effects of age, severity of illness and receipt of antiviral treatment. Studies were identified by searching the PubMed database using the keywords ‘H1N1’, ‘pandemic’, ‘pandemics’, ‘shed’ and ‘shedding’. Any study of humans with an outcome measure of viral shedding was eligible for inclusion in the review. Comparisons by age, degree of severity and antiviral treatment were made with forest plots. The search returned 214 articles of which 22 were eligible for the review. Significant statistical heterogeneity between studies precluded meta-analysis. The mean duration of viral shedding generally increased with severity of clinical presentation, but we found no evidence of longer shedding duration of influenza A(H1N1)pdm09 among children compared with adults. Shorter viral shedding duration was observed when oseltamivir treatment was administered within 48 hours of illness onset. Considerable differences in the design and analysis of viral shedding studies limit their comparison and highlight the need for a standardised approach. These insights have implications not only for pandemic planning, but also for informing responses and study of seasonal influenza now that the A(H1N1)pdm09 virus has become established as the seasonal H1N1 influenza virus.
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