Seroconversion and asymptomatic infections during oseltamivir prophylaxis against Influenza A H1N1 2009.
Seroconversion and asymptomatic infections during oseltamivir prophylaxis against Influenza A H1N1 2009.
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DOI：
10.1186/1471-2334-10-164
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发表时间：
2010-06-10
影响因子：
3.7
通讯作者：
Chen MI
中科院分区：
文献类型：
--
作者：
Lee VJ;Yap J;Tay JK;Barr I;Gao Q;Ho HJ;Tan BH;Kelly PM;Tambyah PA;Kelso A;Chen MI
抗病毒预防是用来防止流感的传播。我们研究了2009年甲型H1N1流感感染在奥司他韦预防期间和停止预防后的血清学确认。在2009年6月22日至7月16日期间，我们在新加坡军队的3次暴发中进行了一项队列研究，在这些暴发中，暴露后给予奥司他韦环化学预防（每天75毫克，持续10天）。整个队列每周使用鼻咽拭子进行3次RT-PCR（含HA基因引物）筛选。在疫情开始时、完成10天奥司他韦预防后2周以及新加坡大流行高峰后3周，采集了3份血样用于血凝抑制试验。调查问卷也用于收集临床症状。237名人员被列入分析。三次疫情期间，2009年甲型H1N1流感总感染率为11.4%（27/237）。其中包括11例指标病例和16名人员（7.1%），他们在奥司他韦预防期间抗体滴度上升了4倍或更高。在这16名人员中，8人（3.5%）出现症状，其余8人（3.5%）无症状，PCR检测呈阴性。停止预防后，又有23例（12.1%）血清转化。在预防期间和预防后进行血清转化的患者中，GMT的平均增加倍数没有显著差异（11.3 vs 11.7, p = 0.888）。没有发现过敏、神经精神或其他严重的副作用。暴露后奥司他韦预防降低了疫情期间的感染率，并且在停止后没有显著增加随后的感染率。无症状感染发生在预防期间，这可能赋予对未来感染的保护。暴露后预防是缓解大流行性流感爆发的有效措施。
Anti-viral prophylaxis is used to prevent the transmission of influenza. We studied serological confirmation of 2009 Influenza A (H1N1) infections during oseltamivir prophylaxis and after cessation of prophylaxis. Between 22 Jun and 16 Jul 09, we performed a cohort study in 3 outbreaks in the Singapore military where post-exposure oseltamivir ring chemoprophylaxis (75 mg daily for 10 days) was administered. The entire cohort was screened by RT-PCR (with HA gene primers) using nasopharyngeal swabs three times a week. Three blood samples were taken for haemagglutination inhibition testing - at the start of outbreak, 2 weeks after completion of 10 day oseltamivir prophylaxis, and 3 weeks after the pandemic's peak in Singapore. Questionnaires were also administered to collect clinical symptoms. 237 personnel were included for analysis. The overall infection rate of 2009 Influenza A (H1N1) during the three outbreaks was 11.4% (27/237). This included 11 index cases and 16 personnel (7.1%) who developed four-fold or higher rise in antibody titres during oseltamivir prophylaxis. Of these 16 personnel, 8 (3.5%) were symptomatic while the remaining 8 personnel (3.5%) were asymptomatic and tested negative on PCR. Post-cessation of prophylaxis, an additional 23 (12.1%) seroconverted. There was no significant difference in mean fold-rise in GMT between those who seroconverted during and post-prophylaxis (11.3 vs 11.7, p = 0.888). No allergic, neuropsychiatric or other severe side-effects were noted. Post-exposure oseltamivir prophylaxis reduced the rate of infection during outbreaks, and did not substantially increase subsequent infection rates upon cessation. Asymptomatic infections occur during prophylaxis, which may confer protection against future infection. Post-exposure prophylaxis is effective as a measure in mitigating pandemic influenza outbreaks.
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影响因子：
11.8
作者：
Earhart, KC;Beadle, C;Wallace, MR
通讯作者：
Wallace, MR
DOI：
10.1016/s0140-6736(03)14854-4
发表时间：
2003-11-22
期刊：
Lancet (London, England)
影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1046/j.1532-5415.2001.49204.x
发表时间：
2001-08-01
影响因子：
6.3
作者：
Peters, PH;Gravenstein, S;Ward, P
通讯作者：
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