Viral Load in Patients Infected With Pandemic H1N1 2009 Influenza A Virus
Viral Load in Patients Infected With Pandemic H1N1 2009 Influenza A Virus
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DOI：
10.1002/jmv.21664
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发表时间：
2010-01-01
影响因子：
12.7
通讯作者：
Yuen, Kwok-Yung
中科院分区：
文献类型：
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作者：
To, Kelvin K. W.;Chan, Kwok-Hung;Yuen, Kwok-Yung
2009年H1N1大流行甲型流感病毒引起的感染的病毒脱落情况尚未报告。这项研究的目的是确定不同身体部位的病毒载量。用定量逆转录聚合酶链式反应(RT-PCR)检测呼吸道标本、粪便、尿液和血清中甲型H1N1流感病毒载量。以季节性流感患者的呼吸道标本作为历史对照。比较两组患者治疗前的初始病毒载量。采集甲型H1N1大流行性流感病毒感染患者的连续呼吸道标本，进行病毒动力学分析。纳入22例甲型H1N1流感大流行病例和44例季节性流感历史对照病例。在奥司他韦治疗前，甲型H1N1大流行病毒的平均初始病毒载量为1.84×10(8)拷贝/毫升，而季节性流感历史对照组为3.28×10(8)拷贝/毫升(P=0.085)。在大流行性H1N1病毒感染患者中，病毒载量高峰出现在症状出现当天，之后逐渐下降，除1例患者外，RT-PCR和培养分别在症状出现8天和5天后的呼吸道标本中检测不到病毒。从9例患者的粪便和14例患者的尿液中分别检出甲型H1N1大流行病毒。病毒载量最高的粪便样本的病毒培养也呈阳性。年龄越小，呼吸道脱落时间越长，粪便病毒载量越高。来自病毒脱落的这种定量分析的数据可能对制定感染控制措施有影响。J.Med.维罗尔。82：1-7,2010。(C)2009年Wiley-Liss，Inc.
Viral shedding profile of infections caused by the pandemic H1N1 2009 influenza A virus has not been reported. The aim of this study was to determine the viral load in different body sites. Viral loads of pandemic H1N1 virus in respiratory specimens, stool, urine, and serum were determined by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Respiratory specimens from patients with seasonal influenza were used as historical controls. Initial pre-treatment viral load were compared between these two groups. Serial respiratory specimens from patients with pandemic H1N1 virus infection were obtained for analysis of viral dynamics. Twenty-two pandemic H1N1 cases and 44 seasonal influenza historical controls were included. The mean initial viral load before oseltamivir therapy was 1.84 x 10(8) copies/ml for pandemic H1N1 virus compared with 3.28 x 10(8) copies/ml in seasonal influenza historical controls (P=0.085). Among patients with pandemic H1N1 virus infection, peak viral load occurred on the day of onset of symptoms, and declined gradually afterwards, with no virus being detectable in respiratory specimens by RT-PCR 8 days and by culture 5 days after the onset of symptoms respectively, except in one patient. Pandemic H1N1 virus was detected in stool and in urine from 4/9 and 1/14 patients, respectively. Viral culture was also positive from the stool sample with the highest viral load. Younger age was associated with prolonged shedding in the respiratory tract and higher viral load in the stool. Data from this quantitative analysis of viral shedding may have implications for formulating infection control measures. J. Med. Virol. 82: 1-7, 2010. (C) 2009 Wiley-Liss, Inc.