Pesquisa | Influenza A (H1N1)

1.

Virological surveillance and antiviral resistance of human influenza virus in Argentina, 20052008/ Vigilancia virológica y resistencia a los antivíricos del virus de la gripe humana en la Argentina, 20052008

Autor(es): Pontoriero, Andrea; Baumeister, Elsa; Campos, Ana M; L. Savy, Vilma

Fonte: Rev Panam Salud Publica;30(6): 634-640, dec. 2011. .

LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde ID: 612962

Resumo: Objective. To describe the virological characteristics of the influenza strains circulating in Argentina in 20052008 and to assess the prevalence of antiviral resistance. Methods. On the basis of their geographical spread and prevalence, influenza A and B isolates grown in MadinDarby canine kidney cells were selected after antigenic and genomic characterization to be analyzed for antiviral resistance by enzymatic assay and pyrosequencing. Amantadine susceptibility was evaluated by pyros (mais) equencing for known resistance markers on 45 strains of influenza A. Susceptibility to oseltamivir and zanamivir was evaluated by enzymatic assay of 67 influenza A and 46 influenza B strains, some of which were further analyzed by sequencing the neuraminidase gene. Results. Resistance to amantadine was observed only on A(H3N2) strains (29/33); all of them carried the mutation S31N in their M2 sequence. Oseltamivir resistance was observed in 12 (34.3%) of the 35 A(H1N1) strains from 2008; all of them carried the mutation H275Y in their neuraminidase sequence. All these viruses remained sensitive to zanamivir. Conclusions. This study describes a high incidence of amantadine-resistant influenza A(H3N2) viruses since 2006 and an unprecedented increase in oseltamivir resistance detected only in influenza A(H1N1) viruses isolated in 2008. Influenza A and B viruses were more sensitive to oseltamivir than to zanamivir, and influenza A viruses were more sensitive to both neuraminidase inhibitors than the influenza B viruses. The national data generated and analyzed in this study may help increase knowledge about influenza antiviral drug resistance, which is a problem of global concern.(AU)

Objetivo. Describir las características virológicas de las cepas de virus de la gripe que circulaban en la Argentina entre el 2005 y el 2008, y evaluar la prevalencia de la resistencia a los antivíricos. Métodos. Según su diseminación geográfica y su prevalencia, se seleccionaron aislados de gripe A y B cultivados en células renales caninas de Madin-Darby después de su caracterización antigénica y genómica, y se analizó su resistencia a los antivíricos mediante análisis enzimático y pirosecuenciación. La sensibilidad a la amantadina se evaluó por pirosecuenciación para los marcadores conocidos de resistencia en 45 cepas de gripe A. La sensibilidad al oseltamivir y al zanamivir se evaluó mediante análisis enzimático de 67 cepas de gripe A y 46 cepas de gripe B, algunas de las cuales se analizaron en mayor profundidad mediante la secuenciación del gen de la neuraminidasa. Resultados. Se observó resistencia a la amantadina solo en las cepas de gripe A (H3N2) (29/33); todas ellas tenían la mutación S31N en su secuencia de M2. Se observó resistencia al oseltamivir en 12 (34,3%) de las 35 cepas de gripe A (H1N1) aisladas en el 2008; todas ellas tenían la mutación H275Y en su secuencia de neuraminidasa. Todos estos virus conservaron su sensibilidad al zanamivir. Conclusiones. En este estudio se describe una incidencia elevada del virus de la gripe A (H3N2) resistente a la amantadina desde el 2006 y un aumento sin precedentes de la resistencia al oseltamivir detectada solo en los virus de la gripe A (H1N1) aislados en el 2008. Los virus de la gripe A y B fueron más sensibles al oseltamivir que al zanamivir y los virus de la gripe A fueron más sensibles a ambos inhibidores de la neuraminidasa que los virus de la gripe B. Los datos nacionales generados y analizados en este estudio pueden ayudar a aumentar los conocimientos acerca de la resistencia a los fármacos antivíricos dirigidos contra el virus de la gripe, lo que es un motivo de preocupación mundial.(AU)

Link(s):

SciELO Saúde Pública

2.

Uso de oseltamivir durante la pandemia de gripe a (H1N1): análisis de las reacciones adversas reportadas al sistema nacional de farmacovigilancia de ANMAT/ Use of oseltamivir during influenza A (H1N1) pandemic: analysis of adverse reactions reported to the ANMAT national pharmacovigilance system

Autor(es): Schiaffino, Santiago; Bologna, Viviana; Bissio, Agustina; Bignone, Inés

Fonte: Rev. argent. salud publica;1(4): 20-25, sept. 2010. tab.

LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde ID: 597389

Resumo: INTRODUCCIÓN: Oseltamivir es un medicamento antiviral usado para profilaxis y tratamiento de la gripe. Sus efectos adversos son conocidos a través de los ensayos clínicos y por la experiencia adquirida en la última epidemia de gripe aviar. Dentro de las reacciones más graves se han reportado casos de anafilaxia, eventos cutáneos y manifestaciones psiquiátricas como alucinaciones, delirium e ideación suicida. OBJETIVO: en julio de 2009, el departamento de Farmacovigilancia de ANMAT (mais) lanzó el Plan Nacional de Farmacovigilancia para Drogas Antivirales con el objetivo de recolectar mayor información de seguridad de estos medicamentos durante su uso masivo, con especial atención a las manifestaciones cutáneas, hepáticas y neuropsiquiátricas. MÉTODOS: se analizaron todas las notificaciones recibidas durante junio - noviembre de 2009. Los datos considerados fueron: sexo, edad, notificador, modalidad terapéutica, severidad, clasificación delefecto adverso principal e imputabilidad asignada. RESULTADOS: serecibieron 179 notificaciones, la mayoría asociadas a la modalidad tratamiento. Las reacciones adversas más reportadas involucraron al sistema gastrointestinal, siendo en su mayoría leves y autolimitadas. Con respecto a los casos psiquiátricos reportados, su severidad y variabilidad obliga a prestar especial atención a estas notificaciones. Se reportaron además casos de prolongación del Intervalo QTc, evento no descripto previamente en la literatura. CONCLUSIÓN: Dada la escasa experiencia en la Argentina y el estrecho perfil de seguridad de este fármaco, es indispensable continuar con una vigilancia activa del mismo.(AU)

INTRODUCTION: Oseltamivir is an antiviral drug used for profhylaxis and treatment of influenza. Adverse effects are known through clinical trials and in large part by the experience gained after its use in the last outbreak of avian influenza in Asia. Among the most serious reactions are reported cases of anaphylaxis, cutaneous events and psychiatric symptoms such as hallucinations, delirium and suicidal behaviour. OB JECTIVE: in line with various international regulatory authori ties, during July 2009, the ANMAT through Pharmacovigilance Department launched the National Pharmacovigilance Plan for antiviral drugs used for prophylaxis and treatment of the pandemic H1N1 influenza virus. The plan called for reporting any signs or symptoms, paying particular attention to the cutaneous, hepatic and neuropsychiatric symptoms. METHOD:we analyzed all reports received during June to November 2009. The data considered were: sex, age, notifier, therapeutic modality, severity, classification of main side effect and imputation assigned. RESULTS: 179 notifications were received, most associated with treatment modality. As can be seen world wide, in Argentina, the great majority of reported adverse reactions involve the gastrointestinal system, being mostly mild and self-limiting. Given the variability and severity of psychiatric cases reported it is very important to pay close attention to these reports. Reported cases include the QTc interval prolongation, an event not previously described in the literature. CONCLUSIONS: it is essential to continu e with proactive monitoring of this drug because of the limited current experience and the benefits/ risks ratio of the safety profile of this drug.(AU)

Assunto(s): Humanos Oseltamivir/efeitos adversos Oseltamivir/uso terapêutico Vigilância Sanitária Sistemas de Notificação de Reações Adversas a Medicamentos Vírus da Influenza A Subtipo H1N1/efeitos de drogas Vírus da Influenza A Subtipo H1N1/imunologia Zanamivir/uso terapêutico

Link(s):

http://www.msal.gov.ar/rasp/rasp/articulos/volumen4/RASP4-AO3.pdf

3.

Estrategias para la reducción de la brecha del conocimiento a la acción en Argentina: la prevención y tratamiento de la influenza A (H1N1) en embarazadas como caso de análisis/ Knowledge to action gap reduction strategies in Argentina: influenza A (H1N1) prevention and treatment in pregnant women as a case of analysis

Autor(es): Esandi, María Eugenia; De Luca, Mario; Chapman, Evelina; García Dieguez, Marcelo; Carbonelli, Natacha; Ortiz, Zulma

Fonte: Bol. Acad. Nac. Med. B.Aires;88(1): 97-107, ene.-jun. 2010. graf

LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde ID: 606178

Resumo: Los reportes rápidos basados en la evidencia constituyen una de las estrategias para la reducción de la brecha del conocimiento a la acción. Objetivo: comunicar los resultados y lecciones aprendidas a partir de la elaboración de un reporte rápido sobre la efectividad y seguridad del uso de vacunas y antivirales para la influenza pandémica en embarazadas. Métodos: revisión sistemática sobre efectividad y seguridad del uso de antivirales y vacunas para influenza tipo A (H1N1) en emba (mais) razadas. Resultados: se recuperaron 166 citas: aunque sólo 88 cumplieron los criterios de inclusión. Los reportes epidemiológicos de la afectación de la pandemia señalan un riesgo de hospitalización tres a cinco veces más alto en embarazadas en comparación con la población general. Dos revisiones recientes indican que el oseltaminivir no estaría asociado con un mayor riesgo teratogénico. La evidencia sobre el zanamivir es escasa, absorción sistémica. A noviembre de 2009, la evidencia sobre la efectividad y seguridad de la vacuna para influenza A (H1N1) en embarazadas era escasa (dos ensayos en curso). Conclusión: los reportes rápidos constituyen una estrategia eficiente para el intercambio de conocimiento entre investigadores y decisores, aún en el contexto de una pandemia; sin embargo, es necesario encontrar métodos que permitan optimizar su implementación de manera sistemática y transparente.(AU)

Evidence-based rapid reviews constitute one of the knowledge to action GAP reduction strategies. Objective: to communicate the results and learned lessons during the elaboration of an evidence-based rapid review about the effectiveness and safety of vaccines and antivirals for influenza pandemic in pregnant women. Methods: all document containing evidence on adverse events and / or vaccines for influenza type A (H1N1) in pregnant women or that describes the evolution of the pandemic in this population was considered for analysis. Results: 166 articles were retrieved, although only 88 accomplished the inclusion criteria. Epidemiological reports of the pandemic situation indicate three to five times higher risk of hospitalization in pregnant women compared with the general population. Two recent reviews indicate that oseltamivir would not be associated with increased teratogenic risk. The evidence on the zanamivir is scarce, but the risk associated with its use is considered low because of its reduced systemic absortion. Through november 2009, evidence on effectiveness and safety of the H1N1 vaccine in pregnant women was scarce (two on-going clinical trials). Conclusion: evidence-based rapid reviews constitute an efficient strategy for researchers and decision-makers knowledge exchange, even in the context of a pandemic. However, methods that optimize its implementation through a systematic and transparent way are needed.(AU)

Assunto(s): Humanos Feminino Gravidez Influenza Humana/epidemiologia Influenza Humana/prevenção & controle Influenza Humana/terapia Vírus da Influenza A Subtipo H1N1 Complicações Infecciosas na Gravidez Pandemias Oseltamivir/farmacologia Zanamivir/farmacologia Vacinas contra Influenza/uso terapêutico

4.

Prone position ventilation, recruitment maneuver and intravenous zanamivir in severe refractory hypoxemia caused by influenza a (H1N1)

Autor(es): Biatto, Jair F. P; Costa, Eduardo L. V; Pastore, Laerte; Kallás, Esper G; Deheinzelin, Daniel; Schettino, Guilherme

Fonte: Clinics;65(11): 1211-1213, 2010. graf.

LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde ID: 571438

Assunto(s): Feminino Humanos Meia-Idade Anóxia/terapia Antivirais/uso terapêutico Vírus da Influenza A Subtipo H1N1 Influenza Humana/complicações Respiração Artificial/métodos Zanamivir/uso terapêutico Anóxia/etiologia Influenza Humana/quimioterapia Decúbito Ventral

Link(s):

SciELO Brasil

5.

ECDC INTERIM GUIDANCE: Public health use of influenza antivirals during influenza pandemics

Autor(es): European Centre for Disease Prevention and Control

Fonte: Stockholm; ECDC; June. 2009. 35 p.

Repositório Complementar ID: 236

Resumo: This background paper is intended as a resource for those in the European Union and EEA/EFTA area who are developing policies and practices concerning the use of influenza antivirals, especially in relation to influenza pandemics. The paper is based on scientific evidence, WHO guidance, expert opinions including those from ECDC%u2019s Advisory Forum and recommendations in European national pandemic preparedness plans. It focuses on options for the use of antiviral drugs in the context of an influenza pandemic.

Assunto(s): Humanos Influenza Humana/epidemiologia Influenza Humana/prevenção & controle Saúde Pública Antivirais/uso terapêutico Zanamivir Oseltamivir

Link(s):

6.

Clínica y tratamiento de la influenza A (H1N1)/ Clinic and treatment of the influenza A (H1N1)

Autor(es): San Juan, Jorge

Fonte: Bol. Acad. Nac. Med. B.Aires;87(1): 121-126, ene.-jun. 2009.

LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde ID: 562359

Assunto(s): Vírus da Influenza A Influenza Humana/complicações Influenza Humana/diagnóstico Influenza Humana/terapia Infecções Respiratórias/quimioterapia Infecções Respiratórias/etiologia Síndrome Respiratória Aguda Grave/diagnóstico Síndrome Respiratória Aguda Grave/quimioterapia Síndrome Respiratória Aguda Grave/etiologia Virus da Influenza A Subtipo H5N1 Oseltamivir/administração & dosagem Oseltamivir/uso terapêutico Zanamivir/administração & dosagem Zanamivir/uso terapêutico Antivirais/uso terapêutico

7.

Infográfico 07: Antivirais e resistência/ Infografía 07: Antivirales y la resistencia/ Infographic 07: Antivirals and resistance

Autor(es): BIREME

Fonte: São Paulo; BIREME; 2009.

Repositório Complementar ID: 317

Resumo: Vírus são parasitas intracelulares obrigatórios, precisam utilizar os mecanismos da célula para poder se replicar. Assim, os possíveis alvos de drogas antivirais são reduzidos, pois atacar as células pode causar graves efeitos colaterais. Os antivirais disponíveis contra o Influenza são específicos para suas proteínas e agem em duas etapas do ciclo viral: o desempacotamento e o brotamento.

Viruses are compulsorily intracellular parasites, and they have to use the mechanisms (mais)

Assunto(s): Vírus da Influenza A Subtipo H1N1 Influenza Humana/epidemiologia Influenza Humana/prevenção & controle Antivirais Amantadina/uso terapêutico Rimantadina/uso terapêutico Zanamivir/uso terapêutico Oseltamivir/uso terapêutico

Link(s):

8.

Updated review of influenza antiviral medicinal products for potential use during pandemic by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA)

Autor(es): European Medicines Agency

Fonte: London; EMEA; Dec. 13, 2007. 23 p.

Repositório Complementar ID: 283

Resumo: Influenza A virus is able to cause serious global outbreaks (pandemics) of influenza. The virus has several proteins, including two important surface glycoproteins, haemagglutinin (H) and neuraminidase (N) and two matrix proteins (M). N and M proteins are targets for the current influenza antiviral medicinal products. Influenza A viruses are classified into subtypes according to their H and N proteins. There are 16 different types of H (H1-H16) whereas 9 different types of influenza neurami (mais)

Assunto(s): Humanos Vírus da Influenza A Subtipo H1N1 Influenza Humana/epidemiologia Influenza Humana/prevenção & controle Surtos de Doenças Antivirais/farmacologia Antivirais/uso terapêutico Rimantadina/farmacologia Amantadina/farmacologia Oseltamivir/farmacologia Zanamivir/farmacologia

Link(s):

9.

Summary Report: Review on influenza antiviral medicinal products for potential use during pandemic

Autor(es): European Medicines Agency

Fonte: London; EMEA; Oct. 27, 2005. 18 p.

Repositório Complementar ID: 284

Resumo: Occasionally, emerging influenza A virus strains undergo major changes in their genes, especially in the neuraminidase (NA) and haemagglutinin (HA) genes. This may be due to an adaptation of an avian or porcine strain to the human host or to a genetic reassortment in a coinfection setting. The changes may provide the virus means for both increased infectivity and altered tissue distribution as well as a possibility to avoid detection by the host immune defence. Therefore, the new strains ma (mais)

Assunto(s): Humanos Influenza Humana/prevenção & controle Surtos de Doenças Vírus da Influenza A Subtipo H1N1 Antivirais/farmacologia Rimantadina/farmacologia Rimantadina/uso terapêutico Amantadina/farmacologia Oseltamivir/farmacologia Zanamivir/farmacologia

Link(s):

10.

Interim Guidance on Antiviral Recommendations for Patients with Novel Influenza A (H1N1) Virus Infection and Their Close Contacts

Autor(es): U.S.A. Centers for Disease Control and Prevention

Fonte: Atlanta; U.S.A. Centers for Disease Control and Prevention; s.d.

Repositório Complementar ID: 36

Resumo: Objective: To provide updated interim guidance on the use of antiviral agents for treatment and chemoprophylaxis of novel influenza (H1N1) virus infection, and assist clinicians in prioritizing use of antivirals for treatment or chemoprophylaxis of patients at higher risk for influenza-related complications. Additional revisions to these recommendations for antiviral treatment should be expected as the epidemiology and clinical presentation of novel influenza A (H1N1) virus infection is bet (mais)

Assunto(s): Humanos Masculino Feminino Gravidez Lactente Pré-Escolar Criança Adolescente Adulto Meia-Idade Idoso Condutas na Prática dos Médicos Influenza Humana Vírus da Influenza A Subtipo H1N1/efeitos de drogas Oseltamivir/uso terapêutico Antivirais/uso terapêutico Zanamivir/uso terapêutico Grupos de Risco

Link(s):

http://www.cdc.gov/h1n1flu/recommendations.htm

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Virological surveillance and antiviral resistance of human influenza virus in Argentina, 20052008/ Vigilancia virológica y resistencia a los antivíricos del virus de la gripe humana en la Argentina, 20052008

Uso de oseltamivir durante la pandemia de gripe a (H1N1): análisis de las reacciones adversas reportadas al sistema nacional de farmacovigilancia de ANMAT/ Use of oseltamivir during influenza A (H1N1) pandemic: analysis of adverse reactions reported to the ANMAT national pharmacovigilance system

Prone position ventilation, recruitment maneuver and intravenous zanamivir in severe refractory hypoxemia caused by influenza a (H1N1)

ECDC INTERIM GUIDANCE: Public health use of influenza antivirals during influenza pandemics

Clínica y tratamiento de la influenza A (H1N1)/ Clinic and treatment of the influenza A (H1N1)

Infográfico 07: Antivirais e resistência/ Infografía 07: Antivirales y la resistencia/ Infographic 07: Antivirals and resistance

Updated review of influenza antiviral medicinal products for potential use during pandemic by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMEA)

Summary Report: Review on influenza antiviral medicinal products for potential use during pandemic

Interim Guidance on Antiviral Recommendations for Patients with Novel Influenza A (H1N1) Virus Infection and Their Close Contacts