Dr Aeron C Hurt PhD, Prof Tawee Chotpitayasunondh MD, Nancy J Cox PhD, Rod Daniels PhD, Alicia M Fry MD, Larisa V Gubareva PhD, Prof Frederick G Hayden MD, David S Hui MD, Olav Hungnes PhD, Angie Lackenby PhD, Wilina Lim MD, Adam Meijer PhD, Charles Penn PhD, Masato Tashiro MD, Timothy M Uyeki MD, Prof Maria Zambon PhD on behalf of the WHO Consultation on Pandemic Influenza A (H1N1) 2009 Virus Resistance to Antivirals
The Lancet Infectious Diseases, Early Online Publication, 19 December 2011
Influenza A H1N1 2009 virus caused the first pandemic in an era when neuraminidase inhibitor antiviral drugs were available in many countries. The experiences of detecting and responding to resistance during the pandemic provided important lessons for public health, laboratory testing, and clinical management. We propose recommendations for antiviral susceptibility testing, reporting results, and management of patients infected with 2009 pandemic influenza A H1N1. Sustained global monitoring for antiviral resistance among circulating influenza viruses is crucial to inform public health and clinical recommendations for antiviral use, especially since community spread of oseltamivir-resistant A H1N1 2009 virus remains a concern.
Further studies are needed to better understand influenza management in specific patient groups, such as severely immunocompromised hosts, including optimisation of antiviral treatment, rapid sample testing, and timely reporting of susceptibility results.
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