Details

Autor(en) / Beteiligte

• Wang, Yeming
• Guo, Qiang
• Yan, Zheng
• Zhou, Daming
• Zhang, Wei
• Zhou, Shujun
• Li, Yu-Ping
• Yuan, Jing
• Uyeki, Timothy M
• Shen, Xinghua
• Wu, Wenjuan
• Zhao, Hui
• Wu, Yun-Fu
• Shang, Jia
• He, Zhengguang
• Yang, Yi
• Zhao, Hongsheng
• Hong, Yongqing
• Zhang, Zehua
• Wu, Min
• Wei, Tiemin
• Deng, Xilong
• Deng, Yijun
• Cai, Li-hua
• Lu, Weihua
• Shu, Hongmei
• Zhang, Lin
• Luo, Hong
• ing Zhou, Y
• Weng, Heng
• Song, Keyi
• Yao, Li
• Jiang, Mingguang
• Zhao, Boliang
• Chi, Ruibin
• Guo, Boqi
• Fu, Lin
• Yu, Long
• Min, Haiyan
• Chen, Pu
• Chen, Shuifang
• Hong, Liang
• Mao, Wei
• Huang, Xiaoping
• Gu, Lijun
• Li, Hui
• Wang, Chen
• Cao, Bin

Titel

Factors Associated With Prolonged Viral Shedding in Patients With Avian Influenza A(H7N9) Virus Infection

Ist Teil von

• The Journal of infectious diseases, 2018-05, Vol.217 (11), p.1708-1717

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2018

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Corticosteroid therapy and delayed neuraminidase inhibitor (NAI) treatment were associated with prolonged influenza A(H7N9) viral RNA shedding. Our findings suggest that NAI treatment should be started as soon as possible in patients with suspected A(H7N9) infection and that use of corticosteroids should be prudent. Abstract Background Data are limited on the impact of neuraminidase inhibitor (NAI) treatment on avian influenza A(H7N9) virus RNA shedding. Methods In this multicenter, retrospective study, data were collected from adults hospitalized with A(H7N9) infection during 2013–2017 in China. We compared clinical features and A(H7N9) shedding among patients with different NAI doses and combination therapies and evaluated factors associated with A(H7N9) shedding, using Cox proportional hazards regression. Results Among 478 patients, the median age was 56 years, 71% were male, and 37% died. The median time from illness onset to NAI treatment initiation was 8 days (interquartile range [IQR], 6–10 days), and the median duration of A(H7N9) RNA detection from onset was 15.5 days (IQR, 12–20 days). A(H7N9) RNA shedding was shorter in survivors than in patients who died (P < .001). Corticosteroid administration (hazard ratio [HR], 0.62 [95% confidence interval {CI}, .50–.77]) and delayed NAI treatment (HR, 0.90 [95% CI, .91–.96]) were independent risk factors for prolonged A(H7N9) shedding. There was no significant difference in A(H7N9) shedding duration between NAI combination treatment and monotherapy (P = .65) or between standard-dose and double-dose oseltamivir treatment (P = .70). Conclusions Corticosteroid therapy and delayed NAI treatment were associated with prolonged A(H7N9) RNA shedding. NAI combination therapy and double-dose oseltamivir treatment were not associated with a reduced A(H7N9) shedding duration as compared to standard-dose oseltamivir.