Persistent Infection of Drug-resistant Influenza A Virus during Chemotherapy for Malignant Lymphoma

Intern Med. 2016;55(13):1807-10. doi: 10.2169/internalmedicine.55.6327. Epub 2016 Jul 1.

Abstract

We herein report the case of an 80-year-old man with malignant lymphoma who became persistently infected with influenza A virus. Although he was repeatedly treated with NA inhibitors, such as oseltamivir or peramivir, nasal cavity swab tests for influenza A antigen continued to be positive for more than 2 months. Virological analyses revealed that he was infected with the NA inhibitor-resistant A (H3N2) virus possessing an R292K substitution in the NA protein. These findings suggest that a drug-resistant influenza virus strain might selectively survive antiviral therapy in elderly patients with refractory malignant lymphoma undergoing multiple chemotherapies.

Publication types

  • Case Reports

MeSH terms

  • Acids, Carbocyclic
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use*
  • Cyclopentanes / therapeutic use
  • Drug Resistance, Viral
  • Guanidines / therapeutic use
  • Humans
  • Influenza A Virus, H3N2 Subtype*
  • Influenza, Human / virology*
  • Lymphoma / drug therapy*
  • Male
  • Mutation
  • Neuraminidase / antagonists & inhibitors*
  • Neuraminidase / genetics
  • Oseltamivir / therapeutic use

Substances

  • Acids, Carbocyclic
  • Antiviral Agents
  • Cyclopentanes
  • Guanidines
  • Oseltamivir
  • Neuraminidase
  • peramivir