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Influenza A/H3N2 virus infection in immunocompromised ferrets and emergence of antiviral resistance

tetano

Editor, Senior Moderator
PLoS One. 2018 Jul 19;13(7):e0200849. doi: 10.1371/journal.pone.0200849. eCollection 2018.
[h=1]Influenza A/H3N2 virus infection in immunocompromised ferrets and emergence of antiviral resistance.[/h] Roosenhoff R[SUP]1[/SUP], van der Vries E[SUP]2[/SUP], van der Linden A[SUP]1[/SUP], van Amerongen G[SUP]3[/SUP], Stittelaar KJ[SUP]3[/SUP], Smits SL[SUP]3[/SUP], Schutten M[SUP]4[/SUP], Fouchier RAM[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] Influenza viruses can cause severe life threatening infections in high-risk patients, including young children, the elderly and patients with compromised immunity due to underlying medical conditions or immunosuppressive treatment. The impaired immunity of these patients causes prolonged virus infection and combined with antiviral treatment facilitates the emergence of viruses with resistance mutations. The diverse nature of their immune status makes them a challenging group to study the impact of influenza virus infection and the efficacy of antiviral therapy. Immunocompromised ferrets may represent a suitable animal model to assess influenza virus infection and antiviral treatment strategies in immunocompromised hosts. Here, ferrets were given a daily oral solution of mycophenolate mofetil, tacrolimus and prednisolone sodium phosphate to suppress their immune system. Groups of immunocompromised and immunocompetent ferrets were inoculated with an A/H3N2 influenza virus and were subsequently treated with Oseltamivir or left untreated. Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was performed on the throat and nose specimens to study virus replication during the course of infection. All immunocompromised ferrets had prolonged presence of viral RNA and a higher total amount of virus shedding compared to the immunocompetent ferrets. Although Oseltamivir reduced the total amount of virus shedding from the nose and throat of treated ferrets, it also resulted in the emergence of the neuraminidase R292K resistance substitution in all these animals, as determined by mutation specific RT-PCR and next-generation sequencing. No additional mutations that could be associated with the emergence of the R292K resistance mutation were detected. The immunocompromised ferret model can be used to study A/H3N2 virus shedding and is a promising model to study new antiviral strategies and the emergence of antiviral resistance in immunocompromised hosts.


PMID: 30024940 DOI: 10.1371/journal.pone.0200849
 
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