Although vaccines are the best means of protection against influenza, neuraminidase
inhibitors are currently the main antiviral treatment available to control severe
influenza cases. One of the most frequent substitutions in the neuraminidase (NA)
protein of influenza A(H3N2) viruses during or soon after oseltamivir administration
is E119V mutation. We describe the emergence of a mixed viral population with the
E119E/V mutation in the NA protein sequence in a post-treatment influenza sample
collected from an immunocompromised patient in Argentina. This substitution was
identified by a real-time reverse transcriptase polymerase chain reaction (RT-PCR)
protocol and was confirmed by direct Sanger sequencing of the original sample. In
2014, out of 1140 influenza samples received at the National Influenza Centre, 888
samples (78%) were A(H3N2) strains, 244 (21.3%) were type B strains, and 8 (0.7%)
were A(H1N1)pdm09 strains. Out of 888 A(H3N2) samples, 842 were tested for the E119V
substitution by quantitative RT-PCR: 841 A(H3N2) samples had the wild-type E119
genotype and in one sample, a mixture of viral E119/ V119 subpopulations was
detected. Influenza virus surveillance and antiviral resistance studies can lead to
better decisions in health policies and help in medical treatment planning,
especially for severe cases and immunocompromised patients.
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