Treatment of Resistant Influenza Virus Infection in a Hospitalized Patient with Cystic Fibrosis with DAS181, a Host-Directed Antiviral

• Published in: Antiviral therapy Vol. 21; no. 1; pp. 71 - 74
• Main Authors: Silveira, Fernanda P, Abdel-Massih, Rima, Bogdanovich, Tatiana, Pakstis, Diana L, Routh, Rebecca L, Moss, Ronald B
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2016
• Subjects: Antiviral Agents - pharmacology; Antiviral Agents - therapeutic use; Cystic Fibrosis - complications; Drug Resistance, Viral; Female; Humans; Influenza A Virus, H1N1 Subtype - drug effects; Influenza A Virus, H1N1 Subtype - physiology; Influenza, Human - complications; Influenza, Human - diagnosis; Influenza, Human - drug therapy; Influenza, Human - virology; Mutation; Orthomyxoviridae; Recombinant Fusion Proteins - therapeutic use; Treatment Outcome; Viral Load; Young Adult
• ISSN: 1359-6535; 2040-2058
• DOI: 10.3851/IMP2977

We report a cystic fibrosis patient infected with influenza 2009H1N1 who had persistent viral shedding and clinical deterioration despite prolonged treatment with oseltamivir and zanamivir. The patient was diagnosed with H275Y neuraminidase inhibitor resistant influenza during treatment, thus was treated for 10 days with DAS181, an investigational host-directed inhaled sialidase fusion protein. Viral clearance occurred after 5 days of therapy and the patient became eligible for lung transplantation. Although the patient succumbed prior to receiving a transplant, this case exemplifies the potential utility of a host-directed approach against influenza which has potential to become resistant to neuraminidase inhibitors.