Research on expulsion law of influenza A(H1N1) virus and antiviral therapy

Abstract

Objective To investigate the A (H1N1 ) influenza patients whose viral expulsion law and antiviral effecacy in Shenzhen city in 2009. Methods A (H1N1) flu virus nucleic acid positive by reverse transcription-polymerasechain reaction (RT-PCR) with nose swabs pharynx swabs two times were showed in 75 patients. Thereafter, to detect the virus nucleic acid once per day until negative for two days in a row. Begin the antiviral therapy with Oseltamivir (Ⅰ) or the Chinese medicine (Ⅱ) or Oseltamivir combined the Chinese medicine (Ⅲ) respectively for 5 days immediately after testing virus positive at the first time. T lymphocyte subpopulation and IL-17 were identified by flow cytometry. Results 78.7% ( 59/75) of patients whose mean age was (22.25±10.38) years old virus nucleic acid turned negative in 7 days of duration. 21.3% (16/75) of patients whose mean age was (17.16±13.66) years old virus were still positive after 7 days of duration. Analysis of humoral and cellular immune function in 56 patients with A (H1N1) flushowed down IL-17 expression compared with seasonal flu and health control(P ＜ 0.01 ). 10cases virus persistence more than 7 days showed down IL-17 expression( 1.91 ± 0. 80)compared with that of 46 cases virus persistence smaller or equal to 7 days ( 3.05±1.59 ) ( P ＜ 0.05 ). Likewise, the former showed significant low IL-17 expression compared with seasonal flu ( P＜ 0.01 ) and health control ( P ＜0.001 ). Virus-negative ratio was different among three antiviral groups after a standard treatment course of 5days. The ratio was 92.86% for group Ⅲ, 71.43% for group Ⅰ and 46.15% for group Ⅱ in turn. Virusnegative ratio of the former two group was significantly higher than that of group Ⅱ ( P＜0.01, P ＜0.05 respectively). It took smaller hours of getting normathermia after treatment in group Ⅲ than that of the other two groups( P ＜ 0.05 ). Conclusion IL-17 and age are possibly interrelate with A (H1N1)flu virus infection and virus persistence. Oseltamivir combined traditional Chinese medicine treatment shows its unique advantage in antiviral efficacy and to alleviate the symptoms. Key words: Influemza A virus; Antiviral agents; Interleukin-17