Manifestações clínicas e evolução da infecção pelo vírus da influenza A (H1N1) em receptores de transplante renal

• Autor(a) principal: Freitas, Tainá Veras de Sandes [UNIFESP]
• Data de Publicação: 2011
• Outros Autores: Ono, Gislaine [UNIFESP], Corrêa, Luci [UNIFESP], Gomes, Pollyane Sousa [UNIFESP], Galante, Nelson Zocoler [UNIFESP], Tedesco-Silva Junior, Hélio [UNIFESP], Camargo, Luís Fernando Aranha [UNIFESP], Pestana, Jose Osmar Medina [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0101-28002011000200004; http://repositorio.unifesp.br/handle/11600/6484
• topic: respiratory tract infections; influenza A virus; H1N1 subtype; risk factors; kidney transplantation; immunosuppression; infecções respiratórias; vírus da influenza A subtipo H1N1; fatores de risco; transplante de rim; imunossupressão

INTRODUCTION: The emergence of the pan>demic outbreak of influenza A (H1N1) in April, 2009, represented a logistic challenge for public health. Although most infected patients presented clinical and evolutionary manifestations which were very similar to seasonal influenza, a significant number of individuals developed pneumonia and severe acute respiratory failure. The impact of influenza A (H1N1) in immunocompromised patients is not well established yet. METHODS: This study aimed to analyze the clinical presentations and evolution of influenza A (H1N1) in 19 kidney transplant recipients. Influenza A (H1N1) infection was confirmed by RT-PCR in all patients. Treatment included antiviral therapy with oseltamivir phosphate and antibiotics. RESULTS: The studied population was compounded mostly of white people (63%), males (79%), at a mean age of 38.6 ± 17 years and patients with at least one comorbidity (53%). Influenza A (H1N1) infection was identified 41.6 ± 49.6 months after transplantation. Common symptoms included cough (100%), fever (84%), dyspnea (79%), and myalgia (42%). Acute allograft dysfunction was observed in 42% of the patients. Five patients (26%) were admitted to the Intensive Care Unit, two (10%) required invasive ventilation support, and two (10%) required vasoactive drugs. Mortality rate was 10%. CONCLUSIONS: Acute renal allograft dysfunction was a common finding. Clinical, laboratory, and evolutionary characteristics were comparable to those in the general population.