Restricted accessResearch articleFirst published online 1998-1
Effect of Rimantadine on Induced Specific Serum Haemagglutination-Inhibiting Antibody and Nasal IgA Titres after Experimental Exposure of Adults to Influenza a Virus
Haemagglutination-inhibiting (HI) antibody and specific nasal IgA responses to infection with influenza A (H1N1) virus were compared between 35 rimantadine-treated subjects (100 mg, orally, twice daily from day 2 to day 10, post-challenge) and 36 placebo-treated subjects. Infection was documented in 29 (83%) and 34 (94%), viral shedding in 24 (69%) and 30 (83%), and seroconversion in 21 (60%) and 27 (75%) of the rimantadine- and placebo-treated subjects, respectively. The duration of virus shedding (1.7±1.6 days compared with 3.1±2.1 days) was significantly lower in the rimantadine-treated group. Both groups had significant increases in the HI (21 days post-challenge) and virus-specific nasal IgA antibody (7 days post-challenge) titres. Convalescent HI but not IgA antibody titre was significantly greater in the placebo group. Convalescent HI antibody titre correlated with virus shedding, suggesting that differences between treatment groups are attributable to the reduced duration of viral shedding in rimantadine-treated subjects.
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References
1.
WingfieldW.L., PollakD., & GrunertR.R.Therapeutic efficacy of amantadine HC1 and rimantadine HC1 in naturally occurring influenza A2 respiratory illness in man. New England Journal of Medicine1969; 281: 579–584
2.
MontoA.S., GunnR.A., BandykM.G., & KingC.L.Prevention of Russian influenza by amantadine. Journal of the American Medical Association1979; 241: 1003–1007
3.
DolinR., ReichmanR.C., MadoreH.P., MaynardR., LintonP.N., & Webber-JonesJ.A controlled trial of amantadine and rimantadine in the prophylaxis of influenza A infection. New England Journal of Medicine1982; 307: 580–584
4.
PaylerD.K., & PrudhamP.A.Influenza A prophylaxis with amantadine in a boarding school. Lancet1984; i: 502–504
5.
CloverR.D., CrawfordS.A., AbellT.D., RamseyC.N.Jr., & GlezenW.P., & CouchR.B.Effectiveness of rimantadine prophylaxis of children with families. American Journal of Diseases of Children1986; 140: 706–709
6.
HallC.B., DolinR., GalaC.L., MarkovitzD.M., ZhangY.Q., MadoreP.H., DisneyF.A., TalpeyW.B., GreenJ.L., & FrancisA.B.Children with influenza A infection: treatment with rimantadine. Pediatrics1987; 80: 275–282
7.
ThompsonJ., FleetW., LawrenceE., PierceE., MorrisL., & WrightP.A comparison of acetaminophen and rimantadine in the treatment of influenza A infection in children. Journal of Medical Virology1987; 21: 249–255
8.
SearsS.D., & ClementsM.L.Protective efficacy of low-dose amantadine in adults challenged with wild-type influenza A virus. Antimicrobial Agents and Chemotherapy1987; 31: 1470–1473
9.
CrawfordS.A., CloverR.D., AbellT.D., RamseyC.N.Jr., & GlezenP., & CouchR.B.Rimantadine prophylaxis in children: a follow-up study. Pediatric Infectious Diseases Journal1988; 7: 379–393
10.
GlezenW.P.Consideration of the risk of influenza in children and indications for prophylaxis. Reviews of Infectious Diseases1980; 2: 408–420
11.
HaydenF.G., SperberS.J., BelsheR.B., CloverR.D., HayA.J., & PykeS.Recovery of drug resistant influenza A virus during therapeutic use of rimantadine. Antimicrobial Agents and Chemotherapy1991; 35: 1741–1747
12.
HaydenF.G., & HayA.J.Emergence and transmission of influenza A viruses resistant to amantadine and rimantadine. Current Topics in Microbiology and Immunology1992; 176: 119–130
13.
MardineyM.R.Jr., & BredtA.B.The immunosuppressive effect of amantadine upon the response of lymphocytes to specific antigens in vitro. Transplantation1971; 12: 183–188
14.
KoffW.C., PeavyD.L., & KnightV.Inhibition of in vitro proliferative responses of human lymphocytes by rimantadine hydrochloride. Infection and Immunity1979; 23: 665–659.
15.
ReumanP.D., BernsteinD.I., KeelyS.P., YoungE.C., SherwoodJ.R., & SchiffG.M.Differential effect of amantadine hydrochloride on the systemic and local immune response to influenza A. Journal of Medical Virology1989; 27: 437–141
16.
HerrmannJ.E., WestK., BrunsM., & EnnisF.A.Effect of rimantadine on cytotoxic T lymphocyte responses and immunity to re-infection in mice infected with influenza A virus. Journal of Infectious Diseases1990; 161: 180–184
17.
CloverR.D., WanerJ.L., BeckerL., & DavisA.Effect of rimantadine on the immune response to influenza A infections. Journal of Medical Virology1991; 34: 68–73
18.
MorrisD.J.Adverse effects and drug interactions of clinical importance with antiviral drugs. Drug Safety1994; 10: 281–291
19.
DoyleW.J., SkonerD.P., AlperC.M., AllenG., MoodyS.A., SerokyJ.T., & HaydenF.G.Effect of rimantadine treatment on clinical manifestations and otological complications in adults experimentally infected with influenza A (H1N1) virus. Journal of Infectious Diseases1998; 169: in press
20.
HendersonF.W., CollierA.M., SanyaiM.A., WatkinsJ.M., FaircloughD.L., ClydeW.A., & DennyF.W.A longitudinal study of respiratory viruses and bacteria in the etiology of acute otitis media with effusion. New England Journal of Medicine1982; 306: 1377–1383
21.
TobitaK., SugiuraA., EnomotoC., & FuruyamaM.Plaque assay and primary isolation of influenza A viruses in an established line of canine kidney cells (MDCK) in the presence of trypsin. Medical Microbiology & Immunology (Berlin) 1975; 162: 9–14
22.
DowdleW.R., KendalA.P., & NobleG.R.Influenza viruses. In Diagnostic Procedures for Viral Rickettsial and Chlamydial Infections, 5th edn, 1979, pp. 585–609. Edited by LennetteE.H., & SchmidtN.J.Washington, DC: American Public Health Association
23.
MurphyB.R., PhelanM.A., NelsonD.L., YarchoanR., TierneyE.L., AilingD.W., & ChanockR.M.Hemagglutinin-specific enzyme-linked immunosorbent assay for antibodies to influenza A and B viruses. Journal of Clinical Microbiology1981; 13: 554–560
24.
BarberW.H., & SmallP.A.Jr.. Local and systemic immunity to influenza infection in ferrets. Infection and Immunity1978; 21: 221–228
