Effect of Oseltamivir on the Hemagglutination Test and Hemagglutination Inhibition Test of the Influenza A(H3N2) Virus in China.

We compared the effect of oseltamivir on the hemagglutination (HA) test and hemagglutinin inhibition (HI) test of the influenza A(H3N2) virus in China to obtain the "true" HA titer and antigenic variation. A total of 395 influenza H3N2 strains isolated in mainland China from October 2014 to May 2015 were analyzed with HA and HI tests, with or without oseltamivir.. Gene sequencing was undertaken for selected viruses, and the amino-acid sequence of neuraminidase (NA) protein was compared with the vaccine strain. In the HA test in the presence of oseltamivir, the HA titer was unchanged in 44. 8%, decreased in 43. 8%, and increased in 11. 4% of tested strains. In the presence of oseltamivir, the proportion of viruses similar to A/TX/50/2012 egg isolates was significantly higher, and the proportion of viruses similar to A/SZ/9715293/2013 cell isolates significantly lower, than the proportion obtained from the test without the presende of oseltamivir. A significant difference was detected between the tests with or without oseltamivir. In A/TX/50/2012 cell isolates and A/SZ/9715293/2013 egg isolates, no significant difference was detected between the tests with or without oseltamivir. Nineteen selected strains' of influenza A ( H3N2) were sequenced, and the amino-acid sites were compared with A/TX/50/2012 egg isolates. Five strains had a more-than-fourfold decrease in HA titer when addition of oseliamivir showed no common mutation in amino acids, whereas the A/Shandong Laicheng/119/2015 strain had a D151G mutation and the A/Jilin Tiexi/1194/2015 strain had a V4121 and T434A mutation in the NA protein. The strain had a two-to-fourfold decrease in HA titer when addition of oseltamivir showed 126T, G93S, V1491, N234D, T267K and S416G mutations in NA protein.. These data show that, for recent circulating influenza H3N2 viruses, the presence of oseltamivir can be used to obtain more accurate HA and HI titers for antigenic analysis and vaccine evaluations.