Adult influenza A (H3N2) with reduced susceptibility to baloxavir or peramivir cured after switching anti-influenza agents. (2019)

• Record Type: Journal Article
• Authors: Seki, Masafumi; Sakai-Tagawa, Yuko; Yasuhara, Atsuhiro; Watanabe, Yuji
• Is Part Of: IDCases. Volume 18(2019)
• Publication Date: 2019
• Subjects: Baloxavir -- Polymerase -- Peramivir -- Viral infection -- Polymerase acidic subunit; Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2019.e00650
• Languages: English
• ISSNs: 2214-2509

Abstract

Abstract: We describe two adults with A/H3N2 influenza with (patient 1), and without (patient 2) polymerase acidic (PA) subunit I38 T substitution during the same season. Patient 1 had a reduced clinical response to baloxavir, a cap-dependent endonuclease inhibitor (CEI), but was cured by peramivir, a neuraminidase inhibitor. Baloxavir was clinically effective for patient 2, for whom peramivir had been ineffective. Susceptibility to baloxavir can be decreased by a PA unit mutation, but response to treatment can be increased by switching and/or combination with a neuraminidase inhibitor, even though CEI are clinically effective against influenza in adults.