Replicative Fitness of Seasonal Influenza A Viruses With Decreased Susceptibility to Baloxavir

J Infect Dis. 2020 Jan 14;221(3):367-371. doi: 10.1093/infdis/jiz472.

Abstract

Susceptibility of influenza A viruses to baloxavir can be affected by changes at amino acid residue 38 in the polymerase acidic (PA) protein. Information on replicative fitness of PA-I38-substituted viruses remains sparse. We demonstrated that substitutions I38L/M/S/T not only had a differential effect on baloxavir susceptibility (9- to 116-fold) but also on in vitro replicative fitness. Although I38L conferred undiminished growth, other substitutions led to mild attenuation. In a ferret model, control viruses outcompeted those carrying I38M or I38T substitutions, although their advantage was limited. These findings offer insights into the attributes of baloxavir-resistant viruses needed for informed risk assessment.

Keywords: baloxavir acid; drug resistance; ferret; influenza; polymerase acidic protein.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amino Acid Substitution
  • Animals
  • Antiviral Agents / therapeutic use*
  • Dibenzothiepins
  • Disease Models, Animal
  • Dogs
  • Drug Resistance, Viral / genetics*
  • Ferrets
  • High-Throughput Nucleotide Sequencing
  • Influenza A Virus, H1N1 Subtype / genetics*
  • Influenza A Virus, H3N2 Subtype / genetics*
  • Madin Darby Canine Kidney Cells
  • Male
  • Microbial Sensitivity Tests
  • Morpholines
  • Orthomyxoviridae Infections / drug therapy*
  • Orthomyxoviridae Infections / virology
  • Oxazines / therapeutic use*
  • Pyridines / therapeutic use*
  • Pyridones
  • RNA-Dependent RNA Polymerase / genetics
  • Seasons
  • Thiepins / therapeutic use*
  • Treatment Outcome
  • Triazines / therapeutic use*
  • Viral Proteins / genetics
  • Virus Replication / genetics*

Substances

  • Antiviral Agents
  • Dibenzothiepins
  • Morpholines
  • Oxazines
  • PA protein, influenza viruses
  • Pyridines
  • Pyridones
  • Thiepins
  • Triazines
  • Viral Proteins
  • baloxavir
  • RNA-Dependent RNA Polymerase