Duration of fever and PA/I38X-substituted virus emergence in patients treated with baloxavir in the 2018-2019 influenza season

J Infect Chemother. 2020 Apr;26(4):400-402. doi: 10.1016/j.jiac.2019.12.002. Epub 2019 Dec 20.

Abstract

Duration of fever and virus persistence after baloxavir administration were investigated in 81 outpatients, 16 with A(H1N1)pdm09 and 65 with A(H3N2) in the Japanese 2018-2019 influenza season. Only eight cases of A(H3N2) viruses were detected post-dose. PA/I38T-substituted viruses were detected in four (6.2%) of 65 A(H3N2) patients, at days 3 and 4, constituting 50% (4/8) of A(H3N2) detected post-dose. The median duration of fever was 26.0 h for A(H1N1)pdm09 and 20.3 h for A(H3N2). The median duration of fever for patients with PA/I38T-substituted viruses was 22.0 h, without significant difference to that of the patients in whom the mutated virus was not detected. Emergence of PA/I38T-substituted viruses after treatment with baloxavir was confirmed, but no significant prolongation of fever was observed in the four patients with PA/I38T-substituted virus emergence.

Keywords: Baloxavir marboxil; Cap-dependent endonuclease inhibitor; Drug resistance; Duration of fever; Influenza; Mutation.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Dibenzothiepins / therapeutic use*
  • Drug Resistance, Viral / drug effects
  • Fever
  • Humans
  • Influenza A Virus, H1N1 Subtype / drug effects
  • Influenza A Virus, H1N1 Subtype / immunology
  • Influenza A Virus, H3N2 Subtype / drug effects
  • Influenza A Virus, H3N2 Subtype / immunology
  • Influenza, Human / drug therapy*
  • Middle Aged
  • Morpholines / therapeutic use*
  • Pyridones / therapeutic use*
  • Triazines / therapeutic use*
  • Young Adult

Substances

  • Antiviral Agents
  • Dibenzothiepins
  • Morpholines
  • Pyridones
  • Triazines
  • baloxavir