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Influenza A(H3N2) virus exhibiting reduced susceptibility to baloxavir due to a polymerase acidic subunit I38T substitution detected from a hospitalised child without prior baloxavir treatment, Japan, January 2019 
The cap-dependent endonuclease inhibitor baloxavir marboxil became available in Japan in March 2018 for the treatment of influenza virus infection in patients aged 12 years and older and children younger than 12 years weighing at least 10 kg. Between October 2018 and January 2019, baloxavir was supplied to medical institutions that together serve ca 5.5 million people. In December 2018, we detected influenza A(H3N2) viruses exhibiting reduced susceptibility to baloxavir from baloxavir-treated children aged 6 and 7 years [1]. These viruses possessed an I38T substitution in the polymerase acidic subunit (PA), which confers reduced susceptibility to baloxavir [2]. We subsequently increased nationwide monitoring of the baloxavir susceptibility of circulating influenza viruses, irrespective of antiviral treatment [3].
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- Emi Takashita1, Chiharu Kawakami2, Rie Ogawa1, Hiroko Morita1, Seiichiro Fujisaki1, Masayuki Shirakura1, Hideka Miura1, Kazuya Nakamura1, Noriko Kishida1, Tomoko Kuwahara1, Akira Ota3, Hayato Togashi3, Ayako Saito4, Keiko Mitamura5, Takashi Abe6, Masataka Ichikawa7, Masahiko Yamazaki8, Shinji Watanabe1, Takato Odagiri1
The cap-dependent endonuclease inhibitor baloxavir marboxil became available in Japan in March 2018 for the treatment of influenza virus infection in patients aged 12 years and older and children younger than 12 years weighing at least 10 kg. Between October 2018 and January 2019, baloxavir was supplied to medical institutions that together serve ca 5.5 million people. In December 2018, we detected influenza A(H3N2) viruses exhibiting reduced susceptibility to baloxavir from baloxavir-treated children aged 6 and 7 years [1]. These viruses possessed an I38T substitution in the polymerase acidic subunit (PA), which confers reduced susceptibility to baloxavir [2]. We subsequently increased nationwide monitoring of the baloxavir susceptibility of circulating influenza viruses, irrespective of antiviral treatment [3].
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full article