IDCases. 2019 Oct 1;18:e00650. doi: 10.1016/j.idcr.2019.e00650. eCollection 2019. Adult influenza A (H3N2) with reduced susceptibility to baloxavir or peramivir cured after switching anti-influenza agents.
Seki M1, Sakai-Tagawa Y2, Yasuhara A2, Watanabe Y3.
Author information
1 Division of Infectious Diseases and Infection Control, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan. 2 Department of Virology, Institute of Medical Science, University of Tokyo, Tokyo, Japan. 3 Laboratory for Clinical Microbiology, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Japan.
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.
? 2019 The Authors.
KEYWORDS:
Baloxavir; Peramivir; Polymerase; Polymerase acidic subunit; Viral infection
PMID: 31692637 PMCID: PMC6804930 DOI: 10.1016/j.idcr.2019.e00650
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