Virological and Clinical Outcomes of Influenza Outpatients Treated With Baloxavir, Oseltamivir, or Laninamivir in the 2023-2024 Season.

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2024-11-01 DOI:10.1111/irv.70042

Takeyuki Goto, Naoki Kawai, Takuma Bando, Yoshio Takasaki, Shizuo Shindo, Tomonori Sato, Naoki Tani, Yong Chong, Hideyuki Ikematsu

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引用次数: 0

Abstract

Background: Clinical data on patients infected with influenza B Victoria (BV) after the approval of baloxavir is lacking.

Methods: This observational study of the Japanese 2023-2024 influenza season analyzed data from 25 outpatients with A(H1N1)pdm09, 36 with A(H3N2), and 65 with BV. Viral samples were collected before and after administering an antiviral (70 patients received baloxavir and 56 received a neuraminidase inhibitor), on days 1, 5, and 10. Isolated viruses after culturing were amplified using RT-PCR and sequenced to detect mutations of concern, including acidic protein (PA)-amino acid (AA) E23X/I38X for influenza A and M34X/I38X for BV. Fever and symptoms were tracked via self-reporting diaries.

Results: No PA-AA-substituted virus was detected from 126 pre-treatment samples. In the baloxavir cohort, one (7.1%, 1/14) PA I38F-substituted A(H1N1)pdm09 and two (11.1%, 2/18) PA I38T-substituted A(H3N2) viruses were isolated on day 5 but not on day 10. No (0%, 0/37) PA-AA-substituted BV was detected on day 5 or after. The virus isolation rate on day 5 was higher among patients with BV than with influenza A in both baloxavir (35.1% vs. 14.3% for A(H1N1)pdm09 and 16.7% for A(H3N2)) and oseltamivir-treated patients (44.4% vs. 0% for A(H1N1)pdm09 and 33.3% for A(H3N2)). Patients with PA-AA-substituted influenza A after baloxavir administration did not have longer fever duration than those without virus isolation or with wild-type virus on day 5, for both A(H1N1)pdm09 and A(H3N2).

Conclusions: Baloxavir-resistant variants were not detected in influenza BV before treatment, as with A. The emergence of PA-AA-substituted influenza A after baloxavir administration was temporal and did not cause prolonged symptoms. No baloxavir-resistant BV variants were observed after baloxavir administration.

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2023-2024 年流感季节使用巴洛沙韦、奥司他韦或拉尼那韦治疗流感门诊患者的病毒学和临床结果。

背景：缺乏有关巴洛沙韦获批上市后乙型流感维多利亚（BV）感染者的临床数据：方法：这项观察性研究分析了 25 名甲型 H1N1 pdm09 流感门诊患者、36 名甲型 H3N2 流感门诊患者和 65 名乙型流感门诊患者的数据：这项针对日本 2023-2024 年流感季节的观察性研究分析了 25 名甲型 H1N1 pdm09、36 名甲型 H3N2 和 65 名 BV 门诊患者的数据。在使用抗病毒药物（70 名患者使用巴洛沙韦，56 名患者使用神经氨酸酶抑制剂）前后的第 1、5 和 10 天采集了病毒样本。用 RT-PCR 扩增培养后分离出的病毒，并进行测序以检测相关突变，包括甲型流感的酸性蛋白 (PA) - 氨基酸 (AA) E23X/I38X 和乙型流感的 M34X/I38X。通过自我报告日记跟踪发热和症状：结果：126 份治疗前样本中未检测到 PA-AA 取代病毒。在巴洛沙韦队列中，第 5 天分离到 1 个（7.1%，1/14）PA I38F 取代的 A(H1N1)pdm09 病毒，第 10 天分离不到 2 个（11.1%，2/18）PA I38T 取代的 A(H3N2) 病毒。第 5 天及以后均未检测到 PA-AA 取代的 BV（0%，0/37）。在巴洛沙韦（A(H1N1)pdm09为35.1%对14.3%，A(H3N2)为16.7%）和奥司他韦（A(H1N1)pdm09为44.4%对0%，A(H3N2)为33.3%）治疗的患者中，第5天BV患者的病毒分离率高于甲型流感患者。就甲型 H1N1 pdm09 和甲型 H3N2 流感病毒而言，服用巴洛沙韦后感染 PA-AA 取代型甲型流感病毒的患者在第 5 天的发热持续时间并不比未分离病毒或感染野生型病毒的患者长：服用巴洛沙韦后出现的 PA-AA 取代型甲型流感是暂时性的，不会导致症状持续时间延长。服用巴洛沙韦后未发现耐巴洛沙韦的BV变异株。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.