Abstract
BackgroundBaloxavir marboxil (baloxavir) is a new anti-influenza virus agent that is comparable to oseltamivir phosphate (oseltamivir). Since the efficacy of baloxavir in preventing household transmission of influenza is not well established, we compared the secondary household influenza virus transmission rates between patients on baloxavir vs oseltamivir.MethodsBetween October 2018 and March 2019, we enrolled index patients (diagnosed with influenza and treated with baloxavir or oseltamivir) and household members. The secondary attack rate of household members was compared between index patients treated with baloxavir vs oseltamivir. Risk factors of household transmission were determined using multivariate logistic analyses.ResultsIn total, 169 index patients with influenza type A were enrolled. The median age was 27.0 (interquartile range; 11–57) years. The number of index patients treated with baloxavir and oseltamivir was 49 and 120, respectively. The secondary attack rate was 9.0% (95% confidence interval [CI]: 4.6–15.6) in the baloxavir group and 13.5% (95% CI: 9.8–17.9) in the oseltamivir group. In the multivariate analysis, independent risk factors were 0–6 years of age (odds ratio [OR] 2.78, 95% CI: 1.33–5.82, p < 0.01) and not being on baloxavir treatment. (OR: 0.63, 95% CI: 0.30–1.32, p = 0.22).ConclusionThe household secondary attack rate of influenza was comparable in patients treated with baloxavir vs oseltamivir. Therefore, baloxavir can be used as an alternative therapy to oseltamivir in reducing household transmission of influenza.Trial registrationPatients in this study were retrospectively registered. https://www.tosei.or.jp/clinical/pdf/2_influenza.pdf.
Highlights
One of the major ways of transmitting the influenza virus is through household contact [1]
During the study period, 909 patients were confirmed with influenza A; of whom, 169 index patients (18.6%) were eligible for this study
Forty-nine index patients and 122 household members in the baloxavir group and 120 index patients and 296 household members in the oseltamivir group were eligible for this study
Summary
One of the major ways of transmitting the influenza virus is through household contact [1]. Oseltamivir treatment is effective in reducing the duration of symptoms and the risk of household transmission [3, 5]. The efficacy of reducing household transmission of H1N1 varies among different neuraminidase inhibitors [7]. Baloxavir marboxil (baloxavir) is a new class of antiviral agent that works as a cap-dependent endonuclease inhibitor. We conducted a single-center observational study to test our hypothesis that baloxavir can be used as an alternative therapy to oseltamivir in preventing household transmission of influenza. Baloxavir marboxil (baloxavir) is a new anti-influenza virus agent that is comparable to oseltamivir phosphate (oseltamivir). Since the efficacy of baloxavir in preventing household transmission of influenza is not well established, we compared the secondary household influenza virus transmission rates between patients on baloxavir vs oseltamivir
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