Abstract

Baloxavir showed broad-spectrum in vitro replication inhibition of 4 types of influenza viruses (90% effective concentration range 1.2–98.3 nmol/L); susceptibility pattern was influenza A ˃ B ˃ C ˃ D. This drug also inhibited influenza A viruses of avian and swine origin, including viruses that have pandemic potential and those resistant to neuraminidase inhibitors.

Highlights

  • Swine origin¶All 3 viruses were isolated from swine (Appendix Table 2)

  • Baloxavir showed broad-spectrum in vitro replication inhibition of 4 types of influenza viruses (90% effective concentration range 1.2–98.3 nmol/L); susceptibility pattern was influenza A B C D

  • Influenza viruses are classified into 4 types: A, B, C, and D (1)

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Summary

Swine origin

¶All 3 viruses were isolated from swine (Appendix Table 2). Substitution PA-I38M conferred 12-fold reduced baloxavir susceptibility, consistent with previous reports for PA-I38M–containing H3N2 viruses (11,12). Analysis of PA sequences from 2,485 H7N9 viruses (from GISAID and GenBank) showed 1 virus with PA-I38M, 2 with PAE199G, and 1 with PA-A36V (11,12). The effect of these substitutions on baloxavir susceptibility for H7N9 viruses is currently unknown. PA sequence of 1 swine influenza A virus showed PA-I38T, a marker associated with clinically relevant baloxavir resistance (11). None of these viruses were available for phenotypic testing

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