Baloxavir treatment of oseltamivir-resistant influenza A/H1pdm09 in two immunocompromised patients

Transpl Infect Dis. 2021 Jun;23(3):e13542. doi: 10.1111/tid.13542. Epub 2020 Dec 22.

Abstract

Few treatment options are available for oseltamivir-resistant influenza. It has been proposed that baloxavir can be effective in this setting due to its distinct mechanism of action but clinical experience is lacking for immunocompromised patients. We report two such cases treated with baloxavir after failure of oseltamivir and detection of oseltamivir resistance mutations. Baloxavir/zanamivir combination therapy was effective in one patient, but persistent viral shedding was noted with baloxavir monotherapy in the other patient.

Keywords: CAR-T cell therapy; H275Y; lung transplant; lymphoma; neuraminidase inhibitor.

MeSH terms

  • Alphainfluenzavirus
  • Antiviral Agents / therapeutic use
  • Dibenzothiepins / therapeutic use*
  • Drug Resistance, Viral / drug effects
  • Humans
  • Immunocompromised Host
  • Influenza, Human* / drug therapy
  • Morpholines / therapeutic use*
  • Neuraminidase / therapeutic use
  • Oseltamivir / therapeutic use
  • Pyridones / therapeutic use*
  • Triazines / therapeutic use*
  • Zanamivir / therapeutic use

Substances

  • Antiviral Agents
  • Dibenzothiepins
  • Morpholines
  • Pyridones
  • Triazines
  • Oseltamivir
  • baloxavir
  • Neuraminidase
  • Zanamivir