2022 Fiscal Year Final Research Report
Surveillance and control of the emergence of the reduced anti-influenza drug susceptible variant in children
| Project/Area Number |
20K08210
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52050:Embryonic medicine and pediatrics-related
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| Research Institution | Fukushima Medical University |
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Principal Investigator |
Masatoki Sato 福島県立医科大学, 医学部, 准教授 (60423795)
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| Co-Investigator(Kenkyū-buntansha) |
橋本 浩一 福島県立医科大学, 医学部, 准教授 (50322342)
細矢 光亮 福島県立医科大学, 医学部, 教授 (80192318)
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| Project Period (FY) |
2020-04-01 – 2023-03-31
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| Keywords | インフルエンザ / 抗ウイルス薬 |
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| Outline of Final Research Achievements |
Children diagnosed with influenza A and treated with oseltamivir or baloxavir marboxil (baloxavir) were included in the study. Nasal swabs were collected before and over time after treatment for virologic analysis. Moreover, their clinical symptoms after treatment was recorded trice daily by their parents. The variant with the reduced susceptibility against oseltamivir and baloxavir was detected in 3 of 35 (8.6%) and 12 of 38 (31.6%) children, respectively. No clinical impact was observed in children with the reduced oseltamivir susceptible variant. However, the duration of infectious virus shedding after treatment and the time to clinical symptom improvement was longer in patients with variants with the reduced baloxavir susceptibility than those without these variants. The results in this study suggest that children should be monitored for the emergence of the variant with the reduced baloxavir susceptibility after treatment.
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| Free Research Field |
小児感染症学
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| Academic Significance and Societal Importance of the Research Achievements |
キャップ依存性エンドヌクレアーゼ阻害薬であるバロキサビルは、その作用機序から既存のノイラミニダーゼ阻害薬と比較し、投与直後のウイルス量を抑制できる。しかし、小児では、A型インフルエンザ、特にA/H3亜型ウイルス感染患者にバロキサビルを投与すると薬剤低感受性変異株が高率に選択されることが示された。このバロキサビル低感受性変異株が検出された症例では非検出例よりも感染性ウイルス排出時間が有意に遷延し、症状改善後も変異ウイルスによる感染伝播の可能性が示された。本研究により、小児インフルエンザ患者に対する抗インフルエンザ薬の選択基準について提案できたことの社会的意義は大きい。
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