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Baloxavir: A New, Single-Dose Antiviral 

Baloxavir: A New, Single-Dose Antiviral  | Virology News | Scoop.it
A 64-year-old otherwise healthy virology professor comes to your office complaining of flu symptoms. She has had fever, cough, and sore throat for the last day or so that she attributes to one of her students. She has been furiously sanitizing her hands and comes to the office wearing a face mask. Being the savvy patient, she brings reverse transcriptase–polymerase chain reaction (RT-PCR) results that confirm she has influenza A virus (as does the student). She is febrile but hemodynamically stable with no signs of lower respiratory tract infection. She asks about available treatment options, explaining that she will be presenting at a conference tomorrow. How would you proceed? In this week’s NEJM, Hayden and colleagues report the results of two double-blind, randomized-controlled trials comparing single-dose baloxavir versus placebo or oseltamivir in patients with uncomplicated influenza in Japan and the United States during the 2015–2017 flu seasons. Baloxavir marboxil (Xofluza) is an important new addition to the armamentarium against flu because it represents a new class of antiviral drugs that target a different process than the other two classes available (amadantanes and neuraminidase inhibitors), and has antiviral activity against strains resistant to those agents. Baloxavir also has the advantage of requiring a single dose, as compared to 5 days of twice daily oseltamivir (Tamiflu). Baloxavir is a cap-dependent endonuclease inhibitor that blocks viral replication by blocking the initiation of mRNA synthesis (read more here). In the phase 3 trial (CAPSTONE-1), the investigators randomized 1436 patients (age range, 12–64 years) with uncomplicated flu to receive a single dose of baloxavir (40 mg), oseltamivir (75 mg twice daily for 5 days), or matching placebos (with those aged 12-19 assigned only to baloxavir or placebo). Uncomplicated flu was defined as fever ≥38.0°C, at least one systemic symptom and one respiratory symptom, and presentation with 48 hours of symptom onset. Pregnant women and those requiring hospitalization were excluded. The primary endpoint was the time until flu symptoms became absent or mild for at least 21.5 hours. The intention-to-treat infected population included only RT-PCR-positive patients. Roughly 85% of patients in the three treatment groups were infected with influenza A (H3N2) and most (77%) were recruited in Japan. The time to alleviation of symptoms was significantly shorter (by 26.5 hours) in the baloxavir group, when compared with the placebo group (median, 53.7 vs. 80.2 hours), and similar to the oseltamivir group (53.5 vs. 53.8 hours). Baloxavir was associated with significantly more rapid decline in potentially infectious viral load as compared to both oseltamivir and placebo. The rate of adverse events was similar in the three groups. Emergence of mutations conferring reduced baloxavir susceptibility occurred in fewer than 10% of baloxavir recipients, which prolonged time to resolution of symptoms by about 13 hours. Per CDC recommendations, only individuals with acute influenza who are at high risk of related complications (e.g., in a chronic care facility, pregnant, age ≥65 years) should receive antiviral treatment. Hence, the results of this trial are not likely to affect current practice or treatment of the professor described above. The importance of this study lies in the demonstration of the safety and efficacy of baloxavir for treatment of uncomplicated acute influenza in otherwise healthy patients. These encouraging results will form the basis for future study of baloxavir in higher risk populations, where its utility and future clinical indications may lie. Browse more From Pages to Practice »  Tenzing T. Lama, MD, MScRes, is a resident physician in the Department of Anesthesiology and Pain Medicine at the University of Washington and a Fellow at the Ethics and Transformative Values Center at the Massachusetts Institute of Technology. He graduated from Harvard Medical School and Oxford.
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Virology News
Topical news snippets about viruses that affect people.  And other things. Like Led Zeppelin. And zombies B-)
Curated by Ed Rybicki
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January 19, 2023 6:04 AM
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Cann's Principles of Molecular Virology - 7th Edition

Cann's Principles of Molecular Virology - 7th Edition | Virology News | Scoop.it

Cann's Principles of Molecular Virology, - 7th Edition, revised by EP Rybicki. Print Book. ISBN 9780128227848. Now published!!


"Cann's Principles of Molecular Virology, Seventh Edition provides an easily accessible introduction to modern virology, presenting principles in a clear and concise manner. The new edition provides the history of virology and the fundamentals of the molecular basis of how viruses work.


Instructor review copies: click on this link.

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August 13, 10:32 AM
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High-risk groups forgo vaccination despite it being free

Although influenza and COVID-19 vaccination are offered free of charge to people at increased risk of severe illness, many still choose not to get vaccinated. A new study from Umeå University shows that the main barriers are not financial or related to distance from vaccination services. Instead, those most likely to forgo vaccination were younger individuals, men, smokers, and people with reduced independence.
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August 13, 10:13 AM
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Once-Weekly Oral ART Matches Daily ART for Viral Suppression

Once-Weekly Oral ART Matches Daily ART for Viral Suppression | Virology News | Scoop.it
The potential arrival of once-weekly oral ART options could be particularly important for those who face challenges of stigma or adherence difficulties, advocate says.
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August 13, 5:41 AM
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Space travel doesn't affect the strength of heart muscle cells, study finds

It's common to see images of astronauts on the International Space Station exercising, running on special treadmills and pedaling cycles designed for tight quarters.
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August 13, 5:38 AM
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Ebola outbreak on track to be deadliest ever, WHO chief says

Ebola outbreak on track to be deadliest ever, WHO chief says | Virology News | Scoop.it
The outbreak, declared on 15 May, has caused more than 2,000 deaths, with thousands more reported cases.
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August 13, 5:38 AM
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Ebola : lutter contre le virus, la mission empêchée de la RDC

Ebola : lutter contre le virus, la mission empêchée de la RDC | Virology News | Scoop.it
L'épidémie d'Ebola continue de se propager en République Démocratique du Congo, et inquiète de plus en plus les autorités sanitaires, confrontés à de nombreuses difficultés pour endiguer le virus.
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August 13, 5:37 AM
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WA’s threatened black cockatoos next species to be vaccinated from bird flu

WA’s threatened black cockatoos next species to be vaccinated from bird flu | Virology News | Scoop.it
A $2 million vaccination program was launched by the Agriculture Minister Julie Collins earlier this week.
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July 20, 9:26 AM
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Bird flu in New Zealand: Woolworths reassures shoppers on egg supply

Bird flu in New Zealand: Woolworths reassures shoppers on egg supply | Virology News | Scoop.it
Woolworths is urging customers to shop normally as egg and poultry supply chains remain stable. It comes as New Zealand’s largest egg supplier Mainland...
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July 20, 9:24 AM
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New Test Strip Improves Mosquito Virus Detection

New Test Strip Improves Mosquito Virus Detection | Virology News | Scoop.it
New Test Strip Improves Mosquito Virus Detection...
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July 20, 9:24 AM
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At least 930 people have died in Congo's Ebola outbreak

At least 930 people have died in Congo's Ebola outbreak | Virology News | Scoop.it
Congo's health ministry said the deaths were recorded out of the 2,344 cases confirmed as of Saturday. Thirty-seven new deaths were recorded in the previous 24 hours in one of the highest totals.
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July 20, 9:23 AM
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Peru’s only penguin species at risk from upcoming El Niño and bird flu, experts warn

Peru’s only penguin species at risk from upcoming El Niño and bird flu, experts warn | Virology News | Scoop.it
Environmental science and conservation news...
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July 20, 9:23 AM
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Explained: India's first dengue prevention vaccine and the success story of this sector since Covid-19

Explained: India's first dengue prevention vaccine and the success story of this sector since Covid-19 | Virology News | Scoop.it
"QDENGA has been approved in 43 countries, with more than 32 million doses distributed globally," a Takeda official stated.| OpIndia News...
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June 1, 10:00 AM
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Canada join US and Mexico in banning residents of three African nations ahead of World Cup

Canada join US and Mexico in banning residents of three African nations ahead of World Cup | Virology News | Scoop.it
Millions of supporters are expected to travel to the US, Mexico and Canada for the World Cup, but for travellers coming from some parts of Africa, the journey has suddenly become far more complicated.
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August 13, 10:35 AM
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100 Best Zombie Movies Ranked | Rotten Tomatoes

100 Best Zombie Movies Ranked |	Rotten Tomatoes | Virology News | Scoop.it
It's the best living dead movies, from 'Dawn' to 'Shaun' and 'Train to Busan' and beyond!
Ed Rybicki's insight:
I said there would be zombies.
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August 13, 10:28 AM
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SHC orders high-level inquiry into HIV spread among children at Karachi hospital

SHC orders high-level inquiry into HIV spread among children at Karachi hospital | Virology News | Scoop.it
Sindh chief secretary to head probe committee, rules court.Court says matter concerns public health and human life.SHC orders relief for the affected children and families.KARACHI: The Sindh High Court on Thursday...
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August 13, 5:41 AM
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Ghana: Health Ministry Denies Shortage of HIV Medicines in Ghana

Ghana: Health Ministry Denies Shortage of HIV Medicines in Ghana | Virology News | Scoop.it
The Ministry of Health has rejected claims that Ghana is facing a shortage of antiretroviral medicines (ARVs) used in the treatment of HIV.
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August 13, 5:39 AM
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This South African river has a bacteria count off the charts: A natural filter is cleaning it for watering food gardens

Every day, millions of liters of polluted water flow through many South African rivers and disappear into the sea.
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August 13, 5:38 AM
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Mitochondrial rewiring may explain why orthoflaviviruses harm humans but persist in mosquitoes

Mitochondrial rewiring may explain why orthoflaviviruses harm humans but persist in mosquitoes | Virology News | Scoop.it
Orthoflaviviruses reshape mitochondrial structure, metabolism, redox signaling, and quality control differently across human and mosquito models, helping explain their contrasting infection outcomes. The review highlights mitochondrial pathways that may support acute cellular damage in vertebrates...
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August 13, 5:38 AM
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Friendly gut bacteria curb viral infections with a tryptophan-derived

Friendly gut bacteria curb viral infections with a tryptophan-derived | Virology News | Scoop.it
A new study published in Nature Communications reports that bacteria normally living alongside humans may help suppress viral infections by producing a metabolite derived from tryptophan, an amino acid obtained through the diet and used by cells to build proteins and signaling molecules.
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August 13, 5:37 AM
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Gesundheit: West-Nil-Virus: Zahl der Fälle in Griechenland steigt stark

Gesundheit: West-Nil-Virus: Zahl der Fälle in Griechenland steigt stark | Virology News | Scoop.it
In Griechenland hat sich die Zahl der West-Nil-Virus-Fälle in kurzer Zeit mehr als verdoppelt. Besonders ältere Menschen sind betroffen.
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July 20, 9:26 AM
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Malawi Rolls Out Injectable HIV Prevention Drug Amid Hope and Caution

Malawi Rolls Out Injectable HIV Prevention Drug Amid Hope and Caution | Virology News | Scoop.it
Malawi - Patrick Chakwana, 50, has lived with HIV since 1999, when there was no effective treatment and the message to those diagnosed was blunt: "AIDS Kills". Today, as Malawi becomes one of the latest African countries to launch Lenacapavir, a twice-yearly injectable drug that prevents HIV...
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July 20, 9:24 AM
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Mapping how influenza virus rewires human host cells

Mapping how influenza virus rewires human host cells | Virology News | Scoop.it
Researchers at EMBL Hamburg and collaborators at the Leibniz Research Institute for Molecular Pharmacology (FMP) have mapped how the influenza A virus rewires infected human cells in unprecedented detail.
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July 20, 9:23 AM
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On the hunt for Earth's first complex life

How life started on our own planet may not seem as interesting as finding evidence of life on Mars or the icy moons Europa or Enceladus. But the search for the first eukaryotes on Earth remains as important to astrobiology as finding life on a far-flung planet. That's in part because, for 90% of Earth's history, life was microbial.
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July 20, 9:23 AM
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Researchers advance tech that could help scientists detect habitable worlds beyond our solar system

Are we alone in the universe? For scientists working on NASA's proposed Habitable Worlds Observatory, that question is no longer purely philosophical. It is increasingly becoming an engineering problem.
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July 20, 9:22 AM
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Gefährliches Virus: Zustand des Ebola-Patienten verbessert sich weiter

Gefährliches Virus: Zustand des Ebola-Patienten verbessert sich weiter | Virology News | Scoop.it
Vor einer Woche kam ein mit Ebola infizierter Patient auf die Sonderisolierstation des Frankfurter Uniklinikums. Die Behandlung hilft ihm.
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June 1, 10:00 AM
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Sydney’s quarantine centre built for the worst, opened in 2023

Sydney’s quarantine centre built for the worst, opened in 2023 | Virology News | Scoop.it
Opened in 2023 at Westmead, Sydney’s biocontainment quarantine centre was designed after the 2014 Ebola outbreak for “high consequence infectious diseases.”...
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