Reducing Influenza Virus Transmission: The Potential Value of Antiviral Treatment

Abstract

Prompt antiviral treatment has the potential to reduce influenza virus transmission to close contacts, but rigorous data on the magnitude of treatment effects on transmission are limited. Animal model data indicate that rapid reductions in viral replication following antiviral treatment reduce the risk of transmission. Observational and clinical trial data with oseltamivir and other neuraminidase inhibitors indicate that prompt treatment of household index patients appears to reduce the risk of illness in contacts, although the magnitude of the reported effects has varied widely across studies. In addition, the potential risk of transmitting drug-resistant variants exists with all approved classes of influenza antivirals. A controlled trial examining baloxavir treatment efficacy to reduce transmission, including the risk of transmitting virus with reduced baloxavir susceptibility, is currently in progress. If reduced transmission risk is confirmed, modelling studies indicate that early treatment would have major epidemiologic benefits in seasonal and pandemic influenza.

RETRACTED: In-silico modelling studies of 5-benzyl-4-thiazolinone derivatives as influenza neuraminidase inhibitors via 2D-QSAR, 3D-QSAR, molecular docking, and ADMET predictions

“…Due to the highly preserved active site structure of neuraminidase ( Adams et al., 2019 ), it has become an attractive molecular target for the exploration and development of novel anti-influenza inhibitors. Nowadays, zanamivir (Relenza™), oseltamivir (Tamiflu™), laninamivir octanoate (Inavir™), and peramivir (Rapivab™) are the four (4) approved neuraminidase inhibitors for influenza treatment ( Hayden et al., 2022 ). Although, there is a lot of concern for the advent of drug resistance effects resulting from the high variability of the influenza virus ( Abed et al., 2016 ).…”

Effect of neuraminidase inhibitor (oseltamivir) treatment on outcome of hospitalised influenza patients, surveillance data from 11 EU countries, 2010 to 2020

“…Baloxavir marboxil received market authorisation in Europe in January 2021 and has shown to shorten the duration of symptoms as well as prevent infections when given prophylactically [5]. Clinical studies have shown that oseltamivir and zanamivir shorten the duration of symptoms and the length of stay in hospitalised patients, prevent death in hospitalised patients with severe disease and possibly reduce influenza virus transmission [10][11][12][13][14][15]. Despite the documented benefits of antiviral treatment, it is infrequently prescribed for out-patient influenza cases.…”

Comparison of Intra-Familial Transmission of Influenza Virus From Index Patients Treated With Baloxavir Marboxil or Oseltamivir Using an Influenza Transmission Model and a Health Insurance Claims Database

“…Post-exposure prophylactic treatment of household family members with either NAIs [ 11 ] or BXM [ 9 ] is effective in reducing the incidence of intra-familial transmission, irrespective of the treatment of the first patient with influenza infection in the family (index case [IC]). Although several studies have suggested that treatment of ICs with an anti-influenza agent may reduce intra-familial transmission of influenza without the need for prophylaxis in non-infected individuals [ 12–16 ], the magnitude of the effect is variable and highly dependent on the time [ 17 ]. Komeda et al reported a significantly reduced incidence of intra-familial transmission with BXM treatment compared with OTV treatment in ICs by using a Japanese claims database [ 18 ].…”