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NAIs target the surface NA protein whose sialidase activity is responsible for virion release from infected cells. Because of their pivotal role in the transcription\/translation process, the polymerase acidic (PA) and polymerase basic 1 and 2 (PB1 and PB2, respectively) internal proteins also constitute targets of interest for the development of additional anti\u2010influenza agents. Baloxavir marboxil (BXM), an inhibitor of the cap\u2010dependent endonuclease activity of the influenza PA protein, was approved in the United States and Japan in 2018. Baloxavir acid (BXA), the active compound of BXM, demonstrated a potent in vitro activity against different types\/subtypes of influenza viruses including seasonal influenza A\/B strains as well as avian influenza A viruses with a pandemic potential. A single oral dose of BXM provided virological and clinical benefits that were respectively superior or equal to those displayed by the standard (5 days, twice daily) oseltamivir regimen. Nevertheless, BXM\u2010resistant variants have emerged at relatively high rates in BXM\u2010treated children and adults. Consequently, there is a need to study the fitness (virulence and transmissibility) characteristics of mutants with a high potential to emerge as such variants can compromise the clinical usefulness of BXM. The purpose of this manuscript is to review the fitness properties of influenza A and B isolates harbouring mutations of reduced susceptibility to BXA.<\/jats:p>","DOI":"10.1002\/rmv.2175","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T12:30:49Z","timestamp":1601037049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Fitness of influenza A and B viruses with reduced susceptibility to baloxavir: A mini\u2010review"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6983-8790","authenticated-orcid":false,"given":"Yacine","family":"Abed","sequence":"first","affiliation":[{"name":"CHUQ\u2010CHUL and Laval University  Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amel","family":"Saim\u2010Mamoun","sequence":"additional","affiliation":[{"name":"CHUQ\u2010CHUL and Laval University  Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Boivin","sequence":"additional","affiliation":[{"name":"CHUQ\u2010CHUL and Laval University  Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"e_1_2_9_1_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix1060"},{"key":"e_1_2_9_1_3_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1201.051043"},{"key":"e_1_2_9_1_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpb.2015.05.023"},{"key":"e_1_2_9_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2013.03.014"},{"key":"e_1_2_9_1_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0910479"},{"key":"e_1_2_9_1_7_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01311-09"},{"key":"e_1_2_9_1_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/656802"},{"key":"e_1_2_9_1_9_1","unstructured":"FDA News Release.FDA Approves Rapivab to Treat Flu Infection.http:\/\/www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm427755.htm. 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