Potential and action mechanism of favipiravir as an antiviral against Junin virus

PLoS Pathog. 2022 Jul 11;18(7):e1010689. doi: 10.1371/journal.ppat.1010689. eCollection 2022 Jul.

Abstract

Favipiravir is a nucleoside analogue that inhibits the replication and transcription of a broad spectrum of RNA viruses, including pathogenic arenaviruses. In this study, we isolated a favipiravir-resistant mutant of Junin virus (JUNV), which is the causative agent of Argentine hemorrhagic fever, and analyzed the antiviral mechanism of favipiravir against JUNV. Two amino acid substitutions, N462D in the RNA-dependent RNA polymerase (RdRp) and A168T in the glycoprotein precursor GPC, were identified in the mutant. GPC-A168T substitution enhanced the efficiency of JUNV internalization, which explains the robust replication kinetics of the mutant in the virus growth analysis. Although RdRp-N462D substitution did not affect polymerase activity levels in a minigenome system, comparisons of RdRp error frequencies showed that the virus with RdRp-D462 possessed a significantly higher fidelity. Our next generation sequence (NGS) analysis showed a gradual accumulation of both mutations as we passaged the virus in presence of favipiravir. We also provided experimental evidence for the first time that favipiravir inhibited JUNV through the accumulation of transition mutations, confirming its role as a purine analogue against arenaviruses. Moreover, we showed that treatment with a combination of favipiravir and either ribavirin or remdesivir inhibited JUNV replication in a synergistic manner, blocking the generation of the drug-resistant mutant. Our findings provide new insights for the clinical management and treatment of Argentine hemorrhagic fever.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amides
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use
  • Arenavirus*
  • Hemorrhagic Fever, American* / drug therapy
  • Humans
  • Junin virus* / genetics
  • Pyrazines
  • RNA-Dependent RNA Polymerase / genetics
  • Virus Replication

Substances

  • Amides
  • Antiviral Agents
  • Pyrazines
  • RNA-Dependent RNA Polymerase
  • favipiravir

Grants and funding

This work was supported by grants from the Japan Agency for Medical Research and Development (AMED) (Grant No. JP20fk0108072, JP21fk0108080, JP21fk0108114 and JP21fm0208101). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.