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Trevor J Tamura¹, Manish C Choudhary^1,2, Rinki Deo^1,2

¹Brigham and Women's Hospital, Boston, Massachusetts.

JAMA network open

|September 25, 2024

概括

在免疫抑制患者中,新出现的SARS-CoV-2突变 confering nirmatrelvir 耐药性是常见的,但通常是低频和短暂的. 这表明,与当前变种一起,耐尼马特里尔维尔耐药性在社区传播的风险很低.

科学领域:

病毒学病毒学
传染性疾病传染性疾病
药理学药理学是指药理学的学科.

背景情况:

之前的研究发现了SARS-CoV-2突变,使其对nirmatrelvir.vir产生抵抗力.
耐药性出现的频率及其与治疗后病毒学反弹的关联仍然不清楚.

研究的目的:

为了检查COVID-19治疗尼尔马特里尔维尔后新出现的抗病毒耐药性的流行率.
调查耐尔马特里尔维尔耐药性和病毒学反弹之间的关联.

主要方法:

一项针对急性COVID-19感染的门诊成年患者的队列研究于2021年5月至2023年10月进行.
下一代测序用于检测SARS-CoV-2抗病毒耐药性突变,包括低频变异.
参与者接受了尼尔马特里尔维尔,雷梅西维尔或没有抗病毒疗法.

主要成果:

在11.4%的受治疗患者中检测到耐尼马特里尔维尔抗性突变,免疫抑制患者 (22.7%) 的患病率更高.
耐药性突变通常是低频率 (<20%) 和短暂的,恢复到野生类型.
经批准后,美国没有发现尼玛特里尔维尔抗药性增加的证据.

结论:

经常检测到治疗引起的耐尼马特雷尔维尔抗性突变,特别是在免疫抑制个体中.
这些突变的短暂性和低频率性质表明,社区传播的风险很低.
目前的变种和药物使用模式似乎不会导致广泛的尼尔马特里尔维尔耐药性.

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