Nirmatrelvir Resistance—de Novo E166V/L50V Mutations in an Immunocompromised Patient Treated With Prolonged Nirmatrelvir/Ritonavir Monotherapy Leading to Clinical and Virological Treatment Failure—a Case Report
Neta S. Zuckerman, Efrat Bucris, Danielle Keidar-Friedman, Muriel Amsalem, Tal Brosh‐Nissimov
Abstract
Resistance of SARS-CoV-2 to antivirals was shown to develop in immunocompromised individuals receiving remdesivir. We describe an immunocompromised patient who was treated with repeated and prolonged courses of nirmatrelvir and developed de-novo E166V/L50F mutations in the Mpro region. These mutations were associated with clinical and virological treatment failure.
Topics & Concepts
MedicineRitonavirDrug resistanceHuman immunodeficiency virus (HIV)VirologyInternal medicineViral loadAntiretroviral therapyBiologyGeneticsSARS-CoV-2 and COVID-19 ResearchVirus-based gene therapy researchViral Infections and Immunology Research