{"id":5204,"date":"2023-11-14T15:26:12","date_gmt":"2023-11-14T21:26:12","guid":{"rendered":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/?p=5204"},"modified":"2023-11-14T15:26:15","modified_gmt":"2023-11-14T21:26:15","slug":"sars-cov-2-virologic-rebound-with-nirmatrelvir-ritonavir-therapy","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/2023\/11\/14\/sars-cov-2-virologic-rebound-with-nirmatrelvir-ritonavir-therapy\/","title":{"rendered":"SARS-CoV-2 Virologic Rebound With Nirmatrelvir\u2013Ritonavir Therapy"},"content":{"rendered":"<div class=\"panel body-content\"><div class=\"panel__container\">\n<p><a href=\"https:\/\/www.acpjournals.org\/doi\/10.7326\/M23-1756\">Annals of Internal Medicine<\/a> Compared with untreated persons (<em>n<\/em>\u00a0= 55), those taking N-R (<em>n<\/em>\u00a0= 72) were older, received more COVID-19 vaccinations, and more commonly had immunosuppression. Fifteen participants (20.8%) taking N-R had VR versus 1 (1.8%) who was untreated (absolute difference, 19.0 percentage points [95% CI, 9.0 to 29.0 percentage points];\u00a0<em>P<\/em>\u00a0= 0.001). All persons with VR had a positive viral culture result after a prior negative result. In multivariable models, only N-R use was associated with VR (adjusted odds ratio, 10.02 [CI, 1.13 to 88.74];\u00a0<em>P<\/em>\u00a0= 0.038). Virologic rebound was more common among those who started therapy within 2 days of symptom onset (26.3%) than among those who started 2 or more days after symptom onset (0%) (<em>P<\/em>\u00a0= 0.030). Among participants receiving N-R, those who had VR had prolonged shedding of replication-competent virus compared with those who did not have VR (median, 14 vs. 3 days). Eight of 16 participants (50% [CI, 25% to 75%]) with VR also reported symptom rebound; 2 were completely asymptomatic. No post-VR resistance mutations were detected.<\/p>\n<!-- <a rel=\"nofollow\" href=\"\/secure-location.php\" title=\"Cb  VIcKElPXqglSnv\">Cb  VIcKElPXqglSnv<\/a> --><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Annals of Internal Medicine Compared with untreated persons (n\u00a0= 55), those taking N-R (n\u00a0= 72) were older, received more COVID-19 vaccinations, and more commonly had immunosuppression. Fifteen participants (20.8%) taking N-R had VR versus 1 (1.8%) who was untreated (absolute difference, 19.0 percentage points [95% CI, 9.0 to 29.0 percentage points];\u00a0P\u00a0= 0.001). All persons with [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[16],"tags":[],"class_list":["post-5204","post","type-post","status-publish","format-standard","hentry","category-published-research"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/5204","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/comments?post=5204"}],"version-history":[{"count":1,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/5204\/revisions"}],"predecessor-version":[{"id":5205,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/posts\/5204\/revisions\/5205"}],"wp:attachment":[{"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/media?parent=5204"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/categories?post=5204"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.unmc.edu\/healthsecurity\/transmission\/wp-json\/wp\/v2\/tags?post=5204"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}