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J Infect Dis . Combined Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 Reduces Molnupiravir-Induced Mutagenicity and Prevents Selectio

tetano

tetano

Editor, Senior Moderator
J Infect Dis


. 2024 Jul 8:jiae213.
doi: 10.1093/infdis/jiae213. Online ahead of print. Combined Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 Reduces Molnupiravir-Induced Mutagenicity and Prevents Selection for Nirmatrelvir/Ritonavir Resistance Mutations

Shuntai Zhou[SUP] 1 2 [/SUP], Nathan Long[SUP] 1 [/SUP], Kyle Rosenke[SUP] 3 [/SUP], Michael A Jarvis[SUP] 3 4 5 [/SUP], Heinz Feldmann[SUP] 3 [/SUP], Ronald Swanstrom[SUP] 1 6 [/SUP]



Affiliations
Abstract

We investigated the mutation profiles of severe acute respiratory syndrome coronavirus 2 in samples collected from a molnupiravir and nirmatrelvir/ritonavir combination therapy in macaques. We found that molnupiravir induced several nirmatrelvir resistance mutations at low abundance that were not further selected in combination therapy. Coadministration of nirmatrelvir/ritonavir lowered the magnitude of the mutagenetic effect of molnupiravir.

Keywords: SARS-CoV-2; combination therapy; lethal mutagenesis; molnupiravir; nirmatrelvir.

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