Preventing SARS-CoV-2 infection and its severe outcomes in HIV-infected people

Abrescia, Nicola G. A.

doi:10.1097/qad.0000000000003608

Cited by 1 publication

(1 citation statement)

References 29 publications

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“…In keeping with evidence-based medical practice, patients with COVID-19 must be treated with efficacious medications; they deserve nothing less”. Similarly, an editorial by Dr. Abrescia, concerning a study which showed a lack of association between antiretroviral use and the acquisition or severe outcomes of SARS-CoV-2 infection in people with HIV in the Netherlands, recommended the following: “If SARS-CoV-2 infection does take place, drugs proven to be effective against SARS-CoV-2 (remdesivir or nirmatrelvir/ritonavir) should be started within five days of the onset of symptoms” [ 207 , 208 ]. Our calculations of the unbound C max /EC 50 ratios and EC 50 measurements in the cell systems relevant to in vivo SARS-CoV-2 infection lends further support to that conclusion.…”

Section: Discussionmentioning

confidence: 99%

Why Certain Repurposed Drugs Are Unlikely to Be Effective Antivirals to Treat SARS-CoV-2 Infections

Hurwitz,

De,

LeCher

et al. 2024

Viruses

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Most repurposed drugs have proved ineffective for treating COVID-19. We evaluated median effective and toxic concentrations (EC50, CC50) of 49 drugs, mostly from previous clinical trials, in Vero cells. Ratios of reported unbound peak plasma concentrations, (Cmax)/EC50, were used to predict the potential in vivo efficacy. The 20 drugs with the highest ratios were retested in human Calu-3 and Caco-2 cells, and their CC50 was determined in an expanded panel of cell lines. Many of the 20 drugs with the highest ratios were inactive in human Calu-3 and Caco-2 cells. Antivirals effective in controlled clinical trials had unbound Cmax/EC50 ≥ 6.8 in Calu-3 or Caco-2 cells. EC50 of nucleoside analogs were cell dependent. This approach and earlier availability of more relevant cultures could have reduced the number of unwarranted clinical trials.

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Section: Discussionmentioning

confidence: 99%