An Understanding of the Viral Rebound of COVID-19

One of the ongoing mysteries associated with SARS-CoV-2 is the rebound of the virus post antiviral treatment. Certainly it has been well-documented that after treatment of the oral antiviral nirmatrelvir/ritonavir (Paxlovid) patients can experience this and test positive several days later.

To try to understand this rebound, Jonathan Z. Li , MD, presented at this year’s CROI, and his topic, “Viral Rebound During AND After SARS-CoV-2 Treatment,” was at a symposium titled COVID-19: Where Are We Now? Yesterday afternoon.

In his presentation, LI addressed a variety of things surrounding this topic including the characteristics of the rebound, how common this phenomenon is, and if it occurs after treatment of other antivirals.

Li is the director of the Harvard/Brigham Virology Specialty Laboratory, the director of the Harvard University Center for AIDS Research Clinical Core. He is also an associate physician at Brigham and Women's Hospital in Boston, and associate professor of Medicine at Harvard Medical School.

In addition to his work in HIV, Li is a member of the NIH COVID-19 Treatment Guidelines Panel, and has been involved in research around SARS-CoV-2.

Contagion spoke to Li about his presentation and looking at clinical strategies for caring for patients with viral rebounds.