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One universal antiviral to rule them all?

(www.cuimc.columbia.edu)
331 points breve | 4 comments | 26 Aug 25 14:07 UTC | HN request time: 0.819s | source
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giancarlostoro ◴[26 Aug 25 14:37 UTC] No.45027158[source]▶
Wont viruses just adapt and now we've got worse viruses as a result? Isn't this kind of why doctors don't like to prescribe antibiotics too often, because they become ineffective in the long run.

I'm genuinely asking, I'm a simple software dev not a doctor.

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1. 0xDEAFBEAD ◴[27 Aug 25 00:52 UTC] No.45034185[source]▶
My understanding is that there's often at tradeoff between fitness and antiviral resistance. The virus starts on a fitness local maximum, and it has to pay a fitness cost as it evolves resistance to the antiviral (due to stepping off the local maximum). If the antiviral is ineffective, and the virus continues reproducing, over time it will evolve "compensatory mutations" which allow it to regain some or all of the lost fitness.

Based on my recollections of this paper https://pmc.ncbi.nlm.nih.gov/articles/PMC5499642/

So yeah, I wouldn't be super worried about the virus evolving to become worse in absolute terms as a result of antiviral exposure. Virii are evolving all the time anyways. Antivirals can also reduce evolution speed by fighting an infection: A more severe infection means more virions means greater evolution speed. I believe some new COVID variants were thought to have evolved in the body of someone who was severely infected. (However: Note that it's not necessarily beneficial for fitness for the virus to evolve greater infection severity, especially if that interferes with transmission.)

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2. tempestn ◴[27 Aug 25 06:58 UTC] No.45036303[source]▶
Same deal with vaccination, right? We saw this with covid; as new variants evolved to evade the vaccines, they tended to result in less severe infections (even to the unvaccinated) than the original.
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3. ted_dunning ◴[27 Aug 25 07:12 UTC] No.45036393[source]▶
Citation?

I think (also without a citation) that this was never properly demonstrated.

And there is nearly nobody left who has no immunity from either infection or injection. We are definitely still seeing quite a few deaths from COVID.

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4. tempestn ◴[27 Aug 25 19:12 UTC] No.45043768{3}[source]▶
After some reading, it appears it's more of a mixed bag. Evolutionary pressure from vaccines can have that effect, as appears to have been the case with Omicron, but it's not guaranteed, and some variants appear to have been more virulent than the original virus. See the "Relative Severity of Variants" section of this paper: https://www.nature.com/articles/s41579-022-00841-7?utm_sourc...