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Lancet correspondence - Neutralisation sensitivity of the SARS-CoV-2 XBB.1 lineage

sharon sanders

Editor-in-Chief & President
Neutralisation sensitivity of the SARS-CoV-2 XBB.1 lineage
Published:January 05, 2023DOI:https://doi.org/10.1016/S1473-3099(22)00831-3


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Finally, we assessed the sensitivity of XBB.1[SUB]pp[/SUB] to neutralisation by antibodies induced by vaccination or vaccination plus breakthrough infection (figure B; appendix pp 1–2). Plasma of triple vaccinated individuals had almost no detectable neutralising activity against XBB.1[SUB]pp[/SUB] (neutralising titre 50 [NT[SUB]50[/SUB]] 2), whereas the neutralising activity against B.1[SUB]pp[/SUB] was high (NT[SUB]50[/SUB] 1165) and against BA.5[SUB]pp[/SUB] was moderate (NT[SUB]50[/SUB] 127). Next, we measured the plasma of triple vaccinated individuals with breakthrough infection during the BA.5 wave in Germany (June to November, 2022). The plasma samples showed high neutralising activity against B.1[SUB]pp[/SUB] (NT[SUB]50[/SUB] 1779), moderate neutralising activity against BA.5[SUB]pp[/SUB] (NT[SUB]50[/SUB] 538), and low neutralising activity against XBB.1[SUB]pp[/SUB] (NT[SUB]50[/SUB] 14). Similar findings were made for plasma from triple vaccinated individuals who received either monovalent or bivalent (ie, B.1 or B.1 plus BA.5) booster vaccination: B.1[SUB]pp[/SUB] NT[SUB]50[/SUB] 1806 for B.1 or 1939 for B.1 plus BA.5; BA.5[SUB]pp[/SUB] NT[SUB]50[/SUB] 206 for B.1 or 525 for B.1 plus BA.5; and XBB.1[SUB]pp[/SUB] NT[SUB]50[/SUB] 8 for B.1 or 5 for B.1 plus BA.5.

Collectively, our data suggest that the SARS-CoV-2 XBB.1 lineage exhibits an extraordinarily strong ability for antibody evasion, which makes XBB.1 similar to BQ.1 and BQ.1.1;[SUP]9 [/SUP]two highly neutralisation-resistant sublineages of omicron that are currently increasing in incidence in several countries worldwide. The finding that most mAbs do not neutralise XBB.1[SUB]pp[/SUB] highlights that novel mAbs are needed for the treatment of COVID-19 and that other or additional treatment options (eg, paxlovid, molnupiravir, or remdesivir) should be considered in areas with high incidence of the XBB sublineages. The observation that host-cell entry of XBB.1[SUB]pp[/SUB] is reduced as compared with BA.5[SUB]pp[/SUB] suggests that the increased ability of XBB.1 to evade antibody-mediated neutralisation might have come at the cost of a moderately reduced efficiency of host-cell entry.

https://www.thelancet.com/journals/l...831-3/fulltext
 
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