Longitudinal Analysis of Mpox Virus DNA Detectability From Multiple Specimen Types During Acute Illness: A Cohort Study.

Longitudinal data on the detectability of monkeypox virus (MPXV) genetic material in different specimen types are scarce. We describe MPXV-specific polymerase chain reaction (PCR) results from adults with confirmed mpox infection from Toronto, Canada, including a cohort undergoing weekly collection of specimens from multiple anatomic sites until 1 week after skin lesions had fully healed. We quantified the time from symptom onset to resolution of detectable viral DNA (computed tomography [Ct] ≥ 35) by modeling exponential decay in Ct value as a function of illness day for each site, censoring at the time of tecovirimat initiation. Among 64 men who have sex with men, the median (interquartile range [IQR]) age was 39 (32.75-45.25) years, and 49% had HIV. Twenty received tecovirimat. Viral DNA was detectable (Ct < 35) at baseline in 74% of genital/buttock/perianal skin swabs, 56% of other skin swabs, 44% of rectal swabs, 37% of throat swabs, 27% of urine, 26% of nasopharyngeal swabs, and 8% of semen samples. The median time to resolution of detectable DNA (IQR) was longest for genital/buttock/perianal skin and other skin swabs at 30.0 (23.0-47.9) and 22.4 (16.6-29.4) days, respectively, and shortest for nasopharyngeal swabs and semen at 0 (0-12.1) and 0 (0-0) days, respectively. We did not observe an effect of tecovirimat on the rate of decay in viral DNA detectability in any specimen type (all P > .05). MPXV DNA detectability varies by specimen type and persists for over 3-4 weeks in skin specimens. The rate of decay did not differ by tecovirimat use in this nonrandomized study. © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Citation

Darrell H S Tan, Oscar Pico Espinosa, John Matelski, Shreya S Khera, Attia Qamar, Reva Persaud, Jacklyn R Hurst, Angel Ly, Jessica Lam, Maedeh Naghibosadat, Natasha Christie, Maan Hasso, Kevin Gough, Linda R Taggart, Charlie Tan, Mario Ostrowski, Huiting Ma, Scott D Gray-Owen, Robert Kozak, Sharmistha Mishra. Longitudinal Analysis of Mpox Virus DNA Detectability From Multiple Specimen Types During Acute Illness: A Cohort Study. Open forum infectious diseases. 2024 Feb;11(2):ofae073

PMID: 38390463

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