|
1
|
Tan DHS, Pico Espinosa O, Matelski J, Khera SS, Qamar A, Persaud R, Hurst JR, Ly A, Lam J, Naghibosadat M, Christie N, Hasso M, Gough K, Taggart LR, Tan C, Ostrowski M, Ma H, Gray-Owen SD, Kozak R, Mishra S. Longitudinal Analysis of Mpox Virus DNA Detectability From Multiple Specimen Types During Acute Illness: A Cohort Study. Open Forum Infect Dis 2024; 11:ofae073. [PMID: 38390463 PMCID: PMC10883290 DOI: 10.1093/ofid/ofae073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
Background Longitudinal data on the detectability of monkeypox virus (MPXV) genetic material in different specimen types are scarce. Methods 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. Results 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). Conclusions 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.
Collapse
Affiliation(s)
- Darrell H S Tan
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Oscar Pico Espinosa
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - John Matelski
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Shreya S Khera
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Attia Qamar
- Scarborough Health Network, Scarborough, Ontario, Canada
| | - Reva Persaud
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jacklyn R Hurst
- Biological Sciences, Sunnybrook Research Institute, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Angel Ly
- Toronto High Containment Facility, Temerty Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Lam
- Toronto High Containment Facility, Temerty Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maedeh Naghibosadat
- Biological Sciences, Sunnybrook Research Institute, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Natasha Christie
- Toronto High Containment Facility, Temerty Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Maan Hasso
- Public Health Ontario Laboratory, Toronto, Ontario, Canada
| | - Kevin Gough
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Linda R Taggart
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Charlie Tan
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mario Ostrowski
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Huiting Ma
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Scott D Gray-Owen
- Toronto High Containment Facility, Temerty Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Genetics, Temerty Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Robert Kozak
- Biological Sciences, Sunnybrook Research Institute, Sunnybrook Hospital, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Sharmistha Mishra
- Division of Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| |
Collapse
|