Viral dynamics in patients with monkeypox infection: a prospective cohort study in Spain.
| Autor: | Suñer C; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain. Electronic address: csuner@lluita.org., Ubals M; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain; Facultat de Medicina, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain., Tarín-Vicente EJ; Facultat de Medicina, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain; Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Mendoza A; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain; BCN Checkpoint, Projecte dels NOMS - Hispanosida, Barcelona, Spain., Alemany A; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain; Facultat de Medicina, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain., Hernández-Rodríguez Á; Microbiology Department, Clinical Laboratory North Metropolitan Area, University Hospital Germans Trias I Pujol, Badalona, Spain; Department of Genetics and Microbiology, Autonomous University of Barcelona, Barcelona, Spain., Casañ C; Microbiology Department, Clinical Laboratory North Metropolitan Area, University Hospital Germans Trias I Pujol, Badalona, Spain., Descalzo V; Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain., Ouchi D; Fight Infectious Diseases Foundation, Badalona, Spain., Marc A; Université de Paris, INSERM, IAME, F-75018, Paris, France., Rivero À; Fight Infectious Diseases Foundation, Badalona, Spain; BCN Checkpoint, Projecte dels NOMS - Hispanosida, Barcelona, Spain., Coll P; Fight Infectious Diseases Foundation, Badalona, Spain; BCN Checkpoint, Projecte dels NOMS - Hispanosida, Barcelona, Spain., Oller X; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain., Miguel Cabrera J; Fight Infectious Diseases Foundation, Badalona, Spain; BCN Checkpoint, Projecte dels NOMS - Hispanosida, Barcelona, Spain., Vall-Mayans M; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain., Dolores Folgueira M; Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Department of Medicine, Medical School, Universidad Complutense de Madrid, Madrid, Spain., Ángeles Melendez M; Microbiology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain., Agud-Dios M; Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Gil-Cruz E; Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Paris de Leon A; Microbiology Department, Clinical Laboratory North Metropolitan Area, University Hospital Germans Trias I Pujol, Badalona, Spain., Ramírez Marinero A; Microbiology Department, Clinical Laboratory North Metropolitan Area, University Hospital Germans Trias I Pujol, Badalona, Spain., Buhiichyk V; Fight Infectious Diseases Foundation, Badalona, Spain., Galván-Casas C; Fight Infectious Diseases Foundation, Badalona, Spain., Paredes R; Fight Infectious Diseases Foundation, Badalona, Spain; Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; IrsiCaixa AIDS Research Institute, Hospital Germans Trias I Pujol, Badalona, Spain; Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain., Prat N; Direcció d'Atenció Primària - Metropolitana Nord, Sabadell, Catalonia, Spain., Sala Farre MR; Public Health Agency of Catalonia, Generalitat de Catalunya, Barcelona, Spain., Bonet-Simó JM; Direcció d'Atenció Primària - Metropolitana Nord, Sabadell, Catalonia, Spain., Farré M; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Clinical Pharmacology Unit, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias i Pujol (HUGTP-IGTP), Badalona, Spain., Ortiz-Romero PL; Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain., Clotet B; Fight Infectious Diseases Foundation, Badalona, Spain; Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; IrsiCaixa AIDS Research Institute, Hospital Germans Trias I Pujol, Badalona, Spain; Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain., García-Patos V; Department of Dermatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain., Casabona J; Department of Paediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Spain; Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain; Germans Trias i Pujol Research Institute (IGTP), Campus Can Ruti, Badalona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain., Guedj J; Université de Paris, INSERM, IAME, F-75018, Paris, France., Cardona PJ; Microbiology Department, Clinical Laboratory North Metropolitan Area, University Hospital Germans Trias I Pujol, Badalona, Spain; Department of Genetics and Microbiology, Autonomous University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain., Blanco I; Clinical Genetics Department,Clinical Laboratory North Metropolitan Area, University Hospital Germans Trias I Pujol,Badalona, Spain., Marks M; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK; Hospital for Tropical Diseases, London, UK; Division of Infection and Immunity, University College London, London, UK., Mitjà O; Skin Neglected Diseases and Sexually Transmitted Infections Section, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Fight Infectious Diseases Foundation, Badalona, Spain; Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain; School of Medicine and Health Sciences, University of Papua New Guinea Port Moresby, Papua New Guinea. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | The Lancet. Infectious diseases [Lancet Infect Dis] 2023 Apr; Vol. 23 (4), pp. 445-453. Date of Electronic Publication: 2022 Dec 12. |
| DOI: | 10.1016/S1473-3099(22)00794-0 |
| Abstrakt: | Background: Monkeypox DNA has been detected in skin lesions, saliva, oropharynx, urine, semen, and stool of patients infected during the 2022 clade IIb outbreak; however, the viral dynamics within these compartments remain unknown. We aimed to characterise the viral load kinetics over time in various parts of the body. Methods: This was an observational, prospective, multicentre study of outpatients diagnosed with monkeypox in two hospitals and two sexual health clinics in Spain between June 28, 2022, and Sept 22, 2022. Men and women aged over 18 years were eligible if they reported having symptom onset within the previous 10 days of presentation, and were ineligible if disease was severe enough to be admitted to hospital. Samples were collected from five body locations (skin lesions, oropharynx, rectum, semen or vagina, and a dried blood spot) at six time points up to 57 days after the screening visit. Samples were analysed by quantitative PCR and a subset by cell culture. The primary endpoint was time from symptom onset to viral DNA clearance. Findings: Overall, 1663 samples were collected from 77 study participants. 75 (97%) participants were men, the median age was 35·0 years (IQR 29·0-46·0), and 39 (51%) participants were living with HIV. The median time from symptom onset to viral clearance was 25 days (95% CI 23-28) in the skin lesions, 16 days (13-19) in the oropharynx, 16 days (13-23) in the rectum, 13 days in semen (9-18), and 1 day in blood (0-5). The time from symptom onset to viral clearance for 90% of cases was 41 days (95% CI 34-47) in skin lesions and 39 days (27-56) in semen. The median viral load in skin lesions was 7·3 log Interpretation: In immunocompetent patients with mild monkeypox disease, PCR data alone would suggest a contact isolation period of 3 to 6 weeks but, based on detection of replication-competent virus, this time could be reduced. Based on findings from this cohort of patients, semen testing and prolonged use of condoms after recovery from monkeypox might not be necessary. Funding: University Hospital Germans Trias i Pujol and the YoMeCorono. Translation: For the Spanish translation of the abstract see Supplementary Materials section. Competing Interests: Declaration of interests We declare no competing interests. (Copyright © 2023 Elsevier Ltd. All rights reserved.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|