Viral loads in clinical samples of men with monkeypox virus infection: a French case series.
Journal
The Lancet. Infectious diseases
ISSN: 1474-4457
Titre abrégé: Lancet Infect Dis
Pays: United States
ID NLM: 101130150
Informations de publication
Date de publication:
01 2023
01 2023
Historique:
received:
02
08
2022
revised:
24
08
2022
accepted:
26
08
2022
pubmed:
3
10
2022
medline:
24
12
2022
entrez:
2
10
2022
Statut:
ppublish
Résumé
Monkeypox virus (MPXV) is currently spreading among men who have sex with men, outside of sub-Saharan Africa, and close contact during sex seems to be one of the key pathways of viral transmission in the current outbreak. Our aim was to describe the distribution of MPXV in the human body, as it might play a role in its dissemination through sexual contact. The study population in this case series consisted of patients with confirmed MPXV infection attending the Pitié-Salpêtrière Hospital (Paris, France), who had been sampled from multiple anatomical sites, including skin, anus, throat, blood, urine, and semen, at diagnosis and 2 weeks later. We compared the proportion of positive samples and MPXV viral loads (given as PCR cycle thresholds [Ct]) between anatomical sites, and between day 0 (D0) and D14. Overall, 356 samples were collected between May 20 and June 13, 2022, from 50 men with a median age of 34 years (IQR 29-40). 22 (44%) of the 50 men were classified as HIV-negative on day (D)0, and 22 (44%) were living with HIV. At D0, MPXV detection was more frequent from skin (44 [88%] of 50), anus (30 [71%] of 42), and throat (36 [77%] of 47) than from blood (13 [29%] of 45), urine (nine [22%] of 41), or semen (13 [54%] of 24). Viral loads were significantly higher from skin lesions (Ct 19·8) and anal samples (Ct 20·9) than from throat (Ct 27·2), blood (Ct 32·8), urine (31·1), or semen samples (Ct 27·8). When analysing the 107 samples taken from 24 patients at D14, the proportion of positive samples strongly decreased between D0 and D14 at all sites: skin (four [22%] of 18), anus (two [9%] of 22), throat (none of 21), blood (one [5%] of 21), urine (none of 14), and semen (two [9%] of 11). These data contribute to a better understanding of how the virus might spread between sexual partners over a relatively short period of time. High MPXV viral loads from skin and mucosa, including genital and anal sites, suggest that transmission most likely occurs through direct body contact rather than through the respiratory route or contact with body fluids, which should help to refine the prevention messages delivered to individuals most exposed to the virus. None.
Sections du résumé
BACKGROUND
Monkeypox virus (MPXV) is currently spreading among men who have sex with men, outside of sub-Saharan Africa, and close contact during sex seems to be one of the key pathways of viral transmission in the current outbreak. Our aim was to describe the distribution of MPXV in the human body, as it might play a role in its dissemination through sexual contact.
METHODS
The study population in this case series consisted of patients with confirmed MPXV infection attending the Pitié-Salpêtrière Hospital (Paris, France), who had been sampled from multiple anatomical sites, including skin, anus, throat, blood, urine, and semen, at diagnosis and 2 weeks later. We compared the proportion of positive samples and MPXV viral loads (given as PCR cycle thresholds [Ct]) between anatomical sites, and between day 0 (D0) and D14.
FINDINGS
Overall, 356 samples were collected between May 20 and June 13, 2022, from 50 men with a median age of 34 years (IQR 29-40). 22 (44%) of the 50 men were classified as HIV-negative on day (D)0, and 22 (44%) were living with HIV. At D0, MPXV detection was more frequent from skin (44 [88%] of 50), anus (30 [71%] of 42), and throat (36 [77%] of 47) than from blood (13 [29%] of 45), urine (nine [22%] of 41), or semen (13 [54%] of 24). Viral loads were significantly higher from skin lesions (Ct 19·8) and anal samples (Ct 20·9) than from throat (Ct 27·2), blood (Ct 32·8), urine (31·1), or semen samples (Ct 27·8). When analysing the 107 samples taken from 24 patients at D14, the proportion of positive samples strongly decreased between D0 and D14 at all sites: skin (four [22%] of 18), anus (two [9%] of 22), throat (none of 21), blood (one [5%] of 21), urine (none of 14), and semen (two [9%] of 11).
INTERPRETATION
These data contribute to a better understanding of how the virus might spread between sexual partners over a relatively short period of time. High MPXV viral loads from skin and mucosa, including genital and anal sites, suggest that transmission most likely occurs through direct body contact rather than through the respiratory route or contact with body fluids, which should help to refine the prevention messages delivered to individuals most exposed to the virus.
FUNDING
None.
Identifiants
pubmed: 36183707
pii: S1473-3099(22)00586-2
doi: 10.1016/S1473-3099(22)00586-2
pmc: PMC9534074
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
74-80Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of interests We declare no competing interests.
Références
Clin Infect Dis. 2014 Jan;58(2):260-7
pubmed: 24158414
N Engl J Med. 2022 Aug 25;387(8):679-691
pubmed: 35866746
West Afr J Med. 2021 Dec 30;38(12):1242-1246
pubmed: 35038257
J Infect Dis. 2016 Oct 15;214(suppl 3):S177-S184
pubmed: 27443613
N Engl J Med. 2022 Jul 7;387(1):66
pubmed: 35704421
Lancet Infect Dis. 2004 Jan;4(1):15-25
pubmed: 14720564
J Virol Methods. 2010 Oct;169(1):223-7
pubmed: 20643162
Lancet Infect Dis. 2022 Sep;22(9):1267-1269
pubmed: 35931095
Lancet Infect Dis. 2022 Sep;22(9):1321-1328
pubmed: 35785793
Front Public Health. 2018 Sep 04;6:241
pubmed: 30234087
Lancet Infect Dis. 2022 Aug;22(8):1153-1162
pubmed: 35623380
Trop Med Infect Dis. 2016 Dec 20;1(1):
pubmed: 30270859
Euro Surveill. 2022 Jul;27(28):
pubmed: 35837964
Bull World Health Organ. 1988;66(4):465-70
pubmed: 2844429
MMWR Morb Mortal Wkly Rep. 2003 Jul 11;52(27):642-6
pubmed: 12855947
Clin Infect Dis. 2016 May 15;62(10):1272-6
pubmed: 26936667
N Engl J Med. 2016 Jun 2;374(22):2195-8
pubmed: 27074370
PLoS Negl Trop Dis. 2019 Oct 16;13(10):e0007791
pubmed: 31618206
PLoS Negl Trop Dis. 2022 Feb 11;16(2):e0010141
pubmed: 35148313
N Engl J Med. 2018 Apr 12;378(15):1377-1385
pubmed: 29641964
Bull World Health Organ. 1972;46(5):593-7
pubmed: 4340218
Euro Surveill. 2022 Jun;27(22):
pubmed: 35656836
J Gen Virol. 2005 Oct;86(Pt 10):2661-2672
pubmed: 16186219