University Medical Center Hamburg-Eppendorf (UKE), Institute of Medical Microbiology, Virology and Hygiene, Hamburg, Germany.
University Medical Center Hamburg-Eppendorf (UKE), I. Department of Medicine, Division of Infectious Diseases, Hamburg, Germany; German Center for Infection Research, Partner site Hamburg-Lübeck-Borstel-Riems, Germany.
J Clin Virol. 2022 Oct;155:105254. doi: 10.1016/j.jcv.2022.105254. Epub 2022 Aug 11.
The ongoing monkeypox virus outbreak includes at least 7553 confirmed cases in previously non-endemic countries worldwide as of July 2022. Clinical presentation has been reported as highly variable, sometimes lacking classically described systemic symptoms, and only small numbers of cutaneous lesions in most patients. The aim of this study was to compare clinical data with longitudinal qPCR results from lesion swabs, oropharyngeal swabs and blood in a well characterized patient cohort.
16 male patients (5 hospitalized, 11 outpatients) were included in the study cohort and serial testing for monkeypox virus-DNA carried out in various materials throughout the course of disease. Laboratory analysis included quantitative PCR, next-generation sequencing, immunofluorescence tests and virus isolation in cell culture.
All patients were male, between age 20 and 60, and self-identified as men having sex with men. Two had a known HIV infection, coinciding with an increased number of lesions and viral DNA detectable in blood. In initial- and serial testing, lesion swabs yielded viral DNA-loads at, or above 10 cp/ml and only declined during the third week. Oropharyngeal swabs featured lower viral loads and returned repeatedly negative in some cases. Viral culture was successful only from lesion swabs but not from oropharyngeal swabs or plasma.
The data presented underscore the reliability of lesion swabs for monkeypox virus-detection, even in later stages of the disease. Oropharyngeal swabs and blood samples alone carry the risk of false negative results, but may hold value in pre-/asymptomatic cases or viral load monitoring, respectively.
截至 2022 年 7 月，全球至少有 7553 例在以往无地方性流行的国家/地区确诊的猴痘病毒暴发病例。据报道，临床表现高度可变，有时缺乏经典描述的全身症状，大多数患者的皮肤损伤数量较少。本研究旨在比较临床数据与病变拭子、咽拭子和血液的纵向 qPCR 结果，这些拭子和血液来自特征明确的患者队列。
研究队列纳入了 16 名男性患者（5 名住院患者，11 名门诊患者），并在疾病过程中对各种材料中的猴痘病毒-DNA 进行了连续检测。实验室分析包括定量 PCR、下一代测序、免疫荧光检测和细胞培养中的病毒分离。
所有患者均为男性，年龄在 20 至 60 岁之间，自认为是男男性行为者。有 2 例已知 HIV 感染，与病变数量增加和血液中可检测到的病毒 DNA 有关。在初始和连续检测中，病变拭子的病毒 DNA 载量为 10 cp/ml 或更高，仅在第 3 周下降。咽拭子的病毒载量较低，在某些情况下反复呈阴性。病毒培养仅从病变拭子中成功，但从咽拭子或血浆中未成功。
所提供的数据强调了病变拭子在猴痘病毒检测中的可靠性，即使在疾病的后期也是如此。咽拭子和血液样本单独检测存在假阴性的风险，但在预/症状前病例或病毒载量监测中可能具有价值。
