Prolonged viral shedding in an immunocompromised Korean patient infected with hMPXV, sub‐lineage B.1.3, with acquired drug resistant mutations during tecovirimat treatment

Following the worldwide surge in mpox (monkeypox) in 2022, cases have persisted in Asia, including South Korea, and sexual contact is presumed as the predominant mode of transmission, with a discernible surge in prevalence among immunocompromised patients. Drugs such as tecovirimat can result in dru...

Full description

Saved in:
Bibliographic Details
Published in:Journal of medical virology 2024-03, Vol.96 (3), p.e29536-n/a
Main Authors: Lee, Minji, Choi, Chi‐Hwan, Kim, Jin‐Won, Sim, Gyuri, Lee, Sang Eun, Shin, Hwachul, Lee, Jeong hyun, Choi, Myung‐Min, Yi, Hwajung, Chung, Yoon‐Seok
Format: Article
Language:English
Subjects:
Benzamides
Disease transmission
Drug resistance
Genomic analysis
Humans
Immunocompromised Host
Immunocompromised hosts
immunocompromised patient
Isoindoles
monkeypox virus
Mpox
Mpox (monkeypox)
Mutation
Pathogenesis
Public health
Republic of Korea
Subpopulations
Tecovirimat
Virus Shedding
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Following the worldwide surge in mpox (monkeypox) in 2022, cases have persisted in Asia, including South Korea, and sexual contact is presumed as the predominant mode of transmission, with a discernible surge in prevalence among immunocompromised patients. Drugs such as tecovirimat can result in drug‐resistant mutations, presenting obstacles to treatment. This study aimed to ascertain the presence of tecovirimat‐related resistant mutations through genomic analysis of the monkeypox virus isolated from a reported case involving prolonged viral shedding in South Korea. Here, tecovirimat‐resistant mutations, previously identified in the B.1 clade, were observed in the B.1.3 clade, predominant in South Korea. These mutations exhibited diverse patterns across different samples from the same patient and reflected the varied distribution of viral subpopulations in different anatomical regions. The A290V and A288P mutant strains we isolated hold promise for elucidating these mechanisms, enabling a comprehensive analysis of viral pathogenesis, replication strategies, and host interactions. Our findings imply that acquired drug‐resistant mutations, may present a challenge to individual patient treatment. Moreover, they have the potential to give rise to transmitted drug‐resistant mutations, thereby imposing a burden on the public health system. Consequently, the meticulous genomic surveillance among immunocompromised patients, conducted in this research, assumes paramount importance.
ISSN:0146-6615
1096-9071
1096-9071
DOI:10.1002/jmv.29536