Monkeypox Virus Shedding Despite Tecovirimat Treatment in a Cohort in Toronto, Canada
Bibliographic record
Abstract
BACKGROUND: Tecovirimat (TPOXX) is an antiviral authorized for the treatment of mpox infections in Canada, but recent clinical trials found it has no impact on symptom duration. METHODS: We conducted a prospective cohort study of individuals diagnosed with mpox in Toronto, Canada. Skin lesion swabs were collected weekly to quantify infectious monkeypox virus (MPXV) shedding through cell culture. The presence of antiviral resistance mutations was assessed by PCR and sequencing the F13L gene. RESULTS: Among 17 participants, 9 received tecovirimat, with a median initiation time of 14 days post-symptom onset. Infectious MPXV was detected in 31% (17/55) of lesion swabs from tecovirimat-treated participants and 32% (20/62) from untreated individuals. Shedding kinetics were similar between groups, with persistent infectious virus detected in several participants beyond 2 weeks of symptoms. Despite more than 7 days after tecovirimat initiation, 4 treated participants still shed viable virus in at least 1 sampled lesion, including up to 15 days after tecovirimat initiation. No known resistance mutations were identified in viral sequences from a subset of lesion swabs from both treated and untreated individuals, suggesting that tecovirimat resistance mutations were not widely circulating in Toronto during the 2022 outbreak. CONCLUSIONS: Our findings suggest that tecovirimat does not significantly impact the duration of infectious MPXV shedding from skin lesions, aligning with recent randomized trial results. These findings highlight the need for alternative antiviral strategies and continued genomic surveillance to monitor resistance emergence.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".