Durability of the Humoral Response to MPXV Infection

Area of Science:

• Immunology
• Virology
• Public Health

Background:

• Mpox virus (MPXV) outbreaks have increased globally, raising concerns about immunity durability.
• Previous smallpox vaccination and mpox infection history influence immune responses.
• Understanding mpox immunity is crucial for public health strategies.

Purpose of the Study:

• To summarize current knowledge on the durability of humoral immunity against MPXV.
• To identify limitations in existing evidence regarding mpox immunity.

Main Methods:

• Review of longitudinal studies on immune responses post-mpox infection.
• Analysis of antibody titres (neutralizing, binding IgG/IgA) in convalescent individuals.
• Comparison of immune responses based on age, vaccination history, and HIV status.

Main Results:

• Neutralizing antibodies are detectable up to 2 years post-infection; binding antibodies wane faster.
• Immunodominant epitopes like A35R elicit strong antibody responses.
• Older individuals and those with prior smallpox vaccination show higher antibody titres.
• People with HIV may have weaker initial antibody responses but similar durability.

Conclusions:

• Humoral immunity, alongside cellular immunity, contributes to long-term mpox protection.
• Correlates of protection against mpox are not yet established.
• Further research is needed across diverse populations and viral clades to fully understand mpox immunity durability and inform vaccine/therapeutic development.