治疗耐药Mpox管理的挑战 严重超级感染复杂化
Julia C Fortier1, Christopher Marsalisi2, Elian Cordova1
1College of Medicine, University of Florida, Gainesville, Florida, USA.
Open forum infectious diseases
|April 23, 2024
概括
严重的mopox可以抵抗标准抗病毒治疗,特别是在免疫功能低下的患者中. 对于耐治疗的mopox病毒感染,可能需要扩展或替代疗法.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
背景情况:
- 严重的mopox (麻疹) 感染,虽然通常是自我限制的,可能需要抗病毒治疗.
- 德科维里马特是用于重症mopox的主要抗病毒药物,但已有治疗耐药性的报道.
- 治疗耐药性通常与mopox病毒的突变有关,特别是在免疫受损的个体中.
研究的目的:
- 在免疫功能低下的患者中呈现一种传播的,耐治疗的mopox感染病例.
- 讨论可能导致mopox.抗病毒耐药性的潜在因素.
- 突出在免疫功能低下的mpox患者中需要量身定制的治疗策略.
主要方法:
- 一名患有获得性免疫缺陷综合征 (艾滋病) 的男性患者的病例报告.
- 详细的临床过程,包括mopox诊断,接收的抗病毒治疗和结果.
- 实验室监测,包括orthopoxvirus聚合酶链反应 (PCR).
主要成果:
- 这位患者呈现了传播的mopox,并由细菌和真菌感染复杂化.
- 尽管经过4周的口服特科维里马和3剂静脉注射西多福维尔,骨质疏松病毒PCR仍然呈阳性.
- 反应不佳归因于免疫功能受损的状态,由于先前不完整的tecovirimat治疗,mopox病毒菌株的耐药性是可能的.
结论:
- 免疫功能低下的mopox患者可能需要延长或替代抗病毒疗法超出标准的tecovirimat疗程.
- 考虑额外的抗病毒药物,如cidofovir,brincidofovir或静脉注射疫苗和免疫球蛋白至关重要.
- 需要对免疫受损宿主中mopox抗病毒抵抗机制进行进一步的研究.
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