严重的mopox在一个免疫受损的病人复杂的深层组织感染:一个病例报告
Susanne Pfefferle1, Michaela Schweizer2, Kristin Hartmann3,4
1Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
Heliyon
|October 24, 2024
概括
艾滋病毒患者的Mpox感染持续超过14周,尽管接受了tecovirimat治疗,并因深层组织感染和抗tecovirimat突变而复杂. 这凸显了MPOX管理的挑战和需要谨慎监测的需要.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 麻疹是一种由麻疹病毒 (MPXV) 引起的病毒性疾病.
- 同时感染艾滋病毒可能会使MOPOX疾病的病程和治疗复杂化.
- 德科维里马特 (Tecovirimat) 是一种用于治疗mopox的抗病毒药物.
研究的目的:
- 在艾滋病毒阳性患者中报告长期mopox感染病例.
- 为了调查tecovirimat耐药性和深层组织感染的发展.
- 在治疗期间分析病毒分泌,突变和传染性.
主要方法:
- 使用qPCR. 在病变,血液和组织中量化MPXV-DNA.
- 通过免疫光 (IF) 和病毒中和试验 (VNT) 对抗MPXV抗体的分析.
- 通过隔离和测序用于使用数字SNPPCR对tecovirimat耐药性突变 (A288P) 的病毒传染性的评估.
主要成果:
- 在病变和血液中长期存在MPXV-DNA (>14周),具有病毒性,尽管有两次tecovirimat疗程.
- 深层组织MPXV感染的发展,具有高病毒标位和组织中的传染性病毒.
- 在血液和抽样中出现和增加tecovirimat耐药性突变A288P的比例,但不是在深层组织样本中,这表明分隔.
结论:
- 德科维里马特治疗可以选择对细分的病毒突变产生耐药性.
- 深层组织感染和病毒突变凸显了严重mpox病例的治疗挑战.
- 对病毒突变和深层组织参与的持续监测对于有效的mpox患者管理至关重要,特别是在免疫受损的个体中.
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