Cidofovir for treating complicated monkeypox in a man with acquired immune deficiency syndrome

Fabrizio, Claudia; Bruno, Giuseppe; Cristiano, Letizia; Buccoliero, Giovanni Battista

doi:10.1007/s15010-022-01949-x

Cited by 19 publications

(15 citation statements)

References 15 publications

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“…The antiviral tecovirimat prevents the release, spread, and pathogenicity of enveloped viruses by inhibiting the activity of the protein p37 [ 47 ]. MPXV DNA synthesis is slowed by cidofovir [ 48 ]. Brincidofovir is effective against viruses with double-stranded DNA and works as an antiviral by entering infected cells [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review

et al. 2023

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Public health officials around the world are extremely concerned about the global outbreak of monkeypox (MPX), which has been claimed to have originated in Africa. As a result, studies into the origins and reasons behind the outbreak’s rapid spread have been sped up. The goal of the current investigation is to determine whether the monkeypox virus (MPXV) is present in seminal fluid samples from MPX cases that have been verified. Up until 6 January 2023, PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases were used to conduct a thorough evaluation of the literature. The search technique returned a total of 308 items. Fourteen studies reporting the presence of MPXV in the seminal fluid of MPX-confirmed cases were included after the duplicates (n = 158) and searches by title, abstract, and full text were eliminated. In 84 out of the 643 confirmed MPX cases (13.06% or n = 643), MPXV was discovered in seminal fluid. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to identify MPXV, and samples taken from skin lesions (96.27%), pharynx or oropharynx (30.48%), and blood all had higher positivity rates than other samples (12.44%). Additionally, 99.85% of respondents were male with a mean age of 36, 98.45% engaged in MSM (men who have sex with men) sexual conduct, and human immunodeficiency virus (HIV) accounted for 56.9% of all STD cases. This study offers proof that MPXV can be found in the seminal fluid of MPX sufferers. Our data imply that MPXV transmission is a possibility in these samples and that MSM are more vulnerable to it. The creation of hygienic standards is essential for the early identification of MPX cases.

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Section: Discussionmentioning

confidence: 99%

Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review

et al. 2023

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“…Recently, the real‐life use of cidofovir for the treatment of severe cases of Mpox has shown success in a small series of cases, with no adverse events reported 95 . In frail subjects, such as AIDS patients requiring hospitalisation for a severe course of Mpox, Cidofovir may also be considered as a valuable component of treatment 96 . In addition, another antiviral, tecovirimat, could be used for the treatment of Mpox.…”

Section: Discussionmentioning

confidence: 99%

“…95 In frail subjects, such as AIDS patients requiring hospitalisation for a severe course of monkeypox, Cidofovir may also be considered as a valuable component of treatment. 96 In addition, another antiviral, tecovirimat, could be used for the treatment of monkeypox. In fact, a preliminary study identified that oral tecovirimat was well tolerated by 25 males (age range: 26-76) with monkeypox infection, with minimal adverse effects.…”

Section: Practice and Research Implicationsmentioning

confidence: 99%

Risk profile and mode of transmission of Mpox: A rapid review and individual patient data meta‐analysis of case studies

Calatayud

López-Gil

Koyanagi

et al. 2022

Reviews in Medical Virology

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Since May 2022, an outbreak of monkeypox in non-endemic countries has become a potential public health threat. The objective of this rapid review was to examine the risk profile and modes of transmission of monkeypox. PubMed, Web of Science, and Scopus were searched from inception through July 30 to collect case reports/series on patients with monkeypox infection. For meta-analysis, data on the total number of participants and deaths by binary categories of exposure (age, sex, country, other co-infections or existing conditions, and mode of contagion) were used. A total of 62 studies (4659 cases) were included. Most cases came from Africa (84.3%), followed by Europe (13.9%). In 63.6% of the cases, the mode of contagion was human contact, while 22.8% of the cases were by animal contact, and 13.5% were unknown or not reported. The mortality rate was 6.5% throughout these studies. The risk of mortality was higher in the younger age group (risk difference: 0.19; 95% CI: 0.02-0.36), in cases with other co-infections or current chronic conditions (risk difference: 0.03; 95% CI: 0.01-0.05) and in the category of low-and middle-income countries (risk difference: 0.06; 95% CI: 0.05-0.08). There were no significant differences with respect to sex or mode of contagion. These results help to understand the major infection pathways and mortality risk profiles of monkeypox and underscores the importance of preventing outbreaks in specific settings, especially in settings densely populated by children, such as day care centres and schools.

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“…There are currently no antiviral drugs explicitly approved for the treatment of MPXV infection. The antiviral cidofovir has rarely been used as an off-label treatment for MPXV in humans and, although reported to be efficacious, further clinical investigation is necessary [20][21][22]. Tecovirimat, another antiviral that was designed and previously approved for the treatment of smallpox infection, was recently approved by the European Medical Association for the treatment of MPXV infection and is recommended in the treatment of severely ill individuals who are immunocompromised [23,24].…”

Section: Vaccine and Treatmentmentioning

confidence: 99%

“…While the similarities in the different species can complicate the diagnosis, many orthopoxviruses are cross-reactive and cross-protective, which can be beneficial. Sudden-onset fever with mucocutaneous lesions 1-3 days later Headache, lymphadenopathy, myalgia, back pain, asthenia [12,13] Human: corneal opacities, opaque pupil, erythematous sclera [14,15] GPR: corneal opacities and ocular discharge [16] Prairie dog: periocular lesions [17] Vaccines: modified vaccinia vaccine, ACAM200, JYNNEOS TM [13,18,19] Treatment: cidofovir (off-label) [20][21][22], tecovirimat to treat severely ill immunocompromised individuals [23,24] Variola virus (VARV) or Smallpox Human Incubation period: 7-19 days Prodromal phase with fever, malaise, headaches for 2-4 days Maculopapular rash progressing to pustules and scabs that form scars [25,26] Corneal ulceration with associated perforation, hypopyon, and iris prolapse [27][28][29] Posterior segment findings: retinitis, chorioretinitis, optic neuritis [29] Ocular vaccinia: conjunctival and corneal involvement or posterior segment complications [30][31][32][33] Vaccine: made from live vaccinia [34] Treatment: cidofovir, brincidofovir, tecovirimat [35][36][37][38] Cowpox virus (CPXV) Human Cat Cattle Elephant Rodent Incubation period: 8-12 days [39] Fever and lymphadenopathy Painful macular lesion that becomes hard black eschar with edema and erythema [40,41] Eyelid Incubation period: 9-13 days [53] Fever, lymphadenopathy, skin lesions [54] Eyelid lesions and retinal lesions leading to blindness [55] Vaccine: attenuated and inactiva...…”

Section: Introduction (Orthopoxviruses)mentioning

confidence: 99%

Ophthalmic Features and Implications of Poxviruses: Lessons from Clinical and Basic Research

et al. 2022

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Amidst the ongoing monkeypox outbreak, global awareness has been directed towards the prevention of viral transmission and case management, with the World Health Organization declaring the outbreak a public health emergency of international concern. Monkeypox virus is one of several species in the Orthopoxvirus genus, with other species of the genus including the variola, cowpox, mousepox, camelpox, raccoonpox, skunkpox, and volepox viruses. Although the nomenclature of these species is based on the animal host from which they were originally isolated, transmission from animals to humans has been reported with several species. The progression of disease, following an incubation period, typically consists of a prodromal phase with systemic flu-like symptoms. Various organ systems may be affected in addition to the formation of pathognomonic skin lesions. As monkeypox poses a continued public health concern, the ophthalmic sequelae of monkeypox virus, especially those leading to vision loss, warrant consideration as well. This review provides a comprehensive summary of the ophthalmic implications of poxviruses in clinical and laboratory settings reported in the literature, as well as areas of unmet need and future research.

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Cidofovir for treating complicated monkeypox in a man with acquired immune deficiency syndrome

Cited by 19 publications

References 15 publications

Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review

Virus Identification for Monkeypox in Human Seminal Fluid Samples: A Systematic Review

Risk profile and mode of transmission of Mpox: A rapid review and individual patient data meta‐analysis of case studies

Ophthalmic Features and Implications of Poxviruses: Lessons from Clinical and Basic Research

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