Monkeypox viral detection in semen specimens of confirmed cases: A systematic review and meta‐analysis

Abstract

Background The current literature shows increasing concerns about potential seminal transmission of monkeypox virus (MPV). Accordingly, we aimed to understand better the potential presence of MPV in the seminal uids and others specimens obtained from monkeypox (MPX) cases.Methods On June 26, 2022, a systematic search of the literature was conducted across PubMed, Scopus, Web of Science, EMBASE, ScienceDirect, ProQuest, EBSCOHost-Academic Search Complete, and Google Scholar to nd articles that examine the presence of MPV in seminal uid of con rmed cases . The search was updated on August 12 to include newly published articles. The prevalence of MPV DNA presence in the seminal uid and other specimens was pooled in a meta-analysis and results were presented as effect sizes and their corresponding 95% con dence intervals (CI). The quality of included articles was assessed using the National Institute of Health tool.Results Eight articles (including 585 MPX-con rmed patients) were included. Only four studies were eligible for a meta-analysis, and the individual positivity rate of MPV DNA in semen specimens ranged from 61.11% to as high as 90.62%, while the pooled rate was 78% (95% CI: 62-93%; I2=61.93%) among 91 examined patients. Moreover, the pooled positive rate of MPV DNA was the highest in rectal samples (100%; 95%CI: 94-100%), followed by urinary (31%; 95%CI: 1-61%), nasopharyngeal (28%; 95%CI: 24-32%), and blood/plasma (8%; 95%CI: 6-10%) samples, respectively. Furthermore, two articles also investigated the infectivity of MPV particles detected in seminal specimens by testing their replication competence. Culturing MPV was successful in one out of three patients included in these studies. Also, based on available evidence, the positivity of MPV in semen specimens can be observed early and up to 19 days after symptoms onset.Conclusions MPV is highly prevalent in seminal specimens of MPX cases, further corroborating the role of sexual transmission of the disease. However, further evidence is still needed to shed more light on the replication competence of these particles.

Epidemiologic Situation of HIV and Monkeypox Coinfection: A Systematic Review

“…The largest number of cases registered with co-infection of Mpox and HIV are male (91.44%), which is consistent with other reviews in which it is reported that the population most affected by Mpox are men [ 6 , 68 , 69 , 70 ]. The prevalence of Mpox and HIV co-infection was 40% of the cases.…”

“…This disparity would suggest that transmissibility could be higher in people with HIV [ 74 ]. Mpox can be transmitted by respiratory secretions, skin lesions, contaminated fomites and through seminal fluid [ 69 , 75 ]. Reda et al [ 69 ] found that seminal fluid from Mpox-infected patients had a high Monkeypox virus DNA positivity rate (72.4%), behind the positivity rate of anogenital/rectal lesion samples (74.3%).…”

“…Mpox can be transmitted by respiratory secretions, skin lesions, contaminated fomites and through seminal fluid [ 69 , 75 ]. Reda et al [ 69 ] found that seminal fluid from Mpox-infected patients had a high Monkeypox virus DNA positivity rate (72.4%), behind the positivity rate of anogenital/rectal lesion samples (74.3%). Therefore, such sexual behaviors in HIV patients could predispose to Mpox infection.…”

Detection of Monkeypox Virus according to The Collection Site of Samples from Confirmed Cases: A Systematic Review

“…On the other hand, MPXV has been detected in the semen of infected men, which could plausibly transmit the infection [ 21 ]. Reda A et al reported in their systematic review and meta-analysis study that MPXV is highly prevalent in seminal samples of MPX cases, further corroborating the role of sexual transmission of the disease [ 95 ].…”

How and when does monkeypox (mpox) transmit: Implications for prevention and treatments

“…The available literatures showed increasing concerns about possible seminal transmission of MPXV ( Hornuss et al, 2022 ; Lapa et al, 2022 ; Noe et al, 2022 ; Peiró-Mestres et al, 2022 ; Raccagni et al, 2022 ; Reda et al, 2022 ; Reda et al, 2023 ). Detection of viruses in the testes is commonly secondary to viraemia because the blood–testis barrier may be liable to viruses, especially when systemic or local inflammation occurs.…”