Mpox Recurrence and Tecovirimat Resistance in a Patient With Advanced Human Immunodeficiency Virus Disease

David C Griffith; Amary Fall; Mihaela Carter; Caroline C Traut; Joel Sop; Bhakti Hansoti; Kelly A Gebo; Heba H Mostafa; Joel N Blankson

doi:10.1093/ofid/ofae549

Mpox Recurrence and Tecovirimat Resistance in a Patient With Advanced Human Immunodeficiency Virus Disease

Open Forum Infect Dis. 2024 Sep 23;11(10):ofae549. doi: 10.1093/ofid/ofae549. eCollection 2024 Oct.

Authors

David C Griffith^{1

2}, Amary Fall³, Mihaela Carter⁴, Caroline C Traut¹, Joel Sop¹, Bhakti Hansoti⁵, Kelly A Gebo¹, Heba H Mostafa³, Joel N Blankson¹

Affiliations

¹ Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
² Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
³ Department of Pathology, Johns Hopkins Medicine, Baltimore, Maryland, USA.
⁴ Johns Hopkins Regional Physicians, Baltimore, Maryland, USA.
⁵ Department of Emergency Medicine, Johns Hopkins Medicine, Baltimore, Maryland, USA.

Abstract

We present a case of mpox recurrence in a transgender woman with AIDS. Her recurrent lesions required several courses of antiviral therapy over a 5-month period and her monkeypox viral genome was subsequently noted to have tecovirimat resistance mutations. Interestingly, she developed a robust orthopoxvirus-specific T-cell response.

Keywords: HIV; T cells; mpox; resistance; tecovirimat.