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. 2024 Mar 26;229(Supplement_2):S249-S254.
doi: 10.1093/infdis/jiad517.

Surveillance of Complicated Mpox Cases Unresponsive to Oral Tecovirimat in Los Angeles County, 2022

Abraar Karan  1 , Naman Shah  2 , Jacob M Garrigues  2 , Jemma Alarcόn  2 , Peera Hemarajata  2 , Lauren E Finn  2 , Kathleen Poortinga  2 , Phoebe Danza  2 , Sonali Kulkarni  2 , Moon Kim  2 , Dawn Terashita  2 , Nicole M Green  2 , Sharon Balter  2
Affiliations

Surveillance of Complicated Mpox Cases Unresponsive to Oral Tecovirimat in Los Angeles County, 2022

Abraar Karan et al. J Infect Dis. .

Abstract

The Los Angeles County Department of Public Health established a surveillance system to identify complicated (advanced human immunodeficiency virus [HIV] or hospitalized) mpox cases. From 1 August to 30 November 2022, we identified 1581 mpox cases, of which 134 (8.5%) were complicated. A subset of 8 cases did not recover after either initiating or completing a course of oral tecovirimat. All 8 patients were HIV positive and had advanced HIV (CD4 count <200 cells/μL). We identified 8 distinct mutations previously associated with tecovirimat resistance in specimens collected from 6 patients. Ongoing surveillance of viral evolution requires close coordination between health departments and frontline providers.

Keywords: advanced HIV; drug resistance; mpox; surveillance; tecovirimat.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Flowchart of mpox cases in Los Angeles County, 2022. Abbreviation: HIV, human immunodeficiency virus.
See this image and copyright information in PMC

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