{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:40:10Z","timestamp":1783975210868,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MRR-184812"],"award-info":[{"award-number":["MRR-184812"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tier 2 Canada Research Chair"},{"name":"Mathematical Modeling and Program Science"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tecovirimat (TPOXX) is an antiviral authorized for the treatment of mpox infections in Canada, but recent clinical trials found it has no impact on symptom duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study of individuals diagnosed with mpox in Toronto, Canada. Skin lesion swabs were collected weekly to quantify infectious monkeypox virus (MPXV) shedding through cell culture. The presence of antiviral resistance mutations was assessed by PCR and sequencing the F13L gene.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 17 participants, 9 received tecovirimat, with a median initiation time of 14 days post-symptom onset. Infectious MPXV was detected in 31% (17\/55) of lesion swabs from tecovirimat-treated participants and 32% (20\/62) from untreated individuals. Shedding kinetics were similar between groups, with persistent infectious virus detected in several participants beyond 2 weeks of symptoms. Despite more than 7 days after tecovirimat initiation, 4 treated participants still shed viable virus in at least 1 sampled lesion, including up to 15 days after tecovirimat initiation. No known resistance mutations were identified in viral sequences from a subset of lesion swabs from both treated and untreated individuals, suggesting that tecovirimat resistance mutations were not widely circulating in Toronto during the 2022 outbreak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that tecovirimat does not significantly impact the duration of infectious MPXV shedding from skin lesions, aligning with recent randomized trial results. These findings highlight the need for alternative antiviral strategies and continued genomic surveillance to monitor resistance emergence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf471","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T11:49:21Z","timestamp":1757159361000},"page":"e132-e139","source":"Crossref","is-referenced-by-count":2,"title":["Monkeypox Virus Shedding Despite Tecovirimat Treatment in a Cohort in Toronto, Canada"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-0700","authenticated-orcid":false,"given":"Jacklyn R","family":"Hurst","sequence":"first","affiliation":[{"name":"Biological Sciences, Sunnybrook Research Institute, Sunnybrook Hospital , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9391-8426","authenticated-orcid":false,"given":"Mary","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Immunology, University of Toronto , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Li","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, St. Michael's Hospital , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya S","family":"Khera","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, St. Michael's Hospital , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reva","family":"Persaud","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, St. Michael's Hospital 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K","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Sunnybrook Health Sciences Centre , Toronto, Ontario ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, Institute of Health Policy Management, and Evaluation, University of Toronto , Toronto, Ontario ,","place":["Canada"]},{"name":"Department of Medicine, University of Toronto , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3959-5692","authenticated-orcid":false,"given":"Sharon","family":"Walmsley","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, Institute of Health Policy Management, and Evaluation, University of Toronto , Toronto, Ontario ,","place":["Canada"]},{"name":"Division of Infectious Diseases, University Health Network , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8492-5470","authenticated-orcid":false,"given":"Sharmistha","family":"Mishra","sequence":"additional","affiliation":[{"name":"MAP Centre for Urban Health Solutions, St. Michael's Hospital , Toronto, Ontario ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, Institute of Health Policy Management, and Evaluation, University of Toronto , Toronto, Ontario ,","place":["Canada"]},{"name":"Department of Medicine, University of Toronto , Toronto, Ontario ,","place":["Canada"]},{"name":"Division of Infectious Diseases, St. Michael's Hospital , Toronto, Ontario ,","place":["Canada"]},{"name":"Institute of Medical Science, University of Toronto , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3069-2875","authenticated-orcid":false,"given":"Darrell H 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,","place":["Canada"]},{"name":"Department of Laboratory Medicine and Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre , Toronto, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"2026031304532321700_jiaf471-B1"},{"key":"2026031304532321700_jiaf471-B2","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.3390\/biomedicines11041106","article-title":"VP37 protein inhibitors for mpox treatment: highlights on recent advances, patent literature, and future directions","volume":"11","author":"Hudu","year":"2023","journal-title":"Biomedicines"},{"key":"2026031304532321700_jiaf471-B3","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.antiviral.2012.02.012","article-title":"Orthopoxvirus targets for the development of new antiviral agents","volume":"94","author":"Prichard","year":"2012","journal-title":"Antiviral 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