{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:18:57Z","timestamp":1790126337213,"version":"4.0.1"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Korea Health Technology R&D Project"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Health and Welfare, Republic of Korea","award":["HV22C0233"],"award-info":[{"award-number":["HV22C0233"]}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2023-00248157"],"award-info":[{"award-number":["RS-2023-00248157"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["21153MFDS601"],"award-info":[{"award-number":["21153MFDS601"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Viral load dynamics and shedding kinetics are critical factors for studying infectious diseases. However, evidence on the viral dynamics of mpox remains limited and inconclusive. Thus, we aimed to provide a comprehensive understanding of the viral load and viability of the re-emerged mpox virus since 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For this systematic review and meta-analysis, we searched PubMed\/MEDLINE, Embase and Google Scholar for published articles that are related to mpox viral dynamics up to April 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 19 studies, 880 samples and 1477 specimens were collected. The pooled median Ct values appeared in the following order: skin lesion [Ct value 21.7 (IQR 17.8\u201325.5)], anorectal [22.3 (16.9\u201327.6)], saliva [25.9 (22.5\u201331.1)], oral [29.0 (24.5\u201332.8)], semen [29.6 (25.9\u201333.4)], urine [30.5 (24.6\u201336.4)], pharyngeal [31.9 (26.5\u201337.3)], urethra [33.0 (28.0\u201335.0)] and blood [33.2 (30.4\u201336.1)]. People living with human immunodeficiency virus (HIV) have a lower Ct value in the skin [skin HIV+, 19.2 (18.3\u201320.0) vs skin HIV\u2212, 25.4 (21.2\u201329.0)]. From the Ct values and test day since symptom onset, we identified temporal trends of viral load for each specimen type. Changes in the trend were observed at 4\u00a0days in saliva, 5\u00a0days in blood, 6\u00a0days in skin, 7\u00a0days in anorectal, urine, semen and pharyngeal and 8\u00a0days in the urethra. We determined optimal Ct cutoff values for anorectal (34.0), saliva (27.7) and urethra (33.0) specimens, where a Ct value above each cutoff suggests minimal viral viability. Using these cutoff values, we derived the duration of viable viral isolation in each specific specimen type (anorectal 19\u00a0days, saliva 14\u00a0days and urethra 14\u00a0days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Skin lesion, anorectal and saliva samples contained the highest viral load. The peak viral load manifests within 4\u20138\u00a0days after symptom onset, and viable virus detection was presumed to cease within 14\u201319\u00a0days from symptom onset in anorectal, saliva and urethral samples.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jtm\/taad111","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T08:13:15Z","timestamp":1691741595000},"source":"Crossref","is-referenced-by-count":52,"title":["Viral load dynamics and shedding kinetics of mpox infection: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"30","author":[{"given":"Hakyoung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Medicine, Kyung Hee University College of Medicine , Seoul 02447 , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosie","family":"Kwon","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute, Kyung Hee 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Education and Sport Sciences , Faculty of Literature and Human Sciences, Lorestan University, Khoramabad 6815144316 , Iran"},{"name":"Department of Physical Education and Sport Sciences , Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan 7718897111 , Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Koyanagi","sequence":"additional","affiliation":[{"name":"Research and Development Unit , Parc Sanitari Sant Joan de Deu, Barcelona 08830 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"Centre for Health , Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Seo","family":"Kim","sequence":"additional","affiliation":[{"name":"Cardiovascular Disease Initiative , Broad Institute of MIT and Harvard, Cambridge, MA 02142 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo F","family":"L\u00f3pez S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine and Public Health , Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia 30120 , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragioti","family":"Elena","sequence":"additional","affiliation":[{"name":"Department of Medical and Health Sciences , Pain and Rehabilitation Centre, Link\u00f6ping University, Link\u00f6ping 581 83 , Sweden"},{"name":"Research Laboratory Psychology of Patients , Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina 45221 , Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Geun","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology - Head & Neck Surgery, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2326-1820","authenticated-orcid":false,"given":"Jae Il","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics , Yonsei University College of Medicine, Seoul 03722 , South Korea"},{"name":"Severance Underwood Meta-research Center , Institute of Convergence Science, Yonsei University, Seoul 03722 , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wonyoung","family":"Cho","sequence":"additional","affiliation":[{"name":"Center for Digital Health , Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447 , South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-9948","authenticated-orcid":false,"given":"Dong Keon","family":"Yon","sequence":"additional","affiliation":[{"name":"Center for Digital Health , Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447 , South Korea"},{"name":"Department of Regulatory Science, Kyung Hee University , Seoul 02447 , South Korea"},{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,15]]},"reference":[{"key":"2023090611094405200_ref1","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.54724\/lc.2022.e17","article-title":"Demographic, transmission, and clinical characteristics associated with human monkeypox infection, October 2022: a systematic analysis for World Health Organization database and brief review","volume":"2","author":"Yon","year":"2022","journal-title":"Life 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