Prolonged mpox infection and fatal outcome in an HIV patient treated with tecovirimat

This is the authors' abstract. We don't add key points for this paper.

We report a prolonged 59-day MPXV infection in a highly immunocompromised HIV-positive patient. We found progressive within-host viral diversification across lesions from different anatomical sites, including the emergence of a mutation previously associated with tecovirimat resistance. These findings highlight the need to investigate alternative therapeutic strategies for MPXV in severely immunocompromised patients.