Fig. 4: Evidence of MPXV exposure based on composite binding antibody responses.

a Kaplan Meier curves showing magnitude-breadth score in participants with and without evidence of MPXV exposure, based on cumulative responses and antigen-specific boosting. b Paired magnitude-breadth scores from baseline (T0) and follow-up (T1) showing changes in exposed (navy blue) versus unexposed participants (dark orange). c Antigen-specific fold changes in raw mean fluorescence intensity (MFI) and normalized MFI across the six MPXV targets (A29L, A35R, B6R, D6L, H3L, M1R) for each exposed participant. Participants were classified as MPXV-exposed if they demonstrated a > 2-fold increase in magnitude-breadth score between T0 and T1, together with ≥2-fold increases in ≥4 of the six antigens tested. Analyses were restricted to participants with paired serum samples at T0 and T1 (n = 153). Of these, 5 participants met criteria for MPXV exposure and 148 were classified as unexposed. Each data point represents one individual participant. Participants were classified as MPXV-exposed if they demonstrated a ≥ 2-fold increase in magnitude-breadth scores between T0 and T1 together with ≥2-fold increases in at least 4 of the 6 antigens tested. To the small number of exposed individuals (n = 5), b, c are descriptive and no formal statistical testing was performed. IgG, immunoglobulin G; MPXV, mpox virus; T0, baseline timepoint; T1, follow-up timepoint; y.o, years old.