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Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study

Authors :
Raquel Martín-Iguacel
Carles Pericas
Andreu Bruguera
Gemma Rosell
Erica Martínez
Yesika Díaz
Lucia Alonso
Daniel Kwakye Nomah
Jose Luis Blanco
Pere Domingo
Patricia Álvarez-López
Maria Saumoy Linares
Consuelo Vilades Laborda
Arantxa Mera
Sonia Calzado Isbert
Isik Somuncu Johansen
José M. Miró
Jordi Casabona
Josep M. Llibre
Source :
Microorganisms, Vol 11, Iss 11, p 2701 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

We investigated differences in mpox clinical outcomes in people with HIV (PWH) and without HIV (PWoH) and the impact of vaccination in Catalonia, Spain. We used surveillance data and the PISCIS HIV cohort. We included all confirmed mpox cases (May–December 2022). Of 2122 mpox cases, the majority had mild disease, 56% were Spanish, and 24% were from Latin America. A total of 40% were PWH, with a median CD4+T-cell of 715 cells/μL; 83% had HIV-RNA < 50 copies/mL; and 1.8% CD4+T-cell < 200 cells/μL. PWH had no increased risk for complications, except those with CD4+T-cell < 200 cells/μL. PWH with CD4+T-cell < 200 cells/μL were more likely to be from Latin America, had more generalized exanthema, and required hospitalization more frequently (p = 0.001). Diagnosis of other sexually transmitted infections (STIs) was common, both at mpox diagnosis (17%) and two years before (43%). Dose-sparing smallpox intradermal vaccination was accompanied by a sharp decrease in mpox incidence in both populations (p < 0.0001). In conclusion, unless immunosuppressed, PWH were not at increased risk of severe disease or hospitalization. Mpox is a marker of high-risk sexual behavior and was associated with high HIV and STI rates, supporting the need for screening in all mpox cases. Ethnicity disparities demonstrate the need for interventions to ensure equitable healthcare access. Dose-sparing smallpox vaccination retained effectiveness.

Details

Language :
English
ISSN :
20762607
Volume :
11
Issue :
11
Database :
Directory of Open Access Journals
Journal :
Microorganisms
Publication Type :
Academic Journal
Accession number :
edsdoj.13501b706eaf4ce895ecee9a4381e21c
Document Type :
article
Full Text :
https://doi.org/10.3390/microorganisms11112701