In a recent study published in Morbidity and Mortality Weekly Report
context
The prevalence of HIV infections among people diagnosed with monkeypox was calculated. HIV surveillance data was also used to determine patient care status, use of antiretroviral therapy, time of diagnosis and last CD4 count, which indicates the strength of the immune system.
STI surveillance data were analyzed to record diagnoses of chlamydia, syphilis, and gonorrhea over the past 12 months in people infected with monkeypox. Symptoms and clinical findings of monkeypox in infected individuals have also been correlated with HIV infection status.
Results
The study found that HIV prevalence was 38% among 1,969 monkeypox patients diagnosed between May 17 and July 22, 2022. The prevalence of one or more notifiable STIs among patients diagnosed with monkeypox was 41%. The percentage of people infected with monkeypox virus with HIV and one or more STIs diagnosed in the previous year was 18.
The incidence of monkeypox hospitalization was higher in HIV-infected people (8%) than in HIV-uninfected people (3%). Among monkeypox patients diagnosed with HIV infection, 82% had evidence of viral suppression, 92% had received HIV care in the previous year, and 78% had a rate of CD4 of 350 per microliter or more.
The prevalence of HIV in patients with monkeypox varied according to demographic factors. People aged 18 to 24 had a lower incidence of HIV than those aged 55 or older. Race and ethnicity were also factors in variation in HIV prevalence among patients with monkeypox. African American MSM had the highest prevalence (63%), followed by Hispanic people (41%), non-Hispanic white people (28%) and non-Hispanic Asians (22%).
Additionally, some symptoms of monkeypox, such as rectal pain and bleeding, tenesmus, proctitis, and bloody stools, were reported more by HIV-infected patients than those who were not. Unsuppressed HIV burden in patients with monkeypox was also associated with symptoms such as lymphadenopathy, pruritus, rectal bleeding, and bloody stools. Low CD4 counts (
Further, while the national estimate of eligible people who received a prescription for HIV pre-exposure prophylaxis (PrEP) was 25%, the authors report that nearly two-thirds of patients with monkeypox without coinfection with HIV reported using PrEP.
Conclusions
Overall, the study indicates a prevalence of newly diagnosed HIV infections and STIs among people with monkeypox. The prevalence of monkeypox also appears to be higher among MSM, whose incidence of HIV infections and STIs is higher than in the general population. Additionally, HIV coinfection in patients with monkeypox also shows a higher incidence rate in African American MSM, Hispanic MSM, and MSM over 55 years of age.
According to the authors, the co-occurrence of monkeypox cases with STI diagnoses in the previous year indicates a possible bias that people with known HIV infection or STIs are more likely to seek medical advice. sexual health care providers when they have symptoms of monkeypox. Similarly, HIV and sexual health care providers might recognize the symptoms of monkeypox and test for the virus, compared to care providers not experienced in HIV and STIs.
In conclusion, the results suggest that transmission of monkeypox may be linked to people with HIV infection, indicating the importance of prioritizing monkeypox vaccination for people with HIV infection. HIV and STI diagnosed. The authors recommend routine HIV and STI testing and improved access to HIV care and PrEP for people evaluated for monkeypox. Regular surveillance and matching of monkeypox cases with HIV and STI diagnoses can help establish effective public health measures and interventions against monkeypox.