Severe Monkeypox Impacts People with HIV
During previous monkeypox outbreaks, severe disease manifestations and poor outcomes have been reported among persons with HIV infection, particularly those with AIDS.
A U.S. CDC Morbidity and Mortality Weekly Report (MMWR) issued on October 26, 2022, summarizes findings from CDC clinical consultations provided for 57 adult patients who were hospitalized with severe manifestations of monkeypox from August 10–October 10, 2022.
This MMWR highlights 47 (82%) monkeypox patients who had HIV infection, four (9%) of whom were receiving antiretroviral therapy (ART) before monkeypox diagnosis.
Most patients were male (95%), and 68% were non-Hispanic Black (Black).
Overall, 17 (30%) patients received intensive care unit (ICU)–level care, and 12 (21%) died.
As of this report published on October 26, 2022, monkeypox was a cause of death or contributing factor in five of these deaths; six deaths remain under investigation to determine whether monkeypox was a causal or contributing factor; and in one death, monkeypox was not a cause or contributing factor.
The CDC stated healthcare providers should be aware that severe morbidity and mortality associated with monkeypox have been observed during the current outbreak in the United States, particularly among highly immunocompromised persons.
Providers should test all sexually active patients with suspected monkeypox for HIV at the time of monkeypox testing unless a patient is already known to have HIV infection.
And providers should consider early commencement and extended duration of monkeypox-directed therapy in highly immunocompromised patients with suspected or laboratory-diagnosed monkeypox.
The CDC also highlighted three Representative Case Descriptions.
Engaging all persons with HIV in sustained care remains a critical public health priority.
Furthermore, the CDC encourages using the two-dose JYNNEOS® (MVA-BN, IMVANEX®) vaccine.
About 1,012,283 JYNNEOS vaccine doses had been administered in the 57 U.S. Jurisdictions reporting data to the CDC as of October 25, 2022.
Additional monkeypox outbreak news, vaccines, and research are posted at Monkeypox Today.
Note: As of October 27, 2022, the U.S. FDA has not approved an HIV prevention vaccine. However, several vaccine candidates are conducting studies in 2022.
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