Patients with HIV and Mpox Only More at Risk of Hospitalisation if Immunosuppressed - European Medical Journal

Patients with HIV and Mpox Only More at Risk of Hospitalisation if Immunosuppressed

INCREASED risk of hospitalisation was not experienced in patients with controlled HIV and Mpox infection, according to research conducted using the data from the World Health Organization (WHO)’s Mpox surveillance system. However, the current study did find that uncontrolled HIV and immunosuppression increased hospitalisation risk.

Mpox cases occurred in 113 countries during the 2022 global outbreak. Lead researcher Ana Hoxha, Infectious Diseases Epidemiologist, WHO, stressed the importance of this subject as: “Very relevant for clinicians to be aware of when they start treating patients who have Mpox, and meanwhile also live with HIV.” They went on to stress that physicians should “know the immune status of their patient for prevention of severe outcomes.”

Hoxha and colleagues analysed data on the HIV status of 34,973 cases, of which 48% were living with HIV: 99% of this HIV positive cohort were male; 92% were males who have intercourse with males, and 85% were aged 18–44 years. Among patients who are HIV-positive and diagnosed with Mpox, 5,023 were immunosuppressed, 735 were hospitalised, 20 were admitted to intensive care, and 23 died.

The investigation found that patients who were immunosuppressed and HIV-positive were twice as likely (odds ratio: 2.00; 95% confidence interval: 1.64–2.43), and patients who were immunosuppressed and HIV-negative were more than three times as likely (odds ratio: 3.56; 95% confidence interval: 1.8–7.01), to be hospitalised with Mpox when compared with patients who are HIV-negative immunocompetent. The researchers made clear that living with HIV alone did not increase hospitalisation risk.

Hoxha described the importance of this work: “High prevalence of HIV among Mpox cases highlights the importance of HIV testing for individuals who do not know their status,” adding: “Mpox diagnosis therefore presents a good occasion to be screened for HIV.” The study has been praised for its use of the WHO’s surveillance system, which draws upon countries of all backgrounds, and so should percolate an accurate global picture into these results. Academics have recognised a lack of data on Mpox infection, with or without HIV, from low- and middle-income countries, where this study addresses and encourages more work in the near future.

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