Hoffmann Christian, Jessen Heiko, Wyen Christoph, Grunwald Stephan, Noe Sebastian, Teichmann Jörn, Krauss Anja-Sophie, Kolarikal Henning, Scholten Stefan, Schuler Christoph, Bickel Markus, Roll Clemens, Kreckel Peter, Köppe Siegfried, Straub Matthias, Klausen Gerd, Lenz Johannes, Esser Stefan, Jensen Björn, Rausch Michael, Unger Stefan, Pauli Ramona, Härter Georg, Müller Matthias, Masuhr Anja, Schäfer Guido, Seybold Ulrich, Schellberg Sven, Schneider Jochen, Monin Malte Benedikt, Wolf Eva, Spinner Christoph D, Boesecke Christoph
Infektionsmedizinisches Centrum Hamburg, Hamburg, Germany.
University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany.
HIV Med. 2023 Apr;24(4):389-397. doi: 10.1111/hiv.13378. Epub 2022 Sep 4.
Since May 2022, increasing numbers of monkeypox virus (MPXV) infections have been reported from across Europe and North America. Studies, mainly from Africa, have suggested a higher risk for severe MPXV cases in people living with HIV.
This was a retrospective study of all confirmed MPXV infections observed in the participating centres since 19 May 2022. We conducted a chart review to evaluate clinical characteristics, comorbidities, and coinfections, including HIV, viral hepatitis, and sexually transmitted infections (STIs).
By 30 June 2022, a total of 546 MPXV infections were reported from 42 German centres. All patients were men who have sex with men (MSM), of whom 256 (46.9%) were living with HIV, mostly with a preserved immune system and with viral suppression. In total, 232 (42.5%) MSM were also taking HIV pre-exposure prophylaxis (PrEP) and 58 (10.6%) MSM had no known HIV infection or PrEP use. The median age was 39 years (range 20-67), and comorbidities were rare. However, 52.4% and 29.4% of all patients had been diagnosed with at least one STI within the last 6 months or within the last 4 weeks, respectively. The most frequent localizations of MPXV infection were genital (49.9%) and anal (47.9%), whereas fever (53.2%) and lymphadenopathy (42.6%) were the most frequent general symptoms. The hospitalization rate was low (4.0%), and no fatal course was observed. The clinical picture showed no apparent differences between MSM with or without HIV.
In this preliminary cohort analysis from a current large outbreak among MSM in Germany, the clinical picture of MPXV infection did not differ between MSM with and without HIV infection. Severe courses were rare and hospitalization rates were low. However, most patients were relatively healthy, and only a few people living with HIV were viremic or severely immunosuppressed.
自2022年5月以来，欧洲和北美的猴痘病毒（MPXV）感染报告数量不断增加。主要来自非洲的研究表明，艾滋病毒感染者患严重猴痘病例的风险更高。
这是一项对2022年5月19日以来参与研究的中心观察到的所有确诊猴痘病毒感染病例的回顾性研究。我们进行了病历审查，以评估临床特征、合并症和合并感染情况，包括艾滋病毒、病毒性肝炎和性传播感染（STIs）。
截至2022年6月30日，德国42个中心共报告了546例猴痘病毒感染病例。所有患者均为男男性行为者（MSM），其中256例（46.9%）感染艾滋病毒，大多数患者免疫系统功能保留且病毒得到抑制。总共有232例（42.5%）男男性行为者正在接受艾滋病毒暴露前预防（PrEP），58例（10.6%）男男性行为者未感染艾滋病毒或未使用暴露前预防药物。中位年龄为39岁（范围20 - 67岁），合并症较少见。然而，所有患者中分别有52.4%和29.4%在过去6个月内或过去4周内被诊断至少患有一种性传播感染。猴痘病毒感染最常见的部位是生殖器（49.9%）和肛门（47.9%），而发热（53.2%）和淋巴结病（42.6%）是最常见的全身症状。住院率较低（4.0%），未观察到死亡病例。有或无艾滋病毒的男男性行为者的临床表现无明显差异。
在德国当前男男性行为者大规模疫情的这一初步队列分析中，感染猴痘病毒的男男性行为者中，有或无艾滋病毒感染的临床表现无差异。严重病程罕见，住院率较低。然而，大多数患者相对健康，只有少数艾滋病毒感染者存在病毒血症或严重免疫抑制。
