Rocha Simone Queiroz, Fonsi Mylva, Tancredi Mariza Vono, Alencar Herculano Duarte Ramos de, Abbud Adriano, da Silva Mariliza Henrique
Centro de Referência e Treinamento DST/AIDS, São Paulo, Brazil.
Instituto Adolfo Lutz, São Paulo, Brazil.
AIDS Res Hum Retroviruses. 2023 Nov;39(11):610-615. doi: 10.1089/AID.2022.0189. Epub 2023 Jun 7.
Mpox is caused by a zoonotic orthopoxvirus capable of infecting several animal species, including humans. The analysis of cases in the current outbreak showed that, differently from what happens in the classical disease, mpox has mostly affected men who have sex with men (MSM) and bisexuals, including a high proportion of people living with HIV/AIDS. The role of the immune system in fighting mpox has been discussed in literature and experts believe that immunity conferred by natural infection may be lifelong, advocating against the possibility of reinfection by monkeypox virus. This report presents a MSM couple living with HIV with cycles of mpox lesions after two different risk exposures. The clinical course of both cases, as well as the temporal and anatomical relationship between the second cycle of monkeypox virus lesions and the second exposure, suggests the occurrence of reinfection. The genomic surveillance of monkeypox virus, a better understanding of its interaction with the human host, and knowledge of the postinfection and postvaccine protection correlation are more relevant at this moment, when we observe an intersection of the mpox multicountry outbreak with the HIV/AIDS epidemic, considering the immunosenescence and other immune system issues caused by HIV.
猴痘由一种人畜共患的正痘病毒引起，该病毒能够感染包括人类在内的多种动物物种。对当前疫情中病例的分析表明，与经典疾病不同的是，猴痘主要影响男男性行为者（MSM）和双性恋者，其中包括很大比例的艾滋病毒/艾滋病感染者。免疫系统在对抗猴痘中的作用已在文献中进行了讨论，专家们认为自然感染所赋予的免疫力可能是终身的，因此反对猴痘病毒再次感染的可能性。本报告介绍了一对感染艾滋病毒的男男性行为者伴侣，在两次不同的风险暴露后出现了猴痘病变周期。两例病例的临床病程，以及猴痘病毒病变的第二个周期与第二次暴露之间的时间和解剖学关系，提示了再次感染的发生。在我们观察到猴痘多国疫情与艾滋病毒/艾滋病疫情相交，同时考虑到艾滋病毒引起的免疫衰老和其他免疫系统问题的当下，对猴痘病毒进行基因组监测、更好地了解其与人类宿主的相互作用以及掌握感染后和接种疫苗后的保护相关性更为重要。
