Division of Infectious Diseases, Emory University School of Medicine, Ponce de Leon Center, 341 Ponce de Leon Ave NE, Atlanta, GA, 30308, USA.
Curr HIV/AIDS Rep. 2023 Aug;20(4):261-269. doi: 10.1007/s11904-023-00661-1. Epub 2023 May 13.
We reviewed the available literature on mpox in People with HIV (PWH). We highlight special considerations of mpox infection related to epidemiology, clinical presentation, diagnostic and treatment considerations, prevention, and public health messaging in PWH.
During the 2022 mpox outbreak, PWH were disproportionally impacted worldwide. Recent reports suggest that the disease presentation, management, and prognosis of these patients, especially those with advanced HIV disease, can widely differ from those without HIV-associated immunodeficiency. Mpox can often be mild and resolve on its own in PWH with controlled viremia and higher CD4 counts. However, it can be severe, with necrotic skin lesions and protracted healing; anogenital, rectal, and other mucosal lesions; and disseminated organ systems involvement. Higher rates of healthcare utilization are seen in PWH. Supportive, symptomatic care and single or combination mpox-directed antiviral drugs are commonly used in PWH with severe mpox disease. Data from randomized clinical control trials on the efficacy of therapeutic and preventive tools against mpox among PWH are needed to better guide clinical decisions.
我们回顾了有关人免疫缺陷病毒（HIV）感染者中猴痘的现有文献。我们重点介绍了与 HIV 感染者中猴痘感染相关的流行病学、临床表现、诊断和治疗注意事项、预防以及公共卫生信息传递的特殊考虑因素。
在 2022 年猴痘疫情期间，HIV 感染者在全球范围内受到不成比例的影响。最近的报告表明，这些患者，尤其是那些患有晚期 HIV 疾病的患者，其疾病表现、管理和预后与那些没有 HIV 相关免疫缺陷的患者有很大不同。在 HIV 病毒载量得到控制且 CD4 计数较高的 HIV 感染者中，猴痘通常症状较轻，可自行缓解。然而，在某些情况下，猴痘可能会很严重，出现坏死性皮肤损伤和愈合时间延长；累及肛门生殖器、直肠和其他黏膜部位；以及全身性器官系统受累。HIV 感染者的医疗保健利用率较高。在 HIV 感染者中，严重猴痘疾病通常采用支持性、对症治疗以及单一或联合猴痘靶向抗病毒药物进行治疗。需要针对 HIV 感染者开展针对猴痘的治疗和预防工具的随机临床试验，以更好地指导临床决策。
