Infectious Diseases Department, Hospital de Infectología 'Dr Daniel Méndez Hernández' La Raza National Medical Center.
Center for HIV and Hepatogastroenterology, Duesseldorf, Germany.
AIDS. 2023 Nov 1;37(13):1979-1985. doi: 10.1097/QAD.0000000000003623. Epub 2023 Jun 8.
To describe risk factors for mortality and clinical characteristics in patients with mpox infection at a reference hospital in Mexico.
A prospective cohort study was conducted from September to December 2022 at Hospital de Infectología La Raza National Medical Center.
Study participants were patients that met operational definition of confirmed case of mpox according to WHO criteria. Information was obtained through a case report form that included epidemiological, clinical, and biochemical information. The follow-up period was from initial evaluation for hospitalization until discharge due to clinical improvement or death. Written informed consent was obtained from all participants.
Seventy-two patients were included in the analysis, 64 of 72 (88.9%) were people with HIV (PWH). Of the total of patients 71 of 72 (98.6%) were male, with a median age of 32 years old [95% confidence interval (CI), interquartile range (IQR) 27-37]. Coinfection with sexually transmitted infections was reported in 30 of 72 (41.7%). The overall mortality was five of 72 (6.9%). The incidence of mortality rate in PWH was 6.3%. Median days from onset of symptoms to death from any cause during hospitalization was 50 days (95% CI, IQR 38-62). Risk factors for mpox mortality in the bivariate analysis were CD4 + cells count ≤100 cells/μl at the time of assessment RR 20 (95% CI, IQR 6.6-60.2) ( P < 0.001), absence of antiretroviral therapy RR 6.6 (95% CI, IQR 3.6-12.1) ( P = 0.001) and ≥50 skin lesions at presentation RR 6.4 (95% CI, IQR 2.6-15.7) ( P = 0.011).
The clinical presentation between PWH and non-HIV patients was similar in this study, however, reported mortality was associated with advanced-HIV disease.
描述墨西哥一家参考医院感染猴痘病毒患者的死亡风险因素和临床特征。
这是一项在 2022 年 9 月至 12 月期间于国家医学中心拉扎传染病医院进行的前瞻性队列研究。
研究对象为符合世界卫生组织标准的猴痘确诊病例的操作性定义的患者。通过病例报告表收集包括流行病学、临床和生化信息。随访期从住院初始评估开始，直至因临床改善或死亡而出院。所有参与者均获得书面知情同意。
72 例患者纳入分析，其中 72 例中的 64 例（88.9%）为人类免疫缺陷病毒（HIV）感染者。72 例患者中，71 例（98.6%）为男性，中位年龄为 32 岁[95%置信区间（CI），四分位距（IQR）27-37]。30 例（41.7%）患者合并性传播感染。总死亡率为 72 例中的 5 例（6.9%）。HIV 感染者的死亡率为 6.3%。中位住院期间因任何原因导致症状出现至死亡的天数为 50 天（95%CI，IQR 38-62）。在单变量分析中，猴痘死亡的危险因素包括评估时 CD4 +细胞计数≤100 个/μl（RR 20，95%CI，IQR 6.6-60.2）（P<0.001）、未接受抗逆转录病毒治疗（RR 6.6，95%CI，IQR 3.6-12.1）（P=0.001）和就诊时≥50 个皮肤损伤（RR 6.4，95%CI，IQR 2.6-15.7）（P=0.011）。
本研究中 HIV 感染者和非 HIV 感染者的临床表现相似，但报告的死亡率与晚期 HIV 疾病相关。
