Zucker Jason, Hazra Aniruddha, Titanji Boghuma K
Department of Infectious Diseases, Columbia University, New York, NY, USA.
Section of Infectious Diseases and Global Health, University of Chicago Medicine, Chicago, IL, USA.
Curr HIV/AIDS Rep. 2023 Dec;20(6):440-450. doi: 10.1007/s11904-023-00682-w. Epub 2023 Nov 23.
The global outbreak of mpox has brought renewed attention to a previously neglected disease which is particularly severe in people with underlying untreated HIV co-infection. For this population, the disease is progressive, severe, and often lethal. In this review, we examine the pathogenesis of mpox disease and its collision with co-existent HIV infection and discuss key considerations for management as well as emerging clinical dilemmas and areas for future research.
Co-existent untreated HIV infection characterized by severe immunocompromise potentiates the nefarious effects of monkeypox virus infection leading to severe manifestations of mpox. Treating mpox in the context of HIV requires mpox-directed therapies, supportive care, and HIV-specific treatment to restore immune function. Preventative measures for PWH are like those in healthy individuals, but the effectiveness and durability of protection conferred by existing vaccines in PWH remain to be fully characterized. Mpox is an important opportunistic infection in PWH. Clinicians should be aware of the unique features of the disease in this population and approaches to care and management of mpox in PWH.
猴痘的全球爆发再次引发了人们对一种先前被忽视疾病的关注，这种疾病在未接受治疗的合并感染HIV的人群中尤为严重。对于这一人群，该疾病呈进行性发展，病情严重，且往往致命。在本综述中，我们研究了猴痘疾病的发病机制及其与并存的HIV感染的相互作用，并讨论了管理的关键考虑因素以及新出现的临床困境和未来研究领域。
以严重免疫功能低下为特征的并存未治疗的HIV感染会增强猴痘病毒感染的有害影响，导致猴痘的严重表现。在HIV背景下治疗猴痘需要针对猴痘的治疗、支持性护理以及恢复免疫功能的HIV特异性治疗。艾滋病病毒感染者的预防措施与健康个体类似，但现有疫苗对艾滋病病毒感染者的保护效果和持久性仍有待充分明确。猴痘是艾滋病病毒感染者的一种重要机会性感染。临床医生应了解该疾病在这一人群中的独特特征以及艾滋病病毒感染者猴痘的护理和管理方法。
