Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Front Public Health. 2024 Jan 5;11:1276821. doi: 10.3389/fpubh.2023.1276821. eCollection 2023.
Ongoing Monkeypox (MPX) outbreaks in countries outside Africa have unique characteristics. However, data on cohorts of confirmed cases in China is limited. The study provides important epidemiological, diagnostic, and clinical information about this disease in China.
We report a series of Chinese individuals with confirmed MPX infections identified at Beijing Youan Hospital (China) from June 10 to July 15, 2023. Samples were taken from the skin, anus, throat, and blood. An epidemiological questionnaire was used to collect demographic and clinical data. Further, we compared the MPX viral (MPXV) loads across different anatomical sites.
66 samples were collected from 20 patients, all of whom were cisgender men. Median patient age was 29 years. Notably, 19 (95%) patients reported unprotected sexual encounters with men in the preceding month, and 13 (65%) were human immunodeficiency virus (HIV)-positive. Among those with HIV, 12 (92%) were receiving antiretroviral therapy, and 11 (85%) had well-controlled infections (HIV viral load <40/mL). The median CD4+ T cell count was 667 cells/mm. In the HIV-negative group, three (43%) patients were taking preexposure prophylaxis. Fifteen patients (75%) had concurrent sexually transmitted infections (50% had syphilis and 65% had HIV) and eight (40%) had HIV and syphilis co-infection. MPXV loads were significantly higher in samples from the skin (cycle threshold value [Ct value]: 19·0) and anus (Ct value: 23.0) compared to samples from the throat (Ct value: 31.0) or blood (Ct value: 34.5). All patients had skin lesions (85% of whom presented with anogenital lesions). Common systemic symptoms included fever (85%) and lymphadenopathy (55%). The median incubation period was 8 d [interquartile range (IQR): 6-16 d]. The median time from the onset of skin lesions to scab removal was 14 d (IQR: 10-16 d). No deaths or severe cases were reported.
MPXV primarily affects young homosexual men. The high MPXV viral loads in skin and anal lesions indicate that transmission most likely occurs through direct and close body contact. This study also reports high rates of HIV and syphilis co-infection. Therefore, preventive efforts should focus on homosexual men.
在非洲以外国家发生的猴痘（MPX）疫情具有独特特征。然而，中国确诊病例的相关数据有限。本研究提供了有关中国该病的重要流行病学、诊断和临床信息。
我们报告了 2023 年 6 月 10 日至 7 月 15 日在北京佑安医院（中国）确诊的一系列猴痘病毒（MPXV）感染的中国个体病例。采集了皮肤、肛门、喉咙和血液样本。使用流行病学调查问卷收集人口统计学和临床数据。此外，我们比较了不同解剖部位的 MPXV 载量。
从 20 名患者中采集了 66 个样本，所有患者均为顺性别男性。中位患者年龄为 29 岁。值得注意的是，19 名（95%）患者在过去一个月中有过与男性的无保护性行为，13 名（65%）患者 HIV 阳性。在 HIV 阳性患者中，12 名（92%）正在接受抗逆转录病毒治疗，11 名（85%）的 HIV 感染得到了良好控制（HIV 病毒载量<40/mL）。中位 CD4+T 细胞计数为 667 个细胞/mm。在 HIV 阴性组中，3 名（43%）患者正在服用暴露前预防药物。15 名（75%）患者同时患有性传播感染（50%患有梅毒，65%患有 HIV），8 名（40%）患者同时感染 HIV 和梅毒。皮肤（Ct 值：19.0）和肛门（Ct 值：23.0）样本中的 MPXV 载量明显高于喉咙（Ct 值：31.0）或血液（Ct 值：34.5）样本。所有患者均有皮肤损伤（85%的患者有肛门生殖器损伤）。常见的全身症状包括发热（85%）和淋巴结病（55%）。中位潜伏期为 8 天[四分位间距（IQR）：6-16 天]。从皮肤损伤出现到结痂脱落的中位时间为 14 天（IQR：10-16 天）。无死亡或严重病例报告。
MPXV 主要影响年轻同性恋男性。皮肤和肛门病变中高 MPXV 病毒载量表明，传播最有可能通过直接和密切的身体接触发生。本研究还报告了 HIV 和梅毒合并感染的高发生率。因此，预防工作应重点关注同性恋男性。
