Shabil Muhammed, Gaidhane Shilpa, Roopashree R, Kaur Mandeep, Srivastava Manish, Barwal Amit, Siva Prasad G V, Rajput Pranchal, Syed Rukshar, Dev Anoop, Kundra Danish, Yappalparvi Ambanna, Satapathy Prakasini, Zahiruddin Quazi Syed, Kumar Harish, Sah Renu, Bushi Ganesh
University Center for Research and Development, Chandigarh University, Mohali, Punjab, India.
Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq.
BMC Infect Dis. 2025 Jan 22;25(1):102. doi: 10.1186/s12879-025-10512-6.
Mpox is a viral zoonotic disease that has seen a resurgence in recent years, with outbreaks reaching beyond its traditional endemic zones in Central and West Africa to parts of Europe and North America. The relationship between human immunodeficiency virus (HIV) infection and mpox outcomes, particularly hospitalization rates, remains underexplored despite the known immunosuppressive effects of HIV. This systematic review and meta-analysis aimed to clarify the association between HIV infection and the likelihood of hospitalization in mpox cases.
A literature search was conducted through PubMed, Embase, Web of Science, Scopus, and the Cochrane Library up until August 10, 2024. The eligibility criteria focused on observational studies that evaluated hospitalization rates among mpox cases, distinguishing between HIV-positive and HIV-negative individuals. Newcastle-Ottawa Scale was used for evaluating study quality. The meta-analysis used a random-effects model to accommodate expected study heterogeneity using R software (V. 4.4).
The search yielded 686 records, with 14 studies meeting the inclusion and exclusion criteria after screenings and full-text assessments. The pooled analysis revealed a 56.6% increased risk of hospitalization among HIV-positive mpox cases compared to HIV-negative individuals (95% CI: 18.0-107.7%). Notable heterogeneity (I² = 76%) was observed, likely reflecting variations in study settings and methodologies. Sensitivity analysis confirmed the robustness of these findings, and no significant publication bias was detected (Egger's test p-value = 0.733).
HIV infection is associated with a statistically significant increased risk of hospitalization in mpox cases. There is a critical need for integrated care and enhanced surveillance, especially in populations with high HIV prevalence. Our findings emphasize the importance of ongoing research to better understand HIV and mpox co-infection and to refine management strategies for this vulnerable group. Future studies should focus on long-term outcomes and the effectiveness of various management strategies across different healthcare settings.
猴痘是一种病毒性人畜共患病，近年来有所复发，疫情已从其在中非和西非的传统流行地区蔓延至欧洲和北美的部分地区。尽管已知人类免疫缺陷病毒（HIV）具有免疫抑制作用，但HIV感染与猴痘结局，尤其是住院率之间的关系仍未得到充分研究。本系统评价和荟萃分析旨在阐明HIV感染与猴痘病例住院可能性之间的关联。
截至2024年8月10日，通过PubMed、Embase、Web of Science、Scopus和Cochrane图书馆进行文献检索。纳入标准侧重于评估猴痘病例住院率的观察性研究，区分HIV阳性和HIV阴性个体。采用纽卡斯尔-渥太华量表评估研究质量。荟萃分析使用随机效应模型，通过R软件（版本4.4）来适应预期的研究异质性。
检索共获得686条记录，经筛选和全文评估后，有14项研究符合纳入和排除标准。汇总分析显示，与HIV阴性个体相比，HIV阳性猴痘病例的住院风险增加了56.6%（95%置信区间：18.0-107.7%）。观察到显著的异质性（I² = 76%），这可能反映了研究背景和方法的差异。敏感性分析证实了这些发现的稳健性，未检测到显著的发表偏倚（Egger检验p值 = 0.733）。
HIV感染与猴痘病例住院风险在统计学上显著增加相关。迫切需要综合护理和加强监测，尤其是在HIV感染率高的人群中。我们的研究结果强调了持续研究的重要性，以便更好地了解HIV与猴痘合并感染情况，并完善针对这一弱势群体的管理策略。未来的研究应关注长期结局以及不同医疗环境中各种管理策略的有效性。
