People With Advanced HIV Can Have Very Severe Mpox

[Jim Allen]

I'm not surprised by the results.

In Short:

People With Advanced HIV Can Have Very Severe Mpox

The presentation of mpox is “very starkly different” among HIV-positive people with severe immune suppression, so much so that it should be classified as an AIDS-defining opportunistic infection, said presenter Chloe Orkin, MD, of Queen Mary University of London.

The series included nearly 400 cases of mpox among people with HIV who had a CD4 T-cell count below 350. Many patients had severe necrotizing lesions resulting in tissue death, and some had lung involvement and sepsis. The overall mortality rate was 7%, rising to 27% among those with a CD4 count below 100.

The silver lining is that no one with well-controlled HIV and no one who was vaccinated against mpox vaccine died, suggesting that antiretroviral treatment can prevent severe outcomes. However, Orkin advised clinicians who care for untreated patients with severe mpox to be alert for immune reconstitution inflammatory syndrome (IRIS), a worsening of symptoms that can occur when people start antiretrovirals with a very low CD4 count.

POZ.com article in full: https://www.poz.com/article/people-advanced-hiv-can-severe-mpox