Human monkeypox coinfection with acute HIV: an exuberant presentation

Sousa, Diogo de; Patrocínio, João; Frade, Joana Vieitez; Correia, Catarina; Borges‐Costa, João; Filipe, Paulo

doi:10.1177/09564624221114998

Cited by 55 publications

(69 citation statements)

References 8 publications

(13 reference statements)

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“…Persons with newly diagnosed HIV infection at ¶ ¶ https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-andadolescent-opportunistic-infections/introduction *** https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-andadolescent-arv/discontinuation-or-interruption the time of monkeypox diagnosis should commence ART as soon as possible, in consultation with an expert in HIV care, if needed. Monkeypox diagnosis has been reported concurrent with diagnosis of acute HIV infection and other STIs, highlighting the importance of testing for these infections when monkeypox is suspected or diagnosed (24).…”

Section: Monkeypox In Persons With Hiv Infectionmentioning

confidence: 99%

“…Persons with newly diagnosed HIV infection at the time of monkeypox diagnosis should commence ART as soon as possible, in consultation with an expert in HIV care, if needed. Monkeypox diagnosis has been reported concurrent with diagnosis of acute HIV infection and other STIs, highlighting the importance of testing for these infections when monkeypox is suspected or diagnosed ( 24 ).…”

Section: Monkeypox In Persons With Hiv Infectionmentioning

confidence: 99%

See 1 more Smart Citation

Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection — United States, August 2022

O’Shea¹,

Filardo²,

Morris³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

104

118

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On August 5, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).Monkeypox virus, an orthopoxvirus sharing clinical features with smallpox virus, is endemic in several countries in Central and West Africa. The last reported outbreak in the United States, in 2003, was linked to contact with infected prairie dogs that had been housed or transported with African rodents imported from Ghana (1). Since May 2022, the World Health Organization (WHO) has reported a multinational outbreak of monkeypox centered in Europe and North America, with approximately 25,000 cases reported worldwide; the current outbreak is disproportionately affecting gay, bisexual, and other men who have sex with men (MSM) (2). Monkeypox was declared a public health emergency in the United States on August 4, 2022. † Available summary surveillance data from the European Union, England, and the United States indicate that among MSM patients with monkeypox for whom HIV status is known, 28%-51% have HIV infection (3-10). Treatment of monkeypox with tecovirimat as a first-line agent is available through CDC for compassionate use through an investigational drug protocol. No identified drug interactions would preclude coadministration of tecovirimat with antiretroviral therapy (ART) for HIV infection. Pre-and postexposure prophylaxis can be considered with JYNNEOS vaccine, if indicated. Although data are limited for monkeypox in patients with HIV, prompt diagnosis, treatment, and prevention might reduce the risk for adverse outcomes and limit monkeypox spread. Prevention and treatment considerations will be updated as more information becomes available. BackgroundSigns and Symptoms: Classically, monkeypox occurs in three stages. After an incubation period of approximately 1-2 weeks, a prodrome, characterized by fever and lymphadenopathy occurs, which is followed by the onset of a deep-seated vesicular or pustular rash that often begins centrally and spreads to the limbs (11). Transmission of monkeypox can occur through direct contact with the infectious rash, scabs, or body fluids, through respiratory secretions during prolonged face-to-face contact or intimate physical contact, or through touching items, such as clothing or linens, that previously touched a patient's infectious rash or body fluids. § * These authors contributed equally to this report. † h t t p s : / / w w w. w a s h i n g t o n p o s t . c o m / h e a l t h / 2 0 2 2 / 0 8 / 0 4 / monkeypox-public-health-emergency-united-states-becerra/ § https://www.cdc.gov/poxvirus/monkeypox/transmission.html

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Section: Monkeypox In Persons With Hiv Infectionmentioning

confidence: 99%

Section: Monkeypox In Persons With Hiv Infectionmentioning

confidence: 99%

Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection — United States, August 2022

O’Shea¹,

Filardo²,

Morris³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

104

118

View full text Add to dashboard Cite

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“…The median age of reported cases has also increased over the past 50 years, from 4 years in the 1970s, 5 years in the 1980s, 10 years in the 2000s, and 21 years in the 2010s. The researchers believed that these epidemiological changes in HMPX might be correlated with the termination of smallpox vaccination and the weakening of cross-immune protection against MPXV, resulting in human-to-human transmission (de Sousa et al 2022, Guarner et al 2022, Rao et al 2022, Zhu et al 2022. Of interest, A Nigerian study shows that the population immunization rate dropped to 10.1% in 2016, and the level of immune protection has dropped from 65.6% in the 1970s to 2.6%; by 2018, the vaccine immunization rate was 9.3%, and the population immunity level was only 2.2% (Nguyen et al 2021).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Keratitis, encephalitis, pneumonitis, and subsequent bacterial infections are among the complications (Saied et al 2022). According to reports, the danger of serious consequences is higher in young children and immunocompromised adults, such as those who have HIV infection (de Sousa et al 2022). The current worldwide MPXV infection outbreak in humans raises the possibility that the virus may have changed biologically, that human behavior may have changed or both.…”

Section: Introductionmentioning

confidence: 99%

The Historical Epidemiology of Human Monkeypox: A Review of Evidence from the 1970 Emergence to the 2022 Outbreak

Rahimi

Afaghi

Tarki

et al. 2022

Tohoku J. Exp. Med.

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Human Monkeypox (HMPX) outbreak in the year 2022 occurs in many countries outside of the African regions, a common location of such outbreaks, with a considerable rate of human-to-human transmission, which was an uncommon route of infection before. The epidemiological reports also represent a sharping pace of infection spreading between communities rather than in previous outbreaks as the following pace of afflictions is unpredictable. Also, the cautions regarding the sexually transmitted infection of the such virus have been raised in this outbreak. Further, the main reservoirs of the recent outbreaks are yet to be revealed. As a consequence, the World Health Organization (WHO) has declared the 2022 HMPX outbreak as an "Atypical" phenomenon compared to its previous characteristics. To better recognize the properties of this outbreak, herein we systematically described and compared the historical evidence of monkeypox virus outbreaks in the aspects of epidemiological, clinical, and molecular evolutions since its emergence, as well as an explanation of the previous investigations and considerations of WHO and other international health societies over time. The history of human and monkeypox virus interaction during the past 64 years provides viewpoints on preventing strategies and assessing the present and potential future hazards of health implications.

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“…Mucosal involvement has also been described in up to 41% of MPX patients, including the anorectal, oropharyngeal, and conjunctival mucosa [ 9 ]. More atypical presentations such as single lesions, whitlows, macular eruptions, or kissing lesion configurations have also been described [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Monkeypox Diagnosis by Cutaneous and Mucosal Findings

Sousa

Patrocínio

Frade

et al. 2022

Infectious Disease Reports

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A monkeypox outbreak has been reported in several countries since early May 2022. Human monkeypox (MPX) diagnosis is based on a clinical suspicion supported by typical skin and mucosal lesions, confirmed with molecular testing. We present the results of all MPX confirmed patients presenting to our department until July 15 of 2022, describing the characteristics of the lesions at diagnosis. In total, 47 patients were included, all men and 44.7% (n = 21) were HIV-positive. Skin lesions were noted in all patients. The most commonly affected area was the genital region (63.8%), followed by the anorectal region (46.8%). Extra anogenital mucosal (oral or conjunctival mucosa) involvement was reported in three patients. Typical skin findings included erythematous papules, whitish, umbilicated papules, some with a necrotic center and an elevated whitish border. Most patients had lesions in multiple phases presenting simultaneously. Correct identification of MPX skin and mucosal lesions is crucial to avoid late diagnosis and prevent further spreading, ensuring less worldwide morbidity.

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Human monkeypox coinfection with acute HIV: an exuberant presentation

Cited by 55 publications

References 8 publications

Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection — United States, August 2022

Interim Guidance for Prevention and Treatment of Monkeypox in Persons with HIV Infection — United States, August 2022

The Historical Epidemiology of Human Monkeypox: A Review of Evidence from the 1970 Emergence to the 2022 Outbreak

Monkeypox Diagnosis by Cutaneous and Mucosal Findings

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