A new analysis of hundreds of mpox patients suggests it is “a different disease” in those with compromised immune systems.
at a conference in Seattle, which analyzes the death last summer in Mexico and the cases of 381 other mpox patients who also had advanced HIV infections, makes clear the disease poses an enormous risk to those living with uncontrolled HIV. Of the 179 patients with less than 200 CD4 cells per microliter—more than 500 is considered normal—27 died.
Mitjà, Crabtree Ramirez, and their colleagues argue this disseminated form of mpox should be added to the list of AIDS-defining conditions, opportunistic secondary infections that are a typical sign of advanced HIV infection. That might alert physicians to test mpox patients for HIV to be able to prioritize them for any possible treatments. Health authorities should also prioritize people living with HIV for mpox vaccination, Mitjà says.
For now, there are far fewer severely sick patients to care for globally than in the summer and Europe is working on a plan to eliminate the virus entirely. Still, cases continue to be reported from dozens of countries, especially in Latin America. The disease might not cause another large outbreak, Mitjà says. “But I think that it will continue to circulate as an STI [sexually transmitted infection] … with the potential to cause death in a few people.
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