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Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study

We investigated differences in mpox clinical outcomes in people with HIV (PWH) and without HIV (PWoH) and the impact of vaccination in Catalonia, Spain. We used surveillance data and the PISCIS HIV cohort. We included all confirmed mpox cases (May–December 2022). Of 2122 mpox cases, the majority had...

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Autores principales: Martín-Iguacel, Raquel, Pericas, Carles, Bruguera, Andreu, Rosell, Gemma, Martínez, Erica, Díaz, Yesika, Alonso, Lucia, Nomah, Daniel Kwakye, Blanco, Jose Luis, Domingo, Pere, Álvarez-López, Patricia, Linares, Maria Saumoy, Vilades Laborda, Consuelo, Mera, Arantxa, Calzado Isbert, Sonia, Johansen, Isik Somuncu, Miró, José M., Casabona, Jordi, Llibre, Josep M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673392/
https://www.ncbi.nlm.nih.gov/pubmed/38004713
http://dx.doi.org/10.3390/microorganisms11112701
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author Martín-Iguacel, Raquel
Pericas, Carles
Bruguera, Andreu
Rosell, Gemma
Martínez, Erica
Díaz, Yesika
Alonso, Lucia
Nomah, Daniel Kwakye
Blanco, Jose Luis
Domingo, Pere
Álvarez-López, Patricia
Linares, Maria Saumoy
Vilades Laborda, Consuelo
Mera, Arantxa
Calzado Isbert, Sonia
Johansen, Isik Somuncu
Miró, José M.
Casabona, Jordi
Llibre, Josep M.
author_facet Martín-Iguacel, Raquel
Pericas, Carles
Bruguera, Andreu
Rosell, Gemma
Martínez, Erica
Díaz, Yesika
Alonso, Lucia
Nomah, Daniel Kwakye
Blanco, Jose Luis
Domingo, Pere
Álvarez-López, Patricia
Linares, Maria Saumoy
Vilades Laborda, Consuelo
Mera, Arantxa
Calzado Isbert, Sonia
Johansen, Isik Somuncu
Miró, José M.
Casabona, Jordi
Llibre, Josep M.
author_sort Martín-Iguacel, Raquel
collection PubMed
description We investigated differences in mpox clinical outcomes in people with HIV (PWH) and without HIV (PWoH) and the impact of vaccination in Catalonia, Spain. We used surveillance data and the PISCIS HIV cohort. We included all confirmed mpox cases (May–December 2022). Of 2122 mpox cases, the majority had mild disease, 56% were Spanish, and 24% were from Latin America. A total of 40% were PWH, with a median CD4+T-cell of 715 cells/μL; 83% had HIV-RNA < 50 copies/mL; and 1.8% CD4+T-cell < 200 cells/μL. PWH had no increased risk for complications, except those with CD4+T-cell < 200 cells/μL. PWH with CD4+T-cell < 200 cells/μL were more likely to be from Latin America, had more generalized exanthema, and required hospitalization more frequently (p = 0.001). Diagnosis of other sexually transmitted infections (STIs) was common, both at mpox diagnosis (17%) and two years before (43%). Dose-sparing smallpox intradermal vaccination was accompanied by a sharp decrease in mpox incidence in both populations (p < 0.0001). In conclusion, unless immunosuppressed, PWH were not at increased risk of severe disease or hospitalization. Mpox is a marker of high-risk sexual behavior and was associated with high HIV and STI rates, supporting the need for screening in all mpox cases. Ethnicity disparities demonstrate the need for interventions to ensure equitable healthcare access. Dose-sparing smallpox vaccination retained effectiveness.
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spelling pubmed-106733922023-11-03 Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study Martín-Iguacel, Raquel Pericas, Carles Bruguera, Andreu Rosell, Gemma Martínez, Erica Díaz, Yesika Alonso, Lucia Nomah, Daniel Kwakye Blanco, Jose Luis Domingo, Pere Álvarez-López, Patricia Linares, Maria Saumoy Vilades Laborda, Consuelo Mera, Arantxa Calzado Isbert, Sonia Johansen, Isik Somuncu Miró, José M. Casabona, Jordi Llibre, Josep M. Microorganisms Article We investigated differences in mpox clinical outcomes in people with HIV (PWH) and without HIV (PWoH) and the impact of vaccination in Catalonia, Spain. We used surveillance data and the PISCIS HIV cohort. We included all confirmed mpox cases (May–December 2022). Of 2122 mpox cases, the majority had mild disease, 56% were Spanish, and 24% were from Latin America. A total of 40% were PWH, with a median CD4+T-cell of 715 cells/μL; 83% had HIV-RNA < 50 copies/mL; and 1.8% CD4+T-cell < 200 cells/μL. PWH had no increased risk for complications, except those with CD4+T-cell < 200 cells/μL. PWH with CD4+T-cell < 200 cells/μL were more likely to be from Latin America, had more generalized exanthema, and required hospitalization more frequently (p = 0.001). Diagnosis of other sexually transmitted infections (STIs) was common, both at mpox diagnosis (17%) and two years before (43%). Dose-sparing smallpox intradermal vaccination was accompanied by a sharp decrease in mpox incidence in both populations (p < 0.0001). In conclusion, unless immunosuppressed, PWH were not at increased risk of severe disease or hospitalization. Mpox is a marker of high-risk sexual behavior and was associated with high HIV and STI rates, supporting the need for screening in all mpox cases. Ethnicity disparities demonstrate the need for interventions to ensure equitable healthcare access. Dose-sparing smallpox vaccination retained effectiveness. MDPI 2023-11-03 /pmc/articles/PMC10673392/ /pubmed/38004713 http://dx.doi.org/10.3390/microorganisms11112701 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Martín-Iguacel, Raquel
Pericas, Carles
Bruguera, Andreu
Rosell, Gemma
Martínez, Erica
Díaz, Yesika
Alonso, Lucia
Nomah, Daniel Kwakye
Blanco, Jose Luis
Domingo, Pere
Álvarez-López, Patricia
Linares, Maria Saumoy
Vilades Laborda, Consuelo
Mera, Arantxa
Calzado Isbert, Sonia
Johansen, Isik Somuncu
Miró, José M.
Casabona, Jordi
Llibre, Josep M.
Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
title Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
title_full Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
title_fullStr Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
title_full_unstemmed Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
title_short Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
title_sort mpox: clinical outcomes and impact of vaccination in people with and without hiv: a population-wide study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673392/
https://www.ncbi.nlm.nih.gov/pubmed/38004713
http://dx.doi.org/10.3390/microorganisms11112701
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