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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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-10673392 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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