Optimal management of severe mpox in patients with uncontrolled human immunodeficiency virus.
Akira A ShishidoStacy StreetPublished in: Journal of medical virology (2023)
In May 2022, a cluster of nontravel-related cases of human mpox were reported in the United Kingdom. The outbreak has since spread worldwide infecting over 85 000 patients and causing over 100 deaths. Recent data clearly suggest that patients infected with human immunodeficiency virus (HIV) with CD4 counts less than 200 cells per mm
3
suffer significantly worse outcomes than immunocompetent patients. The available countermeasures lack robust clinical data and are deployed based on in vitro and animal studies as well as extrapolations from use against other poxviruses. In many cases, despite administration of these available treatments, initiation of antiretroviral therapy (ART), and management of suspected immune reconstitution inflammatory syndrome after initiating ART, patients die. This review summarizes available data, identifies knowledge gaps and proposes recommendations on the management of severe mpox in people living with HIV.
Keyphrases
- human immunodeficiency virus
- antiretroviral therapy
- end stage renal disease
- hiv infected
- ejection fraction
- newly diagnosed
- chronic kidney disease
- hepatitis c virus
- healthcare
- prognostic factors
- hiv positive
- oxidative stress
- hiv aids
- type diabetes
- hiv infected patients
- big data
- machine learning
- metabolic syndrome
- electronic health record
- endothelial cells
- genome wide
- insulin resistance
- adipose tissue
- induced apoptosis
- patient reported
- drug induced
- endoplasmic reticulum stress