Clinical characteristics of monkeypox virus infections among men with and without HIV: A large outbreak cohort in Germany

HIV Medicine - Tập 24 Số 4 - Trang 389-397 - 2023
Christian Hoffmann1,2, Heiko Jessen3, Christoph Wyen4, Stephan Grunwald5, Sebastian Noé6, Jörn Teichmann3, Anja‐Sophie Krauss7, Henning Kolarikal8, Stefan Scholten9, Christoph Schuler10, Markus Bickel11, Clemens Roll12, Peter Kreckel13, Siegfried Köppe13, Matthias Straub14, Gerd Klausen15, Johannes Lenz10, Stefan Esser16, Björn‐Erik Ole Jensen17, Michael Rausch18, Stefan Unger19, Ramona Pauli20, Georg Härter21, Matthias C. Müller22, Anja Masuhr23, Guido Schäfer1, Ulrich Seybold24, Sven Schellberg25, Jochen Schneider26, Malte B. Monin27, Eva Wolf28, Christoph D. Spinner26, Christoph Boesecke27
1Infektionsmedizinisches Centrum Hamburg, Hamburg, Germany;
2University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
3Praxis Jessen<sup>2</sup> + Kollegen, Dres. Heiko Jessen und Arne Jessen Berlin Germany
4Department I Internal Medicine, University Hospital Cologne, Cologne, Germany
5Zentrum für Infektiologie Berlin/Prenzlauer Berg Berlin Germany
6MVZ Munich am Goetheplatz, Munich, Germany
7Infektiologikum Seestrasse, Berlin, Germany
8Praxis an der Kulturbrauerei, Berlin, Germany
9Dr. Scholten &amp; Schneeweiß GbR Cologne Germany
10Praxis Turmstrasse, Berlin, Germany
11Infektio Research GmbH &amp; Ko KG Frankfurt Germany
12Praxis Schwabstraße 26 Stuttgart Germany
13Internistische Gemeinschaftspraxis m-50.de, Berlin, Germany
14Praxis Prenzlauer Berg, Berlin, Germany
15Schwerpunktpraxis für Infektionsmedizin am Oranienburger Tor Berlin Germany
16Department of Dermatology and Venerology, University of Essen, Essen, Germany
17Department of Gastroenterology, Hepatology and Infectious Diseases Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf Düsseldorf Germany
18Praxis Schoeneberg, Berlin, Germany
19Institute for Interdisciplinary Medicine IFI, Hamburg, Germany
20MVZ am Isartor, Munich, Germany
21MVZ Medicover Ulm, Ulm, Germany
22Praxis für Infektionsmedizin Freiburg Germany
23Auguste Viktoria-Klinikum, Berlin, Germany
24Ludwig-Maximilians-University of Munich, Munich, Germany
25NOVO Praxis Berlin, Berlin, Germany
26Technical University of Munich, Munich, Germany
27Department of Medicine I, Bonn University Hospital, Bonn, Germany
28MUC Research GmbH, Munich, Germany

Tóm tắt

AbstractBackgroundSince May 2022, increasing numbers of monkeypox virus (MPXV) infections have been reported from across Europe and North America. Studies, mainly from Africa, have suggested a higher risk for severe MPXV cases in people living with HIV.MethodsThis was a retrospective study of all confirmed MPXV infections observed in the participating centres since 19 May 2022. We conducted a chart review to evaluate clinical characteristics, comorbidities, and coinfections, including HIV, viral hepatitis, and sexually transmitted infections (STIs).ResultsBy 30 June 2022, a total of 546 MPXV infections were reported from 42 German centres. All patients were men who have sex with men (MSM), of whom 256 (46.9%) were living with HIV, mostly with a preserved immune system and with viral suppression. In total, 232 (42.5%) MSM were also taking HIV pre‐exposure prophylaxis (PrEP) and 58 (10.6%) MSM had no known HIV infection or PrEP use. The median age was 39 years (range 20–67), and comorbidities were rare. However, 52.4% and 29.4% of all patients had been diagnosed with at least one STI within the last 6 months or within the last 4 weeks, respectively. The most frequent localizations of MPXV infection were genital (49.9%) and anal (47.9%), whereas fever (53.2%) and lymphadenopathy (42.6%) were the most frequent general symptoms. The hospitalization rate was low (4.0%), and no fatal course was observed. The clinical picture showed no apparent differences between MSM with or without HIV.ConclusionsIn this preliminary cohort analysis from a current large outbreak among MSM in Germany, the clinical picture of MPXV infection did not differ between MSM with and without HIV infection. Severe courses were rare and hospitalization rates were low. However, most patients were relatively healthy, and only a few people living with HIV were viremic or severely immunosuppressed.

Từ khóa


Tài liệu tham khảo

Ladnyj ID, 1972, A human infection caused by monkeypox virus in Basankusu territory, Democratic Republic of the Congo, Bull World Health Organ, 46, 593

10.1016/j.vaccine.2020.04.062

10.15585/mmwr.mm7123e1

MartínezJI MontalbánEG BuenoSJ et al.Monkeypox outbreak predominantly affecting men who have sex with men Madrid Spain 26 April to 16 June 2022. Eurosurveillance 27 07/Jul/2022 Article.

10.1016/S1473‐3099(22)00411‐X

Noe S, 2022, Clinical and virological features of first human monkeypox cases in Germany, Infection, 1

Robert Koch Institute.International monkeypox outbreak: case numbers and assessment of the situation in Germany. Status 17.6.2022.https://www.rki.de/DE/Content/InfAZ/A/Affenpocken/Ausbruch-2022-Situation-Deutschland.html

10.1101/2022.06.01.494368

10.1101/2022.06.10.495526

10.1099/vir.0.81215-0

10.1016/j.virol.2005.05.030

10.1016/S1473-3099(19)30294-4

10.1086/498115

10.1093/infdis/jix260

10.1038/nm1273

10.1128/CVI.00148-07

10.1016/j.cell.2016.09.049

10.1093/ije/17.3.643

10.1073/pnas.1005769107

10.1016/j.ijid.2018.11.008

10.1056/NEJMoa1705688

10.1128/AAC.00021-09

10.1080/14787210.2020.1819791

UNAIDS.UNAIDS warns that stigmatizing language on monkeypox jeopardizes public health.https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2022/may/20220522_PR_MONKEYPOX. Accessed: June 17 2022.

Thông tin
Thông tin xuất bản

HIV Medicine

Tập 24 Số 4

389-397

Thông tin tác giả