Clinical characteristics of monkeypox complicated with human immunodeficiency virus infection / acquired immunodeficiency syndrome in Chengdu_West China Medical Journal

Authors：

LUO Haixia ¹ ,  MAO Yi ¹ , BAO Lei ² , WU Guihui ³ , CHENG Yao ¹

1. Department of Critical Care, Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610061, P. R. China;
2. Department of Internal Medicine, Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610061, P. R. China;
3. Department of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu, Sichuan 610061, P. R. China;

Corresponding?author：

MAO Yi, Email: 495005468@qq.com

Keywords：

Monkeypox; human immunodeficiency virus infection; acquired immunodeficiency syndrome; clinical features

DOI：

10.7507/1002-0179.202309104

Video：

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Objective To analyze the clinical data of monkeypox (mpox) cases in Chengdu, to investigate the clinical characteristics of patients with mpox complicated with human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS), and provide reference for clinical diagnosis and treatment. Methods Mpox patients admitted to Public Health Clinical Center of Chengdu between June 29 and August 8, 2023 were continuously included. Patients were divided into an observation group and a control group based on whether they were complicated with HIV/AIDS. The clinical characteristics of two groups of patients were observed and compared. Results A total of 56 patients were included, all of whom were male; Age range from 19 to 51 years old, with an average of (31.6±5.9) years old; There were 23 cases in the observation group and 33 cases in the control group. Except for age, perianal lesions with infection, number of rashes, diarrhea, CD4⁺ lymphocyte count, CD4/CD8 ratio, syphilis, chest CT abnormalities, rash duration, and length of hospital stay (P<0.05), there was no statistically significant difference in epidemiological data, clinical features, auxiliary examinations, treatment, and intensive care unit admission between the two groups of patients (P>0.05). There was a statistically significant difference between the Ct values of throat swab nucleic acid and blister fluid nucleic acid in the total population [(30.1±4.4) vs. (23.4±3.8); t=5.462, P<0.001]. Conclusions Mpox patients complicated with HIV/AIDS are prone to persistent, diverse, and severe lesions due to relatively lower CD4⁺ lymphocyte counts. Therefore, it is necessary to actively provide symptomatic treatment and prevent complications for patients.

Citation： LUO Haixia, MAO Yi, BAO Lei, WU Guihui, CHENG Yao. Clinical characteristics of monkeypox complicated with human immunodeficiency virus infection / acquired immunodeficiency syndrome in Chengdu. West China Medical Journal, 2024, 39(1): 56-62. doi: 10.7507/1002-0179.202309104 Copy

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13.	張瑾, 薛曉寧, 滕新棟, 等. 猴痘基礎與臨床研究進展. 中華皮膚科雜志, 2022, 55(12): 1061-1063.
14.	彭丹萍, 牛俊奇, 張凱宇. 猴痘的流行病學和臨床特點. 中華傳染病雜志, 2023, 41(5): 358-361.
15.	朱立華, 王建中. 中國人血液淋巴細胞免疫表型參考值調查. 中華醫學檢驗雜志, 1998, 21(4): 223-226.
16.	姚曉文, 王彩紅, 王蓉, 等. 猴痘病原學特征及防控. 中華微生物學和免疫學雜志, 2023, 43(2): 152-157.
17.	Niu L, Liang D, Ling Q, et al. Insights into monkeypox pathophysiology, global prevalence, clinical manifestation and treatments. Front Immunol, 2023, 14: 1132250.
18.	劉江寧. 猴痘病毒感染動物模型研究及應用進展. 中國比較醫學雜志, 2022, 32(6): 1183.
19.	田山, 黃冰露, 鄭昕. 猴痘病毒的免疫應答特征和防治策略. 中華傳染病雜志, 2023, 41(4): 299-302.
20.	Karupiah G, Buller RM, Van Rooijen N, et al. Different roles for CD4⁺ and CD8⁺ T lymphocytes and macrophage subsets in the control of a generalized virus infection. J Virol, 1996, 70(12): 8301-8309.
21.	Hammarlund E, Dasgupta A, Pinilla C, et al. Monkeypox virus evades antiviral CD4⁺ and CD8⁺ T cell responses by suppressing cognate T cell activation. Proc Natl Acad Sci U S A, 2008, 105(38): 14567-14572.

1. 汪慧, 鐘賢武, 李意蘭, 等. 猴痘病原學及流行病學研究進展. 中國病毒病雜志, 2022, 12(6): 474-480.
2. 姜婷婷, 陳祥生. 全球猴痘流行狀況及趨勢. 中國麻風皮膚病雜志, 2023, 39(7): 535-537.
3. 劉亞蘭, 孫慶云, 陳志美, 等. 中國大陸首例猴痘確診病例收治隔離病房污染狀況. 中華醫院感染學雜志, 2023, 33(14): 2200-2203.
4. 韓輝, 伍波, 邵忠閣, 等. 2023 年 6 月全球傳染病疫情概要. 疾病監測, 2023, 38(7): 762-764.
5. 李蔓兮, 嚴明明, 馮曄囡, 等. 2023 年 8 月中國需關注的突發公共衛生事件風險評估. 疾病監測, 2023, 38(8): 897-900.
6. 浙江省數理醫學學會感染性疾病專業委員會, 浙江省性病艾滋病防治協會艾滋病暴露預防專業委員會. HIV 感染者猴痘診治專家共識. 中華臨床感染病雜志, 2023, 16(4): 241-248.
7. 中華人民共和國國家衛生健康委員會. 猴痘診療指南(2022 年版). 中國感染控制雜志, 2022, 21(6): 600-601.
8. 趙本南, 劉大鳳, 包蕾, 等. 成都市 35 例猴痘患者臨床特征分析. 中國熱帶醫學, 2023, 23(11): 1169-1172.
9. Kaler J, Hussain A, Flores G, et al. Monkeypox: a comprehensive review of transmission, pathogenesis, and manifestation. Cureus, 2022, 14(7): e26531.
10. Thornhill JP, Barkati S, Walmsley S, et al. Monkeypox Virus Infection in Humans across 16 Countries - April-June 2022. N Engl J Med, 2022, 387(8): 679-691.
11. 王利麗, 于應娣, 辛田中, 等. 猴痘一例. 中國麻風皮膚病雜志, 2023, 39(11): 779-780.
12. Grifoni A, Zhang Y, Tarke A, et al. Defining antigen targets to dissect vaccinia virus and monkeypox virus-specific T cell responses in humans. Cell Host Microbe, 2022, 30(12): 1662-1670.e4.
13. 張瑾, 薛曉寧, 滕新棟, 等. 猴痘基礎與臨床研究進展. 中華皮膚科雜志, 2022, 55(12): 1061-1063.
14. 彭丹萍, 牛俊奇, 張凱宇. 猴痘的流行病學和臨床特點. 中華傳染病雜志, 2023, 41(5): 358-361.
15. 朱立華, 王建中. 中國人血液淋巴細胞免疫表型參考值調查. 中華醫學檢驗雜志, 1998, 21(4): 223-226.
16. 姚曉文, 王彩紅, 王蓉, 等. 猴痘病原學特征及防控. 中華微生物學和免疫學雜志, 2023, 43(2): 152-157.
17. Niu L, Liang D, Ling Q, et al. Insights into monkeypox pathophysiology, global prevalence, clinical manifestation and treatments. Front Immunol, 2023, 14: 1132250.
18. 劉江寧. 猴痘病毒感染動物模型研究及應用進展. 中國比較醫學雜志, 2022, 32(6): 1183.
19. 田山, 黃冰露, 鄭昕. 猴痘病毒的免疫應答特征和防治策略. 中華傳染病雜志, 2023, 41(4): 299-302.
20. Karupiah G, Buller RM, Van Rooijen N, et al. Different roles for CD4⁺ and CD8⁺ T lymphocytes and macrophage subsets in the control of a generalized virus infection. J Virol, 1996, 70(12): 8301-8309.
21. Hammarlund E, Dasgupta A, Pinilla C, et al. Monkeypox virus evades antiviral CD4⁺ and CD8⁺ T cell responses by suppressing cognate T cell activation. Proc Natl Acad Sci U S A, 2008, 105(38): 14567-14572.

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