The United States has recorded more than 28,300 MPXV infections since October 21, 2022.
Men who have sex with men (MSM), as well as bisexual and gay individuals, constitute most MPX cases. Racial and ethnic minorities, as well as individuals with human immunodeficiency virus (HIV) infection, have also been disproportionately affected.
Study
In the present study, researchers describe patients from CDC consultations who were hospitalized with MPXV between August 10, 2022, and October 10, 2022. Moreover, they also provided comprehensive histories for three patients with severe MPXV manifestations.
The U.S. Centers for Disease Control and Prevention (CDC) provides consultations for treating MPXV cases. To this end, the U.S. CDC acquired data on demographics, the clinical course, and the outcomes of patients during consultations with healthcare departments/providers.
The CDC provided consultations for 57 patients aged 18 or above hospitalized due to severe manifestations of MPXV during the specified period. Fifty-four patients were male, and the median age of patients was 34. HIV infection was documented in 47 patients, 43 of whom had a known cluster of differentiation 4 (CD4) cell count.
Two patients underwent chemotherapy for hematologic malignancy, three were recipients of solid organ transplants, and three were pregnant. Over 68% of MPXV patients were Black.
Dermatologic manifestations were observed in all patients. Severe mucosal lesions were identified in 39 patients. Some patients exhibited symptoms involving other organs such as the lungs, brain, eyes, or spinal cord.
Tecovirimat was orally administered in 53 patients and intravenously in 37. Thirteen patients received intravenous cidofovir and 29 received vaccinia immune globulin intravenous (VIGIV). Intensive care was required for 17 patients, 12 of whom eventually died.
Conclusion
The current study highlighted the occurrence of severe manifestations in MPXV cases, particularly among AIDS patients. Nearly one-third of patients required intensive care and one-fifth succumbed to infection.
Tecovirimat was administered in most patients; however, there were delays in some patients for treatment initiation. Thus, the authors suggest that healthcare providers start MPXV-directed therapies early for individuals with suspected or confirmed MPXV and those who are at risk for severe disease.
In those with severe disease or ongoing illness despite treatment, healthcare providers must consider tecovirimat treatment for more than two weeks and escalate the therapeutic regimen to include VIGIV or cidofovir if indicated clinically.
Source:
https://www.news-medical.net/news/20221030/New-report-on-the-impact-of-monkeypox-on-people-with-HIV.aspx