Monkeypox worse for patients with weakened immune systems

THURSDAY, Oct. 27, 2022 (HealthDay News) — As monkeypox cases decline in the United States, a new government report shows that patients with weakened immune systems, especially those living with HIV, have been particularly affected by the virus.

Even after taking antiviral drugs for monkeypox, people with untreated HIV were more likely to end up in hospital, researchers from the US Centers for Disease Control and Prevention found.

Since May, around 28,000 cases of monkeypox have been reported in this country and 12 people hospitalized with the virus have died.

In the report, CDC scientists described the cases of 57 patients treated between mid-August and October 10.

All the patients had serious lesions caused by the virus, including 39 people who suffered damage to their eyes, mouth and other mucous membranes.

Almost all of the hospitalized patients were black, 54 were men, three were pregnant and almost 25% were homeless. Two of the patients were undergoing chemotherapy, according to the report. Three others had received organ transplants. About a third of these 57 patients were treated in intensive care.

While approximately 5% to 10% of patients with monkeypox are admitted to hospital, those with HIV are more likely to be hospitalized, the Washington Post reported.

Of the deaths associated with monkeypox, six are still under investigation, according to the report.

The virus typically affects men who have sex with men in the current outbreak, causing painful lesions even when not severe. People living with HIV and people of color represent a disproportionate share of patients. About 38% of monkeypox cases were in someone living with HIV, according to a review of 2,000 cases this summer, the Job reported.

Doctors should test for HIV in all sexually active patients in whom they suspect monkeypox. They should consider treatment for monkeypox in “highly immunocompromised” patients, including those with advanced HIV, the CDC said.

Patients who are being treated for their HIV do not appear to be at increased risk for monkeypox, said Anu Hazra, co-medical director of Howard Brown Health, an LGBT healthcare provider in Chicago. Job.

“While we know that HIV impacts our immune system, we also know that not all people living with HIV are the same,” Hazra noted.

The CDC report detailed specific cases of monkeypox, including that of a Latino man in his 20s who tested positive after going to the emergency room with back pain and a rash. He was also HIV-positive and died after his condition rapidly worsened with difficulty breathing and kidney failure, despite being treated with TPoxx and receiving HIV treatment in hospital.

Another patient was a black man in his thirties who had AIDS and was not being treated. He had a rash in July and was tested and treated for gonorrhea, chlamydia and syphilis. His injuries worsened and he was admitted to hospital with monkeypox, but discharged with a supply of TPoxx. His condition improved, then worsened again and he was hospitalized with an antibiotic-resistant bacterial infection. He continued to bounce back, before being readmitted for his symptoms.

A white man in his 40s who had not received treatment for AIDS also bounced between hospital and discharge with treatment given at varying times. He eventually had a toe and part of one of his index fingers amputated despite multiple treatments. He remains hospitalized.

“This is an important depiction of the severe consequences of monkeypox and should underscore the critical importance of getting vaccines, treatments and risk messages to the most severely affected communities,” said Anne Rimoin, an epidemiologist at UCLA who has studied monkeypox for two decades. say it Job. “The disproportionate impact on communities that have less access to health services is the same story we see repeated locally and globally.”

More information

The World Health Organization has additional information on monkeypox.

THE SOURCE: Morbidity and Mortality Weekly ReportOctober 27, 2022, Washington Post

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