HIV: a severe form of monkeypox affects some patients

As of January 24, 2023, 4,982 cases of Monkeypox virus infection have been identified in France according to figures from Public Health France. A new study published in The Lancet warns of a particularly serious form of monkeypox.

“People living with HIV accounted for 38-50% of those affected during the 2022 mpox epidemic in several countries,” the researchers recall in this study. A team of scientists examined 382 cases of people with advanced HIV disease affected by mpox. A severe form monkeypox has been identified, it is a fulminant mpox. A total of 27 patients died, all had exceeded the threshold for the most advanced stage of HIV infection (acquired immunodeficiency syndrome, or AIDS) and had less than 200 CD4 T lymphocytes per mm3 of blood.

According to findings published in The Lancet, this “severe necrotizing form of mpox in the setting of advanced immunosuppression appears to behave like an AIDS-defining condition.” “The virus seems to behave completely differently in these individuals. Normally the disease affects the area around the site of entry, but in this case it spreads throughout the body and causes these massive, destructive ulcerative skin lesions. It causes also lung diseases. It’s horrible”, describes Professor Chloe Orkin, of Queen Mary University of London and the Barts Health NHS trust, quoted by The Guardian.

The journal also reports that this form of the disease could kill 15% of people with advanced HIV and immunosuppression, this figure could climb to 27% death for those with the lowest CD4 cell count.

In view of these conclusions, the researchers would like this severe form to be added to the list of serious infections for people with advanced HIV from the World Health Organization.