Cases of Monkeypox show highly-overlapping co-infection with HIV and syphilis

PurposeOngoing Monkeypox (MPX) outbreaks in countries outside Africa have unique characteristics. However, data on cohorts of confirmed cases in China is limited. The study provides important epidemiological, diagnostic, and clinical information about this disease in China.MethodsWe report a series...

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Main Authors: Lin Jia (Author), Benyong Yan (Author), Yuan Fang (Author), Xiaodong Yang (Author), Han Jia (Author), Mei Zhang (Author), Shuang Li (Author), Yang Zhang (Author), Wen Wang (Author), Caiping Guo (Author), Tong Zhang (Author), Xiaojie Huang (Author), Taiyi Jiang (Author)
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Published: Frontiers Media S.A., 2024-01-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Lin Jia  |e author 
700 1 0 |a Benyong Yan  |e author 
700 1 0 |a Yuan Fang  |e author 
700 1 0 |a Xiaodong Yang  |e author 
700 1 0 |a Han Jia  |e author 
700 1 0 |a Mei Zhang  |e author 
700 1 0 |a Shuang Li  |e author 
700 1 0 |a Yang Zhang  |e author 
700 1 0 |a Wen Wang  |e author 
700 1 0 |a Caiping Guo  |e author 
700 1 0 |a Tong Zhang  |e author 
700 1 0 |a Xiaojie Huang  |e author 
700 1 0 |a Taiyi Jiang  |e author 
245 0 0 |a Cases of Monkeypox show highly-overlapping co-infection with HIV and syphilis 
260 |b Frontiers Media S.A.,   |c 2024-01-01T00:00:00Z. 
500 |a 2296-2565 
500 |a 10.3389/fpubh.2023.1276821 
520 |a PurposeOngoing Monkeypox (MPX) outbreaks in countries outside Africa have unique characteristics. However, data on cohorts of confirmed cases in China is limited. The study provides important epidemiological, diagnostic, and clinical information about this disease in China.MethodsWe report a series of Chinese individuals with confirmed MPX infections identified at Beijing Youan Hospital (China) from June 10 to July 15, 2023. Samples were taken from the skin, anus, throat, and blood. An epidemiological questionnaire was used to collect demographic and clinical data. Further, we compared the MPX viral (MPXV) loads across different anatomical sites.Results66 samples were collected from 20 patients, all of whom were cisgender men. Median patient age was 29 years. Notably, 19 (95%) patients reported unprotected sexual encounters with men in the preceding month, and 13 (65%) were human immunodeficiency virus (HIV)-positive. Among those with HIV, 12 (92%) were receiving antiretroviral therapy, and 11 (85%) had well-controlled infections (HIV viral load <40/mL). The median CD4+ T cell count was 667 cells/mm3. In the HIV-negative group, three (43%) patients were taking preexposure prophylaxis. Fifteen patients (75%) had concurrent sexually transmitted infections (50% had syphilis and 65% had HIV) and eight (40%) had HIV and syphilis co-infection. MPXV loads were significantly higher in samples from the skin (cycle threshold value [Ct value]: 19·0) and anus (Ct value: 23.0) compared to samples from the throat (Ct value: 31.0) or blood (Ct value: 34.5). All patients had skin lesions (85% of whom presented with anogenital lesions). Common systemic symptoms included fever (85%) and lymphadenopathy (55%). The median incubation period was 8 d [interquartile range (IQR): 6-16 d]. The median time from the onset of skin lesions to scab removal was 14 d (IQR: 10-16 d). No deaths or severe cases were reported.ConclusionMPXV primarily affects young homosexual men. The high MPXV viral loads in skin and anal lesions indicate that transmission most likely occurs through direct and close body contact. This study also reports high rates of HIV and syphilis co-infection. Therefore, preventive efforts should focus on homosexual men. 
546 |a EN 
690 |a Monkeypox 
690 |a transmission routes 
690 |a clinical features 
690 |a sexually transmitted infection 
690 |a viral loads 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Frontiers in Public Health, Vol 11 (2024) 
787 0 |n https://www.frontiersin.org/articles/10.3389/fpubh.2023.1276821/full 
787 0 |n https://doaj.org/toc/2296-2565 
856 4 1 |u https://doaj.org/article/025787486dd04b94981c8fcf899b2f2c  |z Connect to this object online.