Characteristics and clinical manifestations of monkeypox among people with and without HIV in the United States: a retrospective cohort. (15th March 2023)

• Record Type: Journal Article
• Authors: Chastain, Daniel B.; Motoa, Gabriel; Ortiz-Martínez, Yeimer; Gharamti, Amal; Henao-Martínez, Andrés F.
• Is Part Of: AIDS. Volume 37:Number 4(2023)
• Page Start: 611
• Page End: 616
• Publication Date: 2023-03-15
• Subjects: HIV -- hospital -- monkeypox -- retrospective studies -- signs and symptoms; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000003449
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objectives: To compare characteristics and clinical manifestations of monkeypox (MPX) between people with and without HIV in the United States. Design: Retrospective cohort study using TriNetX, a federated research network. Methods: Patients 18 years and older with MPX were identified based on the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code B04 and divided into two groups: people with HIV (PWH) and people without HIV. Differences in baseline characteristics, clinical manifestations, and all-cause healthcare utilization were examined between groups. Outcomes were reported before and after propensity score matching. Results: Of 322 cases of MPX included, 29% ( n = 93) were PWH. Baseline characteristics were similar, but PWH were more likely to identify as Black or African American persons (24% vs. 11%, P = 0.0303) or as Hispanic or Latino persons (24% vs. 11%, P = 0.0345) and more likely to report lifestyle factors affecting health status. Rash and rectal pain were more common in PWH (25% vs. 11%, P < 0.01, and 25% vs. 10%, P < 0.001, respectively). In addition, PWH had higher rates of anal or rectal abscesses (11% vs. 0%, P < 0.0001), phimosis (11% vs. 0%, P < 0.0001), and pneumonia (11% vs. 0%, P < 0.0001). More PWH required urgent care visits (53% vs. 29%, P < 0.0001) and hospitalizations (11% vs. 4%, P = 0.0314), but not emergency department visits (42% vs. 58%, P = 0.0085). Conclusion: PWH had higher rates of clinical manifestations and required greater utilization of healthcare resources for any reason compared with those without HIV.