Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting
2.2. Study Design and Data Sources
2.3. Study Population
3. Statistical Analysis
4. Ethics Approval
5. Results
6. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Transparency Statement
References
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Mpox in PWoH n = 1280 | Mpox in PWH n = 842 | p-Value | |
---|---|---|---|
Age | 36 (30–43) | 40 (34–46) | <0.001 |
Male, n (%) | 1229 (96.1) | 840 (99.8) | <0.001 |
Origin, n (%) | |||
Spanish | 756 (59.1) | 438 (52.0) | 0.001 |
European | 192 (15.0) | 113 (13.4) | 0.31 |
Latin American | 245 (19.1) | 259 (30.8) | <0.001 |
Other | 87 (6.8) | 32 (3.8) | 0.003 |
Asymptomatic, n (%) | 62 (4.8) | 20 (2.4) | 0.004 |
Symptoms, n (%) | |||
Fever | 641 (50.1) | 467 (55.5) | 0.015 |
Asthenia | 394 (30.8) | 243 (28.9) | 0.35 |
Odynophagia | 268 (20.9) | 201 (23.9) | 0.11 |
Myalgia | 251 (19.6) | 150 (17.8) | 0.30 |
Headache | 303 (23.7) | 164 (19.5) | 0.023 |
Generalized lymphadenopathy | 153 (12.0) | 94 (11.2) | 0.58 |
Localized lymphadenopathy | 530 (41.4) | 346 (41.1) | 0.89 |
Anogenital exanthema | 727 (56.8) | 472 (56.1) | 0.74 |
Oro-facial exanthema | 338 (26.4) | 239 (28.4) | 0.32 |
Exanthema in other localization | 509 (39.8) | 393 (46.7) | 0.002 |
Type of exanthema | |||
Maculopapular | 181 (14.1) | 129 (15.3) | 0.45 |
Vesicular | 308 (24.1) | 185 (22.0) | 0.26 |
Pustular | 237 (18.5) | 194 (23.0) | 0.011 |
Umbilicated | 194 (15.2) | 95 (11.3) | 0.011 |
Crusts | 127 (9.9) | 83 (9.9) | 0.96 |
Hemorrhagic | 4 (0.3) | 3 (0.4) | 0.86 |
Complications *, n (%) | 57 (4.5) | 50 (5.9) | 0.13 |
Skin bacterial infections | 22 (1.7) | 15 (1.8) | 0.91 |
Localizations: | |||
Ano-genital | 9 (34.6) | 6 (42.9) | |
Face | 9 (34.6) | 2 (14.3) | |
Limbs | 4 (15.4) | 1 (7.1) | |
Oral | 4 (15.4) | 5 (35.7) | |
Corneal infections | 5 (0.4) | 3 (0.4) | 0.9 |
Pneumonia | 0 | 2 (0.2) | 0.081 |
Proctitis | 15 (1.2) | 14 (1.7) | 0.34 |
Hospitalization | 22 (1.7) | 22 (2.6) | 0.16 |
ICU | 1 (0.1) | 0 | 0.42 |
Sepsis | 0 | 0 | |
Encephalitis | 0 | 0 | |
Death | 0 | 0 | |
Other | 3 (0.2) | 0 | |
Long term complications | 74 (9.3) | 65 (12.3) | 0.085 |
PWH with CD4 ≥ 200 Cells/μL at Mpox Diagnosis n = 661 (98.2) | PWH with CD4 < 200 Cells/μL at Mpox Diagnosis n = 12 (1.8) | p-Value | |
---|---|---|---|
Demographics | |||
Male, n (%) | 659 (99.7) | 12 (99.7) | 0.87 |
Age (years), median (IQR) | 41 (35–46) | 41 (32–44) | 0.26 |
Birth area, n (%) | |||
Spain | 268 (40.5) | 0 | |
Eastern Europe | 17 (2.6) | 0 | |
Western Europe and Northern America | 84 (12.7) | 0 | |
Africa | 11 (1.7) | 0 | |
Latin America | 271 (41.0) | 12 (100) | <0.0001 |
Other | 10 (1.5) | 0 | |
Route of HIV transmission, n (%) | 0.48 | ||
MSM | 610 (95.5) | 11 (91.7) | |
Heterosexual men | 13 (2.0) | 1 (8.3) | |
IDU | 11 (1.7) | 0 | |
Unknown | 5 (0.8) | 0 | |
Mpox | |||
Asymptomatic, n (%) | 19 (2.9) | 0 | 0.55 |
Symptoms, n (%) | |||
Fever | 364 (55.1) | 6 (50.0) | 0.73 |
Asthenia | 181 (27.4) | 5 (41.7) | 0.27 |
Odynophagia | 144 (21.8) | 3 (25.0) | 0.79 |
Muscular pain | 115 (17.4) | 3 (25.0) | 0.49 |
Headache | 121 (18.3) | 0 | 0.10 |
Generalized lymphadenopathy | 73 (11.0) | 2 (16.7) | 0.54 |
Localized lymphadenopathy | 264 (39.9) | 4 (33.3) | 0.64 |
Anogenital exanthema | 350 (53.0) | 6 (50.0) | 0.84 |
Oro-facial exanthema | 197 (29.8) | 1 (8.3) | 0.22 |
Generalized exanthema | 295 (44.6) | 10 (83.3) | 0.008 |
Type of exanthema | |||
Maculopapular | 97 (14.7) | 3 (25.0) | 0.32 |
Vesicular | 130 (19.7) | 3 (25.0) | 0.65 |
Pustular | 136 (20.6) | 6 (50.0) | 0.013 |
Umbilical | 64 (9.7) | 1 (8.3) | 0.88 |
Crusts | 52 (7.9) | 2 (16.7) | 0.26 |
Hemorrhagic | 2 (0.30) | 1 (8.3) | <0.0001 |
Complications, n (%) | |||
Bacterial infections | 6 (0.9) | 0 | 0.74 |
Cornea infections | 3 (0.5) | 0 | 0.82 |
Pneumonia | 1 (0.2) | 0 | 0.89 |
Proctitis | 11 (1.7) | 0 | 0.65 |
Hospitalization | 13 (2.0) | 2 (16.7) | 0.001 |
HIV-related | |||
CD4 cell count at mpox, (cells/μL), median (IQR) | 724 (540–912) | 122 (72–176) | <0.0001 |
Viral load < 50 c/mL at mpox | 553 (83.7) | 8 (66.7) | 0.12 |
Viral load < 200 c/mL at mpox | 579 (87.6) | 10 (83.3) | 0.66 |
AIDS-defining event prior to mpox | 51 (7.7) | 4 (33.3) | 0.001 |
Comorbidity | |||
Malignancy | 38 (5.8) | 3 (25.0) | 0.006 |
Autoimmune disease | 22 (3.3) | 0 | 0.52 |
Inflammatory bowel disease | 16 (2.4) | 1 (8.3) | 0.20 |
Multiple sclerosis | 0 | 0 | |
History of psychiatric disease | 207 (31.3) | 3 (25.0) | 0.64 |
Charlson comorbidity score at mpox, | 0.23 | ||
0 | 523 (79.2) | 10 (83.3) | |
1 | 41 (6.2) | 0 | |
2–3 | 87 (13.2) | 1 (8.3) | |
≥4 | 10 (1.5) | 1 (8.3) |
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Martín-Iguacel, R.; Pericas, C.; Bruguera, A.; Rosell, G.; Martínez, E.; Díaz, Y.; Alonso, L.; Nomah, D.K.; Blanco, J.L.; Domingo, P.; et al. Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study. Microorganisms 2023, 11, 2701. https://doi.org/10.3390/microorganisms11112701
Martín-Iguacel R, Pericas C, Bruguera A, Rosell G, Martínez E, Díaz Y, Alonso L, Nomah DK, Blanco JL, Domingo P, et al. Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study. Microorganisms. 2023; 11(11):2701. https://doi.org/10.3390/microorganisms11112701
Chicago/Turabian StyleMartín-Iguacel, Raquel, Carles Pericas, Andreu Bruguera, Gemma Rosell, Erica Martínez, Yesika Díaz, Lucia Alonso, Daniel Kwakye Nomah, Jose Luis Blanco, Pere Domingo, and et al. 2023. "Mpox: Clinical Outcomes and Impact of Vaccination in People with and without HIV: A Population-Wide Study" Microorganisms 11, no. 11: 2701. https://doi.org/10.3390/microorganisms11112701