Prolonged mpox disease in people with advanced HIV: characterization of mpox skin lesions

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  O’Shea, Jesse ; Zucker, Jason ; Stampfer, Samuel ; Cash-Goldwasser, Shama ; Minhaj, Faisal S. ; Dretler, Alexandra ; Cheeley, Justin ; Chaudhuri, Shaoli ; Gallitano, Stephanie M. ; Gunaratne, Shauna ; Parkinson, Melissa ; Epling, Brian ; Morcock, David R. ; Sereti, Irini ; Deleage, Claire
  More +
• Description:
  We report 3 complicated and prolonged cases of mpox in people with advanced human immunodeficiency virus (HIV) not on antiretroviral therapy (ART) at mpox diagnosis. Multiple medical countermeasures were used, including prolonged tecovirimat treatment and immune optimization with ART initiation. Immunofluorescence of skin biopsies demonstrated a dense immune infiltrate of predominantly myeloid and CD8+ T cells, with a strong type I interferon local response. RNAscope detected abundant replication of monkeypox virus (MPXV) in epithelial cells and dendritic cells. These data suggest that prolonged mpox in people with advanced HIV may be due to ongoing MPXV replication, warranting aggressive medical countermeasures and immune optimization.
• Subjects:
  • Humans
  • HIV
  • Mpox (monkeypox)
  • Skin Diseases
  • Benzamides
  • HIV Infections
• Keywords:
  • Mpox
  • Monkeypox Virus
  • HIV
  • AIDS
  • Orthopoxvirus
• Source:
  J Infect Dis. 229(Suppl 2):S243-S248
• Pubmed ID:
  38019806
• Pubmed Central ID:
  PMC10965209
• Document Type:
  Journal Article
• Funding:
  U01 AI069470/AI/NIAID NIH HHSUnited States/ ; HHSN261201500003C/CA/NCI NIH HHSUnited States/ ; UM1 AI069470/AI/NIAID NIH HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; HHSN261201500003I/CA/NCI NIH HHSUnited States/ ; 775N91019D00024/NH/NIH HHSUnited States/
• Volume:
  229
• Download URL:
  https://stacks.cdc.gov/view/cdc/154068/cdc_154068_DS1.pdf
• File Type:
  [PDF - 741.86 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:966f75e1d4a634c1a1ca9fb8e7ce42b2b9538fdccac47b9a04ab3402f49c49c0260587a94bd951ff1717ffb289624df75dc4dfff9a6c7284b04ad24aa9856f21