People with weakened immune systems, specifically those who have not received treatment for HIV/AIDS, are at a higher risk of experiencing severe and potentially fatal symptoms of monkeypox, according to a Centers for Disease Control and Prevention (CDC) study in Morbidity and Mortality Weekly Report.
From August to October 2022, the CDC offered clinical support for 57 hospitalized patients suffering from severe symptoms of monkeypox. The majority of these patients were Black men living with HIV/AIDS. Many were also facing homelessness.
The study highlights long-standing health disparities, according to Richard Silvera, MD, MPH, CPH, an associate program director of the Infectious Diseases Fellowship and assistant professor of medicine (infectious diseases) at the Icahn School of Medicine Mount Sinai in New York City.
The authors reported that there were delays in starting treatment for monkeypox. In addition, they revealed that of the fifty-seven patients hospitalized, twelve died, with monkeypox being a direct or contributing cause of death for five of them. The cause of death for several other patients is still being investigated.
“These patients really have not been served by the healthcare system,” Silvera said. “Monkeypox is just really taking advantage of that.”
According to the study findings, the majority of the study participants, about eighty-two percent, were found to be HIV-positive. However, only a small percentage ( about four patients ) received antiretroviral therapy (ART) treatment.
Furthermore, they found that out of the forty-three participants whose CD4 counts were available, about seventy-one percent had a CD4 count of fewer than 50 cells/mm3, which is considered low.
The study’s authors stressed the importance of HIV testing for all sexually active individuals who may have monkeypox. They also recommended early or prolonged treatment for monkeypox, as necessary.
Finally, the authors urged healthcare providers to involve and engage communities heavily impacted by HIV actively and to provide not only monkeypox vaccination, diagnosis, and treatment but also sustained HIV care.