“A severe and necrotizing form of mpox (might) resemble an illness characteristic of AIDS”summarize the authors of this study published in the Lancet.
The monkeypox epidemic, which spread globally in 2022 before largely subsiding, primarily affected men who have sex with men (MSM).
However, it is a population where there is a greater proportion of people infected with HIV, which at the most advanced stage (without effective treatment) affects the patient’s immunity by making him vulnerable to a series of diseases (stage AIDS).
In this context, researchers have been interested in the particular risks posed by monkeypox in patients already infected with HIV.
The authors of the study have thus studied the case of nearly 400 patients infected with both HIV and mpox.
In their case, they identified a very serious form of the disease, which they described as « mpox fulminant ».
This form, which focuses on patients where the HIV infection is at an advanced stage, results in massive necrosis of the skin, genitals, and even the lungs.
It caused the death of 27 patients. All had exceeded the threshold generally used to speak of AIDS: less than 200 CD4 T lymphocytes per mm3 of blood.
These deaths alone represent a high proportion of the hundred deaths recorded in the context of the epidemic, out of several tens of thousands of cases.
For the researchers, these conclusions should encourage health authorities to give priority to vaccinating people with HIV once morest mpox.
They also call for this severe form of mpox to be added to the list of AIDS-defining illnesses. This includes around fifteen pathologies which are deemed to be specifically dangerous in the event of advanced HIV infection.
