南佛罗里达州艾滋病毒感染者猴痘的临床表现:病例系列

Q2 Medicine Infezioni in Medicina Pub Date : 2022-01-01 DOI:10.53854/liim-3004-17
Lena Wong, Jose A Gonzales-Zamora, Laura Beauchamps, Zachary Henry, Paola Lichtenberger
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引用次数: 7

摘要

猴痘是一种历史上由猴痘病毒引起的人畜共患疾病,是一种新的全球卫生突发事件。自2022年5月以来,数十个非流行国家出现了快速传播的新病例。一般来说,这是一种自限性疾病,在脆弱人群中可能发生严重或致命的疾病。关于本次疫情中免疫功能低下患者的数据有限,特别是关于艾滋病毒感染者的数据,他们受到的影响尤为严重。方法:我们报告了美国南佛罗里达州7例HIV感染者猴痘病例。描述了相关的人口学、流行病学和临床资料。结果:所有患者均为男性,男同性恋或双性恋,接受抗逆转录病毒联合治疗(cART)。7人中有6人CD4细胞计数超过200个/mm3(一个未知水平),其中1人有可检测到的HIV病毒载量。6人在出现症状前与无症状伴侣有性接触或亲密接触。两人住院,一个是直肠炎,另一个是越来越多的病变。弥散性病变6例,局限性病变1例,病变总数均为5 ~ 25例。5例患者接受替可维林治疗,病变在2-14天内消退,截至本报告报道时,所有患者均恢复良好。密切接触者接种了耐受性良好的Jynneos疫苗。结论:我们的病例系列描述了艾滋病毒感染者的猴痘,并注意到非典型症状(没有发烧和更明显的肛门生殖器病变),并且与艾滋病毒血清阴性患者相比,病程相对较轻。我们强调早期发现和隔离以及对接触者接种疫苗的重要性,这一点得到了很好的容忍。在我们的病例系列中,由于患者数量有限,我们无法估计tecovirimat的有效性,但所有患者的病变在皮疹发作后两周内消退,且无副作用报道。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Clinical presentation of Monkeypox among people living with HIV in South Florida: a case series.

Introduction: Monkeypox, historically a zoonotic disease caused by monkeypox virus, is a new global health emergency. Since May 2022, dozens of non-endemic countries have seen new cases with rapid spread. Generally a self-limited disease, there are vulnerable populations, in which severe or deadly illness can occur. There is limited data on immunocompromised patients in this outbreak, particularly on people living with HIV, who are disproportionately affected.

Methods: We reported seven cases of monkeypox in people living with HIV in South Florida, USA. Relevant demographic, epidemiologic and clinical data were described.

Results: All the patients were men, identified as gay or bisexual, and were on combination antiretroviral therapy (cART) for HIV. Six of the seven had CD4 counts more than 200 cells/mm3 (one unknown level), and one of the seven had detectable HIV viral load. Six had sexual or intimate contact with asymptomatic partners prior to development of symptoms. Two were hospitalized, one for proctitis and one for an increasing number of lesions. Six had disseminated lesions and one had localized perianal lesions and all had 5-25 total number of lesions. Five received tecovirimat with resolution of lesions in 2-14 days and all were doing well at the time of the present report. Close contacts received the Jynneos vaccine which was well tolerated.

Conclusions: Our case series described monkeypox in people living with HIV and have noted atypical symptoms (lack of fever and more notable anogenital lesions) and relatively mild course as described in HIV seronegative patients. We stress the importance of early detection and isolation as well as vaccination to contacts, which has been well tolerated. In our case series, we are unable to estimate the effectiveness of tecovirimat given the limited number of patients, but all our patients had lesions that resolved within two weeks of rash onset and had no side effects reported.

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来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
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