Retrospective Study of Epidemiological and Clinical Characteristics of Mpox-HIV Coinfection in Men Who Have Sex with Men in Hangzhou, China

Monkeypox (Mpox) resurgence raises global public health concerns, particularly among men who have sex with men (MSM) with human immunodeficiency virus (HIV). We recruited 104 confirmed Mpox cases in Hangzhou, categorized into Mpox-HIV coinfection and Mpox monoinfection groups, and HIV monoinfections were 1:1 matched with Mpox-HIV co-infections. We compared the characteristics and identifying coinfection risk factors. Mpox-HIV co-infections had higher lesion pain (67.39% vs. 39.66%, P = 0.004) and all 27 hospitalized (including 1 ICU) were coinfected. Despite 97.83% receiving antiretroviral therapy, up to 28.26% had CD4 + T-cell counts ≤ 350 cells/µL. Mpox-HIV co-infections caused more severe clinical manifestations and higher hospitalization, particularly in people with low CD4 + T-cell counts. High-risk sexual behaviors, including multiple sexual partners and frequent sexual activity, associated with coinfections. These results highlight the critical need to integrate surveillance and prevention strategies for HIV and Mpox among high-risk groups.