Summarizing the characteristics of mpox among people with and without HIV in Hubei Province, China

Currently, few studies have compared the difference of monkeypox (mpox) virus (MPXV) DNA detection in different specimens between people living with HIV (PLWH) and HIV-uninfected patients with mpox, and research on the comparison of clinical characteristics between them remains limited in China. A retrospective observational study was conducted between July 2023 and September 2024 in Hubei Province, China. All patients with mpox were recruited from Wuhan Jinyintan Hospital and Zhongnan Hospital of Wuhan University. Comparisons of the MPXV DNA detection in different clinical specimens and clinical characteristics were performed between PLWH and HIV-uninfected patients. Totally, 33 patients with mpox were enrolled; 32 (97.0%) were male, and 14 (42.4%) were PLWH. Two PLWH died, both of whom had CD4 + T-lymphocyte counts below 50 cells/µL, whereas no deaths occurred among HIV-uninfected patients. PLWH had higher positive rates of MPXV DNA detection in pox fluid, pox scab, anal swab, throat swab and blood plasma than HIV-uninfected patients, though no significant differences were observed between the two groups. Compared with HIV-uninfected patients, PLWH had significantly longer disease duration (27 vs. 16 days, p = 0.041), significantly lower CD4 counts ( p = 0.027) and lower proportion of lymphadenopathy ( p = 0.029). Among PLWH, a significantly negative correlation was observed between the disease duration and CD4 counts ( r =-0.784, p < 0.001). This small cohort has preliminarily found PLWH with mpox exhibited worse clinical outcomes due to immune deficiency. In PLWH, whether the higher positive detection rates of MPXV DNA in multiple specimens were related to transmissibility needs further verification with quantitative viral load detection and epidemiological investigation.