Monkeypox can have “devastating outcomes” on severely immunocompromised patients such as those with untreated HIV, according to the US Centers for Disease Control and Prevention.
New research published Wednesday in the CDC’s Morbidity and Mortality Weekly Report examined clinical case data for 57 patients hospitalized with monkeypox complications and found that 82% had an HIV infection.
“Monkeypox and HIV have collided with tragic effects,” said CDC Monkeypox Incident Commander Dr. Jonathan Mermin in a news release from the agency. “Today’s report reminds all of us that access to monkeypox and HIV prevention and treatment matters—for people’s lives and for public health.”
In the report, 95% of the patients were male and most (68%) were Black.
Seventeen of the patients were hospitalized in the intensive care unit and 12 of the patients died.
Of the patients who died, “monkeypox was a cause of death or contributing factor in five of these cases, six deaths remain under investigation to determine whether monkeypox was a causal or contributing factor, and in one death, monkeypox was not a cause or contributing factor,” the report states.
Health care providers are urged to start monkeypox therapies, such as Tpoxx, early – even before test results and before symptoms worsen.
Tpoxx, or tecovirimat, is a drug used to treat monkeypox that can be taken intravenously or as an oral pill. While not approved by the US Food and Drug Administration specifically for use against monkeypox, the CDC has made the drug available from the Strategic National Stockpile.
Patients with HIV and monkeypox should also take an antiretroviral therapy treatment, the researchers said in the report. ART suppresses the amount of HIV virus in a person’s body to undetectable levels.
The researchers write that nearly a quarter of the monkeypox cases in this cohort were in unhoused people and encouraged “collaboration with homeless services providers.”
“To end this outbreak, we urgently need healthcare providers, community-based partners, and public health partners to band together to close remaining gaps and ensure no one is left behind,” the CDC news release said.
There are 28,061 probable or confirmed monkeypox cases and six deaths reported in the US as of Tuesday, according to the CDC.
Death from monkeypox is extremely rare and is more likely to occur among babies and pregnant women, in addition to people with weakened immune systems, such as from HIV.