The effect of HIV and mpox co-infection on clinical outcomes: Systematic review and meta-analysis

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2024-03-05 DOI:10.1111/hiv.13622

Amira Mohamed Taha, Amr Elrosasy, Abdelrahman Mohamed Mahmoud, Sara Adel Abdelkader Saed, Wesam Abd El-Tawab Moawad, Esraa Hamouda, Dang Nguyen, Van Phu Tran, Hoang Tran Pham, Sanjit Sah, Joshuan J. Barboza, Ranjit Sah

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Abstract

Introduction

Co-infection with HIV and mpox is a significant issue for public health because of the potential combined impact on clinical outcomes. However, the existing literature lacks a comprehensive synthesis of the available evidence. The purpose of this meta-analysis is to provide insight into the impact of HIV and mpox co-infection on clinical outcomes.

Methods

We systematically searched major electronic databases (PubMed, Embase, Cochrane Central, and Web of Science) for pertinent studies published up to June 2023. Included were studies that described the clinical outcomes of people who had both mpox and HIV. We performed the analysis using OpenMeta and STATA 17 software.

Results

With an overall number of participants of 35 207, 21 studies that met the inclusion criteria were considered. The greatest number of the studies (n = 10) were cohort designs, with three being cross-sectional and eight being case series studies. The meta-analysis found that people who had both HIV and mpox had a higher hospitalization rate than those who only had mpox (odds ratio [OR] 1.848; 95% confidence interval [CI] 0.918–3.719, p = 0.085, I² = 60.19%, p = 0.020). Furthermore, co-infected patients had higher mortality rates than those who did not have HIV co-infection (OR 3.887; 95% CI 2.272–6.650, p < 0.001). Meta-regression analysis showed that CD4 levels can significantly predict the risk of hospitalization (p = 0.016) and death (p = 0.031).

Discussion

HIV causes immunosuppression, making it difficult for the body to mount an effective immune response against pathogens such as mpox. Individuals who are co-infected are at a higher risk of severe disease and death, according to our findings. Although hospitalization rates did not differ significantly between the two groups, it is critical to prioritize interventions and improve management strategies tailored specifically for people living with HIV.

Conclusion

This meta-analysis provides substantial evidence that HIV and mpox co-infection has a negative impact on clinical outcomes. Co-infected individuals had higher hospitalization and significantly higher mortality rates. These findings highlight the significance of early diagnosis, prompt treatment initiation, and effective management strategies for people living with HIV and mpox.

查看原文本刊更多论文

HIV 和 mpox 合并感染对临床结果的影响：系统回顾与荟萃分析。

导言：艾滋病毒和麻疹的双重感染是公共卫生的一个重要问题，因为这两种疾病会对临床结果产生潜在的综合影响。然而，现有文献缺乏对现有证据的全面综合。本荟萃分析旨在深入探讨 HIV 和 mpox 合并感染对临床结果的影响：我们系统地检索了主要电子数据库（PubMed、Embase、Cochrane Central 和 Web of Science）中截至 2023 年 6 月发表的相关研究。纳入的研究描述了同时感染麻疹和艾滋病病毒的患者的临床结果。我们使用 OpenMeta 和 STATA 17 软件进行了分析：在 35 207 名参与者中，有 21 项研究符合纳入标准。其中最多的研究（n = 10）是队列研究，3 项是横断面研究，8 项是病例系列研究。荟萃分析发现，同时感染艾滋病毒和麻疹的患者住院率高于仅感染麻疹的患者（几率比 [OR] 1.848；95% 置信区间 [CI] 0.918-3.719，P = 0.085，I2 = 60.19%，P = 0.020）。此外，合并感染的患者死亡率高于未合并感染艾滋病毒的患者（OR 3.887; 95% CI 2.272-6.650, p 讨论）：艾滋病毒会导致免疫抑制，使机体难以对麻疹病毒等病原体产生有效的免疫反应。根据我们的研究结果，合并感染者罹患严重疾病和死亡的风险更高。虽然两组患者的住院率没有显著差异，但确定干预措施的优先次序并改进专为艾滋病病毒感染者量身定制的管理策略至关重要：这项荟萃分析提供了大量证据，证明艾滋病病毒和麻疹病毒合并感染会对临床结果产生负面影响。合并感染者的住院率更高，死亡率也明显更高。这些发现凸显了早期诊断、及时开始治疗和有效管理策略对艾滋病病毒感染者和水痘患者的重要性。

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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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.

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