Abstract:
The high proportion of people with HIV (PWH) in the 2022-2023 mpox outbreak has raised questions surrounding the association between HIV and mpox. The objectives of this study were to evaluate the association between engagement in HIV-associated healthcare and mpox diagnosis, as well as to characterize cases of mpox among PWH. The DC Cohort is a longitudinal cohort of PWH in Washington, DC. We conducted a 5:1 (controls:cases) nested case-cohort study on male participants, matching age and care site. Cases were participants with an identified mpox diagnosis. Conditional logistic regression was used to assess the impact of indicators of engagement in HIV-associated healthcare on mpox diagnosis. We identified 70 cases of mpox in DC Cohort participants randomly matched to 323 controls, for a total of 393 participants included in the analysis. Study participants were primarily non-Hispanic Black (72.3%) with a median age of 41 (IQR: 36, 50). There was no association between engagement in care and mpox diagnosis; however, low CD4 was associated with increased odds of mpox diagnosis (aOR: 4.60 (95% CI: 1.23, 17.11)). Among a cohort of PWH, engagement in care was not associated with mpox diagnosis, suggesting that the overrepresentation of PWH among mpox cases is not due to surveillance bias.
摘要:
在2022-2023年的水痘爆发中,艾滋病毒感染者(PWH)的比例很高,这引发了人们对艾滋病毒与水痘之间关联的质疑。这项研究的目的是评估参与与艾滋病毒相关的医疗保健和水痘诊断之间的关联。以及表征PWH中的水痘病例。DC队列是华盛顿PWH的纵向队列,DC.我们对男性参与者进行了5:1(对照:病例)嵌套病例队列研究,匹配年龄和护理地点。病例是具有确定的痘诊断的参与者。使用条件逻辑回归来评估参与HIV相关医疗保健的指标对水痘诊断的影响。我们在随机匹配323名对照的DC队列参与者中确定了70例天花,纳入分析的393名参与者.研究参与者主要是非西班牙裔黑人(72.3%),中位年龄为41岁(IQR:36,50)。参与护理和痘诊断之间没有关联;然而,低CD4与水痘诊断几率增加相关(aOR:4.60(95%CI:1.23,17.11)).在一群PWH中,参与护理与痘诊断无关,这表明,水痘病例中PWH的比例过高不是由于监测偏倚。