PDF(Pubmed)
Abstract：
OBJECTIVE: Since May 2022, Mpox has spread extensively outside of Africa, posing a serious threat to the health of people globally, and particularly to the men who have sex with men (MSM) population. Chongqing, a province in Southwest China, has relatively large MSM and people living with HIV (PLWH) populations, presenting conditions conducive to the wide dissemination of Mpox. In this study, we investigated the clinical characteristics of Mpox patients among MSM and PLWH in Chongqing, aiming to inform the development of targeted prevention, control, and treatment strategies for Mpox.
METHODS: We evaluated the clinical characteristics, travel history, time of onset, distribution and number of skin lesions of Mpox patients admitted to the Chongqing Public Health Medical Center between September 2022 and October 2023. Meanwhile, a series of clinical samples were collected and the pathogen of interest was identified as Mpox virus using quantitative polymerase chain reaction (qPCR). The results were presented in the form of cycle thresholds (Ct), which help to approximate the quantification of viral load.
RESULTS: As of October 11, 2023, the Chongqing Public Health Medical Center reported a total of nine Mpox virus infections. All the patients identified were male and belonged to the MSM population, among whom seven (77.8%) were living with HIV, and maintained a preserved immune system while achieving viral suppression via effective ART. We observed no discernible clinical differences between MSM with Mpox with or without HIV, and no fatalities were recorded. Viral loads were observed to be higher in samples taken from the skin than those from the throat, nasopharynx, blood, or semen.
CONCLUSIONS: In this retrospective study, the clinical manifestations of MPXV infection appeared consistent among MSM patients, regardless of HIV status. Elevated MPXV viral loads in the skin and mucosal tissues, particularly at genital and anal sites, indicate that transmission is more likely to occur via direct physical contact as opposed to respiratory pathways or through exposure to bodily fluids.
METHODS: We evaluated the clinical characteristics, travel history, time of onset, distribution and number of skin lesions of Mpox patients admitted to the Chongqing Public Health Medical Center between September 2022 and October 2023. Meanwhile, a series of clinical samples were collected and the pathogen of interest was identified as Mpox virus using quantitative polymerase chain reaction (qPCR). The results were presented in the form of cycle thresholds (Ct), which help to approximate the quantification of viral load.
RESULTS: As of October 11, 2023, the Chongqing Public Health Medical Center reported a total of nine Mpox virus infections. All the patients identified were male and belonged to the MSM population, among whom seven (77.8%) were living with HIV, and maintained a preserved immune system while achieving viral suppression via effective ART. We observed no discernible clinical differences between MSM with Mpox with or without HIV, and no fatalities were recorded. Viral loads were observed to be higher in samples taken from the skin than those from the throat, nasopharynx, blood, or semen.
CONCLUSIONS: In this retrospective study, the clinical manifestations of MPXV infection appeared consistent among MSM patients, regardless of HIV status. Elevated MPXV viral loads in the skin and mucosal tissues, particularly at genital and anal sites, indicate that transmission is more likely to occur via direct physical contact as opposed to respiratory pathways or through exposure to bodily fluids.
摘要：
目标：自2022年5月以来，水痘已在非洲以外广泛传播，对全球人民的健康构成严重威胁，尤其是男男性行为者（MSM）人群。重庆,中国西南的一个省，有相对较大的MSM和艾滋病毒感染者(PLWH)人口，提供有利于水痘广泛传播的条件。在这项研究中,我们调查了重庆地区MSM和PLWH中水痘患者的临床特征，旨在为有针对性的预防的发展提供信息，control,以及水痘的治疗策略。
方法：我们评估了临床特征，旅行史,发病时间,2022年9月至2023年10月重庆公共卫生医学中心收治的水痘患者皮损分布及数量.同时,收集了一系列临床样本,使用定量聚合酶链反应(qPCR)将目的病原体鉴定为痘病毒.结果以循环阈值(Ct)的形式呈现，这有助于近似病毒载量的量化。
结果：截至2023年10月11日，重庆市公共卫生医疗中心共报告9例痘病毒感染。确定的所有患者均为男性，属于MSM人群，其中7人(77.8%)感染艾滋病毒，并保持一个保存的免疫系统，同时通过有效的ART实现病毒抑制。我们观察到MSM与有或没有HIV的Mpox之间没有明显的临床差异，没有死亡记录。观察到从皮肤采集的样本中的病毒载量高于从喉咙采集的样本，鼻咽部,血,或者精液.
结论：在这项回顾性研究中，MSM患者MPXV感染的临床表现一致,无论艾滋病毒状况如何。皮肤和粘膜组织中MPXV病毒载量升高，特别是在生殖器和肛门部位，表明传播更有可能通过直接身体接触而不是呼吸途径或通过暴露于体液。
方法：我们评估了临床特征，旅行史,发病时间,2022年9月至2023年10月重庆公共卫生医学中心收治的水痘患者皮损分布及数量.同时,收集了一系列临床样本,使用定量聚合酶链反应(qPCR)将目的病原体鉴定为痘病毒.结果以循环阈值(Ct)的形式呈现，这有助于近似病毒载量的量化。
结果：截至2023年10月11日，重庆市公共卫生医疗中心共报告9例痘病毒感染。确定的所有患者均为男性，属于MSM人群，其中7人(77.8%)感染艾滋病毒，并保持一个保存的免疫系统，同时通过有效的ART实现病毒抑制。我们观察到MSM与有或没有HIV的Mpox之间没有明显的临床差异，没有死亡记录。观察到从皮肤采集的样本中的病毒载量高于从喉咙采集的样本，鼻咽部,血,或者精液.
结论：在这项回顾性研究中，MSM患者MPXV感染的临床表现一致,无论艾滋病毒状况如何。皮肤和粘膜组织中MPXV病毒载量升高，特别是在生殖器和肛门部位，表明传播更有可能通过直接身体接触而不是呼吸途径或通过暴露于体液。
