流行病学研究已经确定,由于CladeIIb痘病毒(MPXV),2022-2023年在全球范围内爆发了水痘(以前称为猴痘),受影响不成比例的同性恋,双性恋,和其他和男人发生性关系的男人.超过35%和40%的水痘病例患有艾滋病毒合并感染和性传播感染(STIs)(例如,沙眼衣原体,淋病奈瑟菌,梅毒螺旋体,和单纯疱疹病毒),分别。也可能发生细菌重叠感染。MPXV和其他感染因子的共同感染可能会增加疾病的严重程度,恶化的结果,延长恢复过程,并可能导致随后疾病的发病率和死亡率。然而,MPXV和HIV之间的相互作用,细菌,其他STI病原体和宿主细胞研究甚少。关于艾滋病毒共同感染的影响,有许多悬而未决的问题,性传播感染,或细菌超感染对MPXV感染的诊断和治疗,包括临床和实验室确诊的痘诊断,治疗效果欠佳,并诱导抗病毒药物的耐药性。在这篇评论文章中,我们将讨论MPXV生物学的进展和知识差距,抗病毒治疗,人类MPXV的发病机制及其与HIV的共同感染,性传播感染,或细菌超感染,以及共感染对水痘诊断和治疗的影响。这篇综述不仅阐明了MPXV感染和其他病原体的共同感染,而且呼吁对MPXV生命周期以及MPXV和其他感染因子共同感染的发病机理的分子机制进行更多的研究。以及用于检测MPXV和其他STI共感染的新型多重分子检测小组的研究和开发。
Epidemiologic studies have established that mpox (formerly known as monkeypox) outbreaks worldwide in 2022-2023, due to Clade IIb mpox virus (MPXV), disproportionately affected gay, bisexual, and other men who have sex with men. More than 35% and 40% of the mpox cases suffer from co-infection with HIV and sexually transmitted infections (STIs) (e.g., Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and herpes simplex virus), respectively. Bacterial
superinfection can also occur. Co-infection of MPXV and other infectious agents may enhance disease severity, deteriorate outcomes, elongate the recovery process, and potentially contribute to the morbidity and mortality of the ensuing diseases. However, the interplays between MPXV and HIV, bacteria, other STI pathogens and host cells are poorly studied. There are many open questions regarding the impact of co-infections with HIV, STIs, or bacterial superinfections on the diagnosis and treatment of MPXV infections, including clinical and laboratory-confirmed mpox diagnosis, suboptimal treatment effectiveness, and induction of antiviral drug resistance. In this review article, we will discuss the progress and knowledge gaps in MPXV biology, antiviral therapy, pathogenesis of human MPXV and its co-infection with HIV, STIs, or bacterial superinfections, and the impact of the co-infections on the diagnosis and treatment of mpox disease. This review not only sheds light on the MPXV infection and co-infection of other etiologies but also calls for more research on MPXV life cycles and the molecular mechanisms of pathogenesis of co-infection of MPXV and other infectious agents, as well as research and development of a novel multiplex molecular testing panel for the detection of MPXV and other STI co-infections.