Intersecting HIV and mpox epidemics: more questions than answers

Mpox was declared a Public Health Emergency of International Concern by the World Health Organization on 23 July 2022 [ 1], following a rapid increase in cases beginning in Europe in May 2022. Whether genital secretions (e.g. semen) can lead to the sexual transmission before lesions appear or after healing, and the duration of cutaneous/mucosal shedding of the infectious virus remain unknown—questions of utmost importance for informing recommendations for condom use. Several studies have reported on the characteristics of people with mpox with and without HIV (Table 1). [...]far in high-income settings, there is no clear evidence that the risk factors or clinical course differ by HIV status, except for a higher prevalence of rectal lesions at presentation among PLWH [ 9]. Table 1 Comparison in clinical differences in individuals with mpox, according to HIV status Source Number of PLWH n/total (%) Median CD4 cell count (IQR), /μl PLWH with viral load > 200 copies/ml n/total (%) Differences between PLWH and HIV-negative individuals with mpox Tarín-Vicente et al.