Mpox often leads to severe illness or even death in people with advanced HIV.

The mortality rate among these patients is around 15%, the researchers reported. The virus should be added to the list of opportunistic infections seen in patients with advanced HIV, the scientists said.

In people with HIV advance. disease, the mpox virus - formerly known as monkeypox - often causes severe illness, with a mortality rate of around 15%, researchers reported Tuesday.

The severity of the infection warrants the inclusion of mpox among opportunistic conditions that are particularly dangerous for people with advanced HIV, researchers said at the Conference on Retroviruses and Opportunistic Infections in Seattle.

"These results show very, very clearly that every person with mpox should have an H.I.V. test," said HIV expert Dr. Chloe Orkin at Queen Mary University of London and the researcher who led the work.She and her colleagues also described the findings in The Lancet on Tuesday.

The outbreak of mpox began to unfold last May.Although the number of cases has slowed to a trickle in most regions, it has so far affected around 86,000 people in 110 countries and killed 92. Several studies have estimated that 40-50% of those infected are living with HIV.< /p>

When antiretroviral drugs prevent H.I.V. under control, mpox is about as dangerous as it is for those who are not infected with H.I.V. infection. But a C.D.C. A study last year, along with observations of previous outbreaks in Nigeria, indicated that mpox was more severe and significantly more deadly in people with high levels of HIV.

In the new study, an international group of clinicians followed 382 adults in 28 countries who had advanced HIV. disease and were infected with mpox. They analyzed the amount of H.I.V. and CD4 cell count, a type of immune system cell, in these patients.

The typical range of CD4 cells is 500 to 1,500 per cubic millimeter of blood. The 27 deaths in the study involved people who had fewer than 200 CD4 cells. Mpox killed almost 30% of people with less than 100 CD4 cells.

The nature of the disease was also very different in patients with weakened immune systems . While most people infected with mpox show lesions only at the site of exposure, those with advanced HIV. developed large ulcerated lesions teeming with virus all over his body.

"It's on the back, it's on the feet, it's in the eyes, it's everywhere - it's horrifying," says Dr Orkin. "This is because the immune system is not able to contain the virus at all."

Many patients also had nodules in the lungs which caused a acute respiratory distress, she added.< /p>

Added mpox to the list of opportunistic infections in people with advanced HIV. would encourage health workers to identify and prioritize patients most at risk of serious illness and death.

Patients would need antibiotics to prevent further infections opportunists and should receive two doses of the vaccine injected under the skin, rather than between the layers of the skin as is currently done, Dr. Orkin said.

The United States has added mpox to the list of possible infections in people living with H.I.V. in September. The World Health Organization plans to discuss doing the same over the coming months, said Dr Meg Doherty, director of global programs on HIV, hepatitis and sexually transmitted infections at WHO

New data makes a "compelling argument" for adding mpox to the list of opportunities...