BACKGROUND: The new mpox outbreak extending worldwide is mostly affecting gays and other men who have sex with men, and people living with HIV/AIDS (PLWHA). There are limited data on mpox and PLVHA. This study aims to describe and compare the demographic and clinical characteristics of mpox cases according to HIV/AIDS status in Brazil.
METHODS: We conducted a cross-sectional study using data obtained from the mpox and HIV/AIDS MoH national databases in Brazil. We included confirmed and probable mpox cases aged 15 and over reported to the MoH systems between June 7th and December 31st, 2022, according to the case definition adopted in the country. Descriptive statistics and Chi-square tests were used to compare sociodemographic and clinical characteristics for PLWHA, and HIV-negative people or unknown status (HIV-).
RESULTS: As of December 2022, 10,046 confirmed and probable mpox cases were included in this study, out of those 46%(4,657) were HIV positive. The median age was 32 (IQR:27-38), 73%(7,235) were cisgender males, and 64% were gays and other men who have sex with men (MSM). Among those PLWHA, the median age was slightly higher (34yo,IQR:29-38), 79% (3,620) were cisgender male, and 70%(3,232) were MSM. STIs were more frequent among PLWHA (n=710;15%) than HIV- people (n=372;7%) (p-value<0.001); 9%(416) PLWHA were diagnosed with syphilis at mpox notification, and 3%(165) among HIV- cases. Signs and symptoms were also significantly more prevalent among PLWHA: 93% presented at least one sign or symptom, and 58% presented rashes; among HIV- cases proportions were 90% and 51%, respectively. 5.3%(246) PLWHA and 4.5%(243) HIV- or unknown-status cases were hospitalized. Twelve deaths due to mpox and 13 due to other causes were registered; 11 and five, respectively, among PLWHA.
CONCLUSIONS: This study has shown a high frequency of HIV/AIDS among mpox cases reported in Brazil. PLWHA had more STIs, signs and symptoms, complications, hospitalization, and deaths. These results highlight the importance of reorganizing health services and investing in professional capacity building to face the mpox outbreak, especially in HIV/AIDS and other STI services. Furthermore, it reinforces the need to plan prevention strategies, including vaccination against mpox, specifically targeted at this population.

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