People living with HIV who have monkeypox are hospitalized more than twice as often as other patients diagnosed with the rapidly spreading virus, according to a study by the Centers for Disease Control and Prevention.
In a report released Thursday, the CDC found that 38 percent of nearly 2,000 people diagnosed with monkeypox between May and July were living with HIV. Among the 1,300 monkeypox patients with more detailed clinical data, 8% of HIV-positive individuals were hospitalized compared with 3% of people without HIV infection.
The CDC found that HIV-positive individuals, particularly with low T-cell counts, indicating a weaker immune system, and in whom the virus is not suppressed, are hospitalized more frequently with monkeypox.
But data on the reason for hospitalization is incomplete, so it’s not known whether HIV-positive people admitted to hospital with monkeypox suffer from more serious illnesses, according to the CDC. People who have lived with HIV in previous monkeypox outbreaks in Nigeria have had poor results.
Monkeypox is mainly spread during sex between gay and bisexual men, although anyone can contract the virus through close physical contact with someone who is infected or contaminated materials such as towels and sheets.
Men who have sex with men have HIV infections more often than the general population, according to the CDC. But 38 percent of monkeypox patients who also have HIV is much higher than the rate seen among the larger population of gay and bisexual men, according to the study.
The percentage of monkeypox patients who have HIV has also increased over time, suggesting that monkeypox may be spreading more in networks of people who have HIV, according to the agency.
The CDC found a large racial disparity between people who have HIV and monkeypox. Black and Hispanic patients had monkeypox and HIV at a much higher rate – 63% and 41%, respectively – compared to white patients at 28%.
Monkeypox has a disproportionate impact on Black and Hispanic populations. Nearly 38 percent of monkeypox patients are black, 29 percent are Hispanic, and 27 percent are white, according to data from the CDC. The overall US population is 12 percent black, 19 percent Hispanic, and 61 percent white, according to 2020 census data.
People with HIV who also have monkeypox report some symptoms more often such as rectal pain and proctitis. Monkeypox causes a rash, resembling pimples or blisters, which often develops on sensitive areas such as the anus or genitals.
CDC officials who wrote the study said monkeypox vaccination should be a priority for people who are HIV-positive and who have other sexually transmitted infections.
People evaluated for monkeypox should also undergo screening for HIV and STI, the authors said. About 41 percent of monkeypox patients have been diagnosed with one or more sexually transmitted diseases in the past year, according to the CDC study. Healthcare professionals should also offer patients drugs such as PrEP, which helps reduce the risk of contracting HIV through sex.
The CDC has estimated that 1.6 million gay and bisexual men who are HIV-positive or who are taking medications to reduce their risk of getting HIV face the highest threat of monkeypox. More than 460,000 doses of monkeypox vaccine have been administered so far. Officials from the Department of Health and Human Services said the United States is nearing the point where there are enough doses available to fully vaccinate the highest-risk population.
The United States is battling the largest monkeypox epidemic in the world, with more than 21,000 cases reported in all 50 states, Washington DC and Puerto Rico, according to data from the CDC. White House health officials said Wednesday that the outbreak appears to be slowing as vaccinations rise, although racial disparity in people diagnosed with monkeypox is growing.