Multisite Mpox Infection and Viral Dynamics Among Persons With HIV in Metro Atlanta.

Area of Science:

• Infectious Diseases
• Virology
• Public Health

Background:

• The 2022 mpox outbreak predominantly spread through sexual contact among men who have sex with men.
• Individuals with human immunodeficiency virus (HIV) were disproportionately affected during the mpox outbreak.

Purpose of the Study:

• To investigate the viral dynamics and clinical characteristics of mpox infection in a cohort of individuals with HIV.
• To understand mpox viral shedding across different anatomic sites in people with HIV.

Main Methods:

• Evaluation of mpox cases at a comprehensive HIV clinic in Atlanta, Georgia.
• Detection of mpox viral DNA in oropharyngeal and anorectal specimens using polymerase chain reaction (PCR).
• Analysis of cycle threshold (Ct) values to assess viral load at various anatomic sites.

Main Results:

• Mpox viral DNA was identified in 8 oropharyngeal and 5 anorectal specimens from 10 confirmed mpox cases.
• The site with the lowest Ct value (indicating higher viral load) varied among participants.
• Lower Ct values were observed in oropharyngeal and anorectal swabs when symptoms were present at those sites.

Conclusions:

• Mpox can infect and replicate across multiple anatomic sites, including the oropharynx and anorectum, in individuals with HIV.
• Symptom presence may correlate with higher viral loads at specific anatomic sites.
• Findings provide crucial insights into mpox pathogenesis and transmission dynamics within the HIV-positive population.