The impact of human immunodeficiency virus coinfection on mpox patients during the 2022 global outbreak: a systematic review and meta-analysis based on comparative observational studies

BACKGROUND: The mpox outbreak in 2022 posed a new challenge to the medical system. We aimed to study the impact of human immunodeficiency virus (HIV) coinfection on mpox patients. METHODS: This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: Our study included 27 articles for meta-analysis and divided mpox patients into two groups: one group was HIV-positive, and the other group was HIV-negative. We found that the age of HIV-positive patients was significantly greater than that of HIV-negative patients (SMDƒ__=ƒ__0.35, 95% CI: 0.29-0.41) and that there were more men who had sex with men in the HIV-positive group (ORƒ__=ƒ__3.98, 95% CI: 3.04-5.21). Syphilis (ORƒ__=ƒ__2.66, 95% CI: 2.13-3.33), hepatitis B (ORƒ__=ƒ__3.94, 95% CI: 2.93-5.30), hepatitis C (ORƒ__=ƒ__5.71, 95% CI: 3.06-10.64), proctitis (ORƒ__=ƒ__1.52, 95% CI: 1.17-1.98), fever (ORƒ__=ƒ__1.15, 95% CI: 1.01-1.30), diarrhea (ORƒ__=ƒ__1.69, 95% CI: 1.03-2.77) and pustules (ORƒ__=ƒ__1.33, 95% CI: 1.08-1.62) were more common among HIV-positive patients. HIV coinfection seemed to be associated with a decrease in the CD4(+) T-cell count (SMDƒ__=ƒ__-0.78, 95% CI: -1.34 to -0.23) and hemoglobin (SMDƒ__=ƒ__-0.43, 95% CI: -0.64 to -0.22) and albumin (SMDƒ__=ƒ__-0.35, 95% CI: -0.55 to -0.15) levels, whereas the CD8(+) T-cell count yielded the opposite statistical conclusion (SMDƒ__=ƒ__0.35, 95% CI: 0.03-0.67). We also found that HIV-positive patients had more hospitalizations (ORƒ__=ƒ__1.63, 95% CI: 1.22-2.19), more severe mpox (ORƒ__=ƒ__1.82, 95% CI: 1.28-2.58), more need for tecovirimat treatment (ORƒ__=ƒ__4.25, 95% CI: 1.59-11.4), and higher mortality (ORƒ__=ƒ__3.36, 95% CI: 1.15-9.83). CONCLUSION: Overall, HIV coinfection may influence the disease process and clinical indicators of mpox patients and is associated with more severe clinical outcomes. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251056729, PROSPERO registration number: CRD420251056729

• Population(s)
  • General HIV+ population
  • General HIV- population
• Co-infections
  • Other