疾病預防控制中心的研究顯示，患有猴痘的愛滋病毒陽性者住院治療的頻率更高
資料來源：斯賓塞·金博爾 / 2022 年 9 月 8 日 / CNBC / 財團法人台灣紅絲帶基金會編譯
關鍵點
• CDC 發現，在 5 月至 7 月間被診斷出患有猴痘的近 2,000 人中，有 38% 感染了 HIV。
• 在擁有更詳細臨床數據的 1,300 名猴痘患者中，8% 的 HIV 陽性患者住院，而未感染 HIV 的患者為 3%。
• CDC 表示猴痘可能在 HIV 感染者中傳播得更多。
2022 年 8 月 3 日，洛杉磯縣公共衛生部門在加利福尼亞州西好萊塢的西好萊塢圖書館開設了一臨時性猴痘疫苗接種診所，衛生工作者坐在登記台前。馬里奧.多摩 |蓋蒂圖片社
根據疾病控制和預防中心的一項研究，感染猴痘的 HIV 感染者住院的頻率是其他被診斷為感染這種迅速傳播的病毒的患者的兩倍多。
在周四發布的一份報告中，疾病預防控制中心發現，在 5 月至 7 月期間被診斷出患有猴痘的近 2,000 人中，有 38% 感染了愛滋病毒。在 1,300 名具有更詳細臨床數據的猴痘患者中，8% 的 HIV 陽性個體住院治療，而未感染 HIV 的人為 3%。
CDC 發現 HIV 陽性個體，尤其是 T 細胞計數低的個體，這表明免疫系統較弱，並且病毒未被抑制的人更頻繁地因猴痘而住院。
但根據疾病預防控制中心的說法，關於住院原因的數據不完整，因此尚不清楚因猴痘住院的 HIV 陽性患者是否患有更嚴重的疾病。但在奈及利亞之前爆發的猴痘疫情中，愛滋病病毒感染者的結果確實很差。
猴痘主要在男同性戀和雙性戀男性的性行為中傳播，但任何人都可以透過與被感染者或被污染的材料（如毛巾和床單）進行密切的身體接觸來感染病毒。
根據疾病預防控制中心的數據，與男性發生性關係的男性比普通人群更容易感染愛滋病毒。但研究發現，38% 的猴痘患者同時感染 HIV，遠高於在更廣泛的男同性戀和雙性戀男性人群中觀察到的比例。
據該機構稱，感染愛滋病毒的猴痘患者的百分比也隨著時間的推移而增加，這顯示猴痘可能在愛滋病毒感染者網絡中傳播得更多。
疾病預防控制中心發現愛滋病毒和猴痘感染者之間存在重大種族差異。黑人和西班牙裔患者的猴痘和 HIV 感染率分別為 63% 和 41%，遠高於白人患者的 28%。
猴痘對黑人和西班牙裔人口的影響尤為嚴重。根據疾病預防控制中心的數據，近 38% 的猴痘患者是黑人，29% 是西班牙裔，27% 是白人。根據 2020 年人口普查的數據，美國總人口為 12% 的黑人、19% 的西班牙裔和 61% 的白人。
患有猴痘的 HIV 感染者更經常報告一些症狀，例如直腸疼痛和直腸炎。猴痘會引起皮疹，類似於丘疹或水泡，通常在肛門或生殖器等敏感區域發展。
撰寫該研究的 CDC 官員表示，應該優先為 HIV 陽性和患有其他性傳播感染的人接種猴痘疫苗。
作者說，接受猴痘評估的人也應該接受 HIV 和 STI 篩查。根據疾病預防控制中心的研究，在過去一年中，約 41% 的猴痘患者被診斷出患有一種或多種性傳播感染。醫療保健提供者還應為患者提供藥物，例如 PrEP，這有助於降低透過性行為感染 HIV 的風險。
疾病預防控制中心估計，160 萬愛滋病毒陽性或正在服用藥物以降低感染愛滋病毒風險的男同性戀和雙性戀男性，他們面臨猴痘的威脅最大。迄今為止，已經接種了超過 460,000 劑猴痘疫苗。衛生與公眾服務部官員表示，美國正在接近有足夠劑量為高危人群完全接種疫苗的地步。
根據疾病預防控制中心的數據，美國正在與世界上最大的猴痘疫情作鬥爭，在所有 50 個州、華盛頓特區和波多黎各報告了超過 21,000 例病例。白宮衛生官員周三表示，隨著疫苗接種的增加，疫情似乎正在放緩，儘管被診斷患有猴痘的人的種族差異正在擴大。
HIV-positive people who have monkeypox are hospitalized more often, CDC study says
Spencer Kimball / SEP 8 2022 / CNBC
KEY POINTS
•The CDC found that 38% of nearly 2,000 people diagnosed with monkeypox between May and July were living with HIV.
•Among 1,300 monkeypox patients with more detailed clinical data, 8% of HIV positive individuals were hospitalized compared to 3% of people without HIV infection.
•The CDC said monkeypox might be spreading more among people who have HIV.
Health workers sit at a check-in table at a pop-up monkeypox vaccination clinic which opened today by the Los Angeles County Department of Public Health at the West Hollywood Library on August 3, 2022 in West Hollywood, California.
Mario Tama | Getty Images
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 from the Centers for Disease Control and Prevention.
In a report published Thursday, the CDC found that 38% of nearly 2,000 people diagnosed with monkeypox between May and July were living with HIV. Among 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 in particular with low T-cell counts, which indicates 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 unknown whether HIV-positive people hospitalized with monkeypox are suffering from more severe disease, according to the CDC. People living with HIV in previous monkeypox outbreaks in Nigeria did have poor outcomes.
Monkeypox is primarily spreading during sex among gay and bisexual men, though anyone can catch the virus through close physical contact with someone who is infected or contaminated materials such as towels and bedsheets.
Men who have sex with men have HIV infections more often than the general population, according to the CDC. But the 38% of monkeypox patients who also have HIV is far higher than than the rate observed among the broader population of gay and bisexual men, the study found.
The percentage of monkeypox patients who have HIV has also increased over time, which suggests monkeypox may be spreading more in networks of people who have HIV, according to the agency.
The CDC found a major racial disparity among people who have HIV and monkeypox. Black and Hispanic patients had monkeypox and HIV at a far higher rate – 63%, and 41% – respectively, than white patients at 28%.
Monkeypox is disproportionately impacting Black and Hispanic populations. Nearly 38% of monkeypox patients are Black, 29% are Hispanic and 27% are white, according to CDC data. The overall U.S. population is 12% Black, 19% Hispanic and 61% White, according to data from the 2020 Census.
People with HIV who also have monkeypox are reporting some symptoms more often such as rectal pain and proctitis. Monkeypox causes a rash, which resembles pimples or blisters, that often develops on sensitive areas such as the anus or genitals.
The CDC officials who authored the study said vaccination against monkeypox should be prioritized for people who are HIV-positive and who have other sexually transmitted infections.
People evaluated for monkeypox should also undergo HIV and STI screening, the authors said. Some 41% of monkeypox patients were diagnosed with one or more STIs over the past year, according to the CDC study. Health-care providers should also offer patients medication such as PrEP, which helps lower the risk of getting HIV through sex.
The CDC has estimated that 1.6 million gay and bisexual men who are HIV-positive or who are taking medication to reduce their risk of HIV face the highest threat from monkeypox. More than 460,000 monkeypox vaccine doses have been administered so far. Department of Health and Human Services officials have said the U.S. is approaching the point where there are enough doses available to fully vaccinate the highest-risk population.
The U.S. is battling the largest monkeypox outbreak in the world, with more than 21,000 cases reported across all 50 states, Washington D.C., and Puerto Rico, according to CDC data. White House health officials said Wednesday that the outbreak appears to be slowing as vaccinations ramp up, though the racial disparity in people diagnosed with monkeypox is growing.