The impact of HIV coinfection on mpox patients: a systematic review and meta-analysis
Abstract
A substantial proportion of mpox cases occur in people with HIV, but how HIV coinfection and immune status affect clinical outcomes remains unclear. We systematically searched major databases up to March 2025 for observational studies comparing mpox patients with and without HIV coinfection. Pooled effect sizes were calculated using random-effects models. Risk ratios (RRs) or standardized mean differences (SMDs) with 95% confidence intervals were used for dichotomous or continuous outcomes. Post hoc subgroup analyses explored differences by economic development, viral suppression, and advanced HIV disease (AHD) proportion. Among 15,522 patients from 29 studies, 52.43% had HIV. HIV coinfection was associated with higher hospitalization [RR = 1.50, 95% CI (1.17, 1.93)] and mortality [RR = 4.54, 95% CI (2.11, 9.77)]. Coinfected patients had more syphilis, HBV, and HCV coinfections, and higher rates of fever, proctitis, malaise, rectal irritation syndrome, diarrhoea, skin and soft tissue infections, and pneumonia. Blood tests showed lower albumin, calcium, and haemoglobin, and higher CK-MB. Perianal lesions were more common with HIV. HIV coinfection is linked to greater clinical severity, mortality, and STI coinfections. Exploratory analyses suggest poor viral suppression may drive adverse outcomes, and lesion severity relates to immune status. All subgroup findings are post hoc and hypothesis-generating, limited by aggregate data. Intensified monitoring and supportive care,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 15,522 participants or records.
Read the paper
Related studies
- Biportal endoscopic versus microscopic lumbar decompressive laminectomy in patients with spinal stenosis: A randomized controlled trial
- A whey protein-based multi-ingredient nutritional supplement stimulates gains in lean body mass and strength in healthy older men: A randomized controlled trial
- Supplement-based nutritional strategies to tackle frailty: A multifactorial, double-blind, randomized placebo-controlled trial
- A randomized, double-blind, placebo-controlled, proof-of-concept trial of creatine monohydrate as adjunctive treatment for bipolar depression
- Creatine supplementation (3 g/day) and bone health in older women: a 2-year, randomized, placebo-controlled trial
- A Multi-Ingredient Nutritional Supplement in Combination With Resistance Exercise and High-Intensity Interval Training Improves Cognitive Function and Increases N-3 Index in Healthy Older Men: A Randomized Controlled Trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.