Severe Mpox Among People With Advanced Human Immunodeficiency Virus Receiving Prolonged Tecovirimat in New York City

Elizabeth A Garcia; Mary M K Foote; Tristan D McPherson; Maura K Lash; Amma N Bosompem; Alyssa Bouscaren; Justin Chan; Madeline A DiLorenzo; Dennis Feihel; Randal C Fowler; Vani Gandhi; Elizabeth R Jenny-Avital; Erik J Kopping; Dana Mazo; Jacob McLean; Ofole Mgbako; Mark N Sayegh; Raphael N Shaw; Michelle Su; Jeanne Sullivan Meissner; Jade C Wang; Wendy Wen; John C Winters; Cosmina B Zeana; Jason Zucker; Marcia Wong

doi:10.1093/ofid/ofae294

Severe Mpox Among People With Advanced Human Immunodeficiency Virus Receiving Prolonged Tecovirimat in New York City

Open Forum Infect Dis. 2024 May 17;11(6):ofae294. doi: 10.1093/ofid/ofae294. eCollection 2024 Jun.

Authors

Elizabeth A Garcia¹, Mary M K Foote¹, Tristan D McPherson¹, Maura K Lash¹, Amma N Bosompem², Alyssa Bouscaren³, Justin Chan^{4

5}, Madeline A DiLorenzo⁴, Dennis Feihel⁶, Randal C Fowler¹, Vani Gandhi⁷, Elizabeth R Jenny-Avital⁸, Erik J Kopping¹, Dana Mazo⁴, Jacob McLean⁹, Ofole Mgbako^{4

5

10}, Mark N Sayegh^{11

12}, Raphael N Shaw^{11

12}, Michelle Su¹, Jeanne Sullivan Meissner¹, Jade C Wang¹, Wendy Wen¹, John C Winters^{7

13}, Cosmina B Zeana¹⁴, Jason Zucker⁹, Marcia Wong¹

Affiliations

¹ Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, New York, USA.
² Human Resources Administration, New York City Department of Social Services, New York, New York, USA.
³ Department of Homeless Services, New York City Department of Social Services, New York, New York, USA.
⁴ Division of Infectious Diseases and Immunology, New York University Grossman School of Medicine, New York, New York, USA.
⁵ Department of Internal Medicine and Infectious Diseases, NYC Health + Hospitals/Bellevue, New York, New York, USA.
⁶ Lenox Hill Hospital Department of Medicine, Northwell Health, New York, New York, USA.
⁷ Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁸ Division of Infectious Diseases, NYC Health + Hospitals/Jacobi, Bronx, New York, USA.
⁹ Division of Infectious Diseases, New York Presbyterian Hospital, Columbia University, New York, New York, USA.
¹⁰ New York University Langone Institute for Excellence in Health Equity, NYU Langone Health, New York, New York, USA.
¹¹ Division of Infectious Diseases, NYC Health + Hospitals/Harlem, New York, New York, USA.
¹² Division of Infectious Diseases, Columbia University, New York, New York, USA.
¹³ Department of Internal Medicine and Infectious Diseases, NYC Health + Hospitals/Elmhurst, Queens, New York, USA.
¹⁴ Division of Infectious Diseases, BronxCare Health System, Bronx, New York, USA.

Abstract

Severe mpox has been observed in people with advanced human immunodeficiency virus (HIV). We describe clinical outcomes of 13 patients with advanced HIV (CD4 <200 cells/μL), severe mpox, and multiorgan involvement. Despite extended tecovirimat courses and additional agents, including vaccinia immune globulin, cidofovir, and brincidofovir, this group experienced prolonged hospitalizations and high mortality.

Keywords: HIV/AIDS; immunocompromise; mortality; mpox treatment; tecovirimat.

Grants and funding

T32 AI100852/AI/NIAID NIH HHS/United States