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Tecovirimat Treatment of Mpox in People With HIV

During the summer of 2022, the HIV status of people with mpox did not seem to affect treatment outcomes with tecovirimat, researchers report. “Although it remains unclear how the incidence and demographic features of the current mpox outbreak will develop going forward, the current scenario requires better understanding of both disease and treatment in those persons who bear the greatest burden of disease to date—primarily [men who have sex with men and people living with HIV],” the authors conclude. “Tecovirimat is a promising treatment whose efficacy will hopefully be borne out in future rigorous studies.”

The use of the novel antiviral agent in 196 people at 2 academic medical centers in New York City was evaluated retrospectively. A total of 154 people tested positive for mpox (MPXV), and 72 of these were people with HIV (PWH). “Indications for tecovirimat treatment were similar between the PWH and HIV-negative groups,” the authors write. “Four participants had serious adverse events; none were attributed to tecovirimat. Three of these 4 participants had HIV infection, and 2 had CD4 counts less than 0.20 × 109 cells/L. Twenty-two percent of participants had nonsevere adverse effects. Groups had similar rates of hospitalization, indications for treatment, and co-occurring infections, but PWH had fewer days from symptom onset to treatment (7.5 vs. 10). There was no difference in treatment outcomes, including days to improvement or rate of persistent symptoms.”

Source: Annals of Internal Medicine