{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:53:57Z","timestamp":1790927637574,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV causes immunosuppression by targeting CD4+\u2009T lymphocytes, which may influence susceptibility and clinical outcomes of coinfections such as the Mpox virus (MPXV). Despite conflicting evidence, understanding the relationship between CD4 counts and MPXV severity in people living with HIV (PLWH) remains critical. This study systematically reviews and meta\u2010analyzes available evidence to elucidate this association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, a comprehensive search from a variety of databases was conducted for studies published between January 2014 and August 2025. Inclusion criteria encompassed observational studies reporting on HIV and MPXV co\u2010infection with data on CD4 counts and clinical outcomes. Six studies, including 1254 participants, were included. Data extraction focused on immune parameters, disease severity, and clinical manifestations. The Newcastle\u2013Ottawa Scale assessed study quality, and meta\u2010analyses evaluated pooled associations, heterogeneity, and publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Meta\u2010analysis revealed no statistically significant association between CD4 counts and MPXV disease severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.1072). The pooled mean CD4 count was 692.38 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      (95% CI: 647.73 to 737.03). Most HIV\u2010positive patients, particularly those on ART, experienced mild disease courses with favorable outcomes, with no mortality reported. Although there was a trend indicating that lower CD4 counts (&lt;\u2009200 or 500 cells\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ) might be associated with increased complications, these differences were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CD4 count alone was not found to be a statistically significant factor associated with MPXV severity among HIV\u2010coinfected individuals on ART. Effective viral suppression and immune reconstitution through ART appear protective, emphasizing the need to prioritize ART adherence over reliance on CD4 metrics and validation in well\u2010designed prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73016","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:12:02Z","timestamp":1786335122000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CD4 Count and Clinical Outcomes of Mpox in People Living With HIV: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2946-2668","authenticated-orcid":false,"given":"Kesaobaka","family":"Batisani","sequence":"first","affiliation":[{"name":"Department of Public Health School of Medicine and Health Sciences, University of Lusaka Lusaka 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Sciences, Faculty of Health Sciences and Technology University of Jos Jos Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9389-995X","authenticated-orcid":false,"given":"Ronald","family":"Simusokwe","sequence":"additional","affiliation":[{"name":"Department of Public Health School of Medicine and Health Sciences, University of Lusaka Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7282-9166","authenticated-orcid":false,"given":"Misheck","family":"Chileshe","sequence":"additional","affiliation":[{"name":"Department of Public Health School of Medicine and Health Sciences, University of Lusaka Lusaka Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8103-8363","authenticated-orcid":false,"given":"Dike Ujunwa","family":"Precious","sequence":"additional","affiliation":[{"name":"Faculty of Pharmaceutical Sciences University 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