{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:44:44Z","timestamp":1790729084917,"version":"4.1.0"},"update-to":[{"DOI":"10.12688\/f1000research.130272.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000}}],"reference-count":123,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>The World Health Organization (WHO) proclaimed a public health emergency in July 2022 due to the emergence of Mpox (formerly monkeypox) while the globe was still dealing with the COVID-19 epidemic. The characteristics of mpox in immunocompetent individuals are well-characterized, despite difficulties in diagnostics, immunization, and access to treatment that persist in low-income countries. Patients with weakened immune systems are more likely to spread an illness and die from it than healthy people because they cannot mount a protective immune response against it, such as a neutralizing IgG and poxvirus-specific Th1 response. A health warning on severe mpox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advice does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as \u201chaving autoimmune disease with immunodeficiency as a clinical component\u201d. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, \u201cof the people with severe mpox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells\/ml, indicating substantial immunosuppression\u201d. However, new cases are still expected to be discovered, especially in low-income countries with limited access to diagnosis, treatment, and prevention, and where a large percentage of the mpox-infected population also has advanced HIV infection. Thus, further research is always needed to determine the best way to treat mpox in immunocompromised people. In this context, we discussed \/reviewed the mpox clinical presentation, available treatment options and current preventive guidelines in immunocompromised patients.<\/ns4:p>","DOI":"10.12688\/f1000research.130272.2","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T13:50:05Z","timestamp":1680529805000},"page":"127","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":62,"title":["Monkeypox (mpox) in\u00a0immunosuppressed patients"],"prefix":"10.12688","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8361-0546","authenticated-orcid":false,"given":"Sirwan Khalid","family":"Ahmed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7041-444X","authenticated-orcid":false,"given":"Mona Gamal","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Abdelaziz","family":"Dabou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israa","family":"Abuijlan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9873-6969","authenticated-orcid":false,"given":"Deepak","family":"Chandran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahed A.","family":"El-Shall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitesh","family":"Chopra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7469-4752","authenticated-orcid":false,"given":"Kuldeep","family":"Dhama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"15-25","DOI":"10.1016\/S1473-3099(03)00856-9","article-title":"Human monkeypox: an emerging zoonosis.","volume":"4","author":"D Di Giulio","year":"2004","journal-title":"Lancet Infect. 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The article has given authoritative references for different figures and all the data has been comprehensively put forward and has a natural flow and coherence. The figure is well made and is up to mark. Answer: Authors are very thankful to the reviewer for devoting time for improving the quality of the manuscript. The inputs and suggestions from the reviewer have been taken under consideration and have been implemented in the manuscript.  However, I would like to recommend to add more details on the underlying mechanisms of pathophysiological details in immunocompromised individuals. Moreover, the current epidemiological status of monkeypox needs to be more stressed in the introduction1,2,3. Answer: The authors have updated the manuscript using the information gathered from following references  References 1. Saeed S, Shabbir H, Basit J, Ur Rehman ME: Monkeypox: Potentially another pandemic or a mere hoax?. Ann Med Surg (Lond). 2022; 81: 104364 PubMed Abstract | Publisher Full Text 2. Beer EM, Rao VB: A systematic review of the epidemiology of human monkeypox outbreaks and implications for outbreak strategy.PLoS Negl Trop Dis. 2019; 13 (10): e0007791 PubMed Abstract | Publisher Full Text 3. Bunge EM, Hoet B, Chen L, Lienert F, et al.: The changing epidemiology of human monkeypox-A potential threat? A systematic review.PLoS Negl Trop Dis. 2022; 16 (2): e0010141 PubMed Abstract | Publisher Full Text 4. Jang W, Kandimalla L, Rajan S, Abreu R, Campos JE. Monkeypox in an immunocompromised patient with underlying human immunodeficiency virus and syphilis infections in Southern Florida of the United States: a case report. AIDS Res Ther. 2023 Feb 18;20(1):12. doi: 10.1186\/s12981-023-00504-4. PMID: 36800970; PMCID: PMC9937856. 5. Dammann F, Raja M, Camargo JF. Progression of human monkeypox infection despite tecovirimat in an immunocompromised adult. Transpl Infect Dis. 2023 Feb;25(1):e14022. doi: 10.1111\/tid.14022. Epub 2023 Jan 30. PMID: 36714983 6. Sharma V, Aggarwal D, Sharma AK, et al. An overview on Monkeypox, Current Paradigms and Advances in its Vaccination, Treatment and Clinical Management: Trends, Scope, Promise and Challenges.&nbsp;\n<i>J Pure Appl Microbiol.&nbsp;<\/i>2022;16(suppl 1):3000-3012\n<i>.&nbsp;<\/i>doi: 10.22207\/JPAM.16.SPL1.21 7. Sharma V, Panwar A, Garg VK, et al. Tecovirimat as a Potential Bioavailable Iinhibitor against MPXVgp158 Established through Molecular Dynamic Simulations and Docking Studies.&nbsp;\n<i>J Pure Appl Microbiol<\/i>. 2022;16(suppl 1):3168-3178. doi: 10.22207\/JPAM.16.SPL1.13 8. Chandran D, Nandanagopal VG, Gopan M, et al. Major Advances in Monkeypox Vaccine Research and Development \u2013 An Update.&nbsp;\n<i>J Pure Appl Microbiol.&nbsp;<\/i>2022;16(suppl 1):3083-3095. doi: 10.22207\/JPAM.16.SPL1.0 9. Chandran D, Hridya P, Prasanth D, et al. Changing Patterns in the Spread of Human Monkeypox: A Dangerous New Development in Disease Epidemiology.&nbsp;\n<i>J Pure Appl Microbiol.&nbsp;<\/i>2022;16(suppl 1):3106-3118. doi: 10.22207\/JPAM.16.SPL1.11 &nbsp;10. Thornhill JP, Barkati S, Walmsley S, et al. Monkeypox virus infection in humans across 16 countries: April\u2013June 2022. N Engl J Med. 2022;387(8):679-691. doi:10.1056\/NEJMoa2207323 11. Sigler R, Haidar G. Mpox in immunocompromised patients: with more data, more questions. Transpl Infect Dis. 2023 Feb;25(1):e14023. doi: 10.1111\/tid.14023. Epub 2023 Jan 30. PMID: 36714963. 12. Mitj&agrave; O, Ogoina D, Titanji BK, Galvan C, Muyembe JJ, Marks M, Orkin CM. Monkeypox. Lancet. 2023 Jan 7;401(10370):60-74. doi: 10.1016\/S0140-6736(22)02075-X. Epub 2022 Nov 17. Erratum in: Lancet. 2022 Dec 3;400(10367):1926. PMID: 36403582; PMCID: PMC9671644.","URL":"https:\/\/f1000research.com\/articles\/12-127\/v2#referee-comment-9497","order":1,"name":"referee-comment-9497","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.146045.r168602, Osaretin Okonji, School of Pharmacy, University of the Western Cape, Cape Town, 13 Apr 2023, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-127\/v2#referee-response-168602","order":2,"name":"referee-response-168602","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.146045.r168603, Dattatreya Mukherjee, International School, Jinan University, Guangzhou, 18 Apr 2023, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/12-127\/v2#referee-response-168603","order":3,"name":"referee-response-168603","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}