{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:18:34Z","timestamp":1787026714670,"version":"build-2736575974"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The mpox outbreak in 2022 posed a new challenge to the medical system. We aimed to study the impact of human immunodeficiency virus (HIV) coinfection on mpox patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our study included 27 articles for meta-analysis and divided mpox patients into two groups: one group was HIV-positive, and the other group was HIV-negative. We found that the age of HIV-positive patients was significantly greater than that of HIV-negative patients (SMD\u202f=\u202f0.35, 95% CI: 0.29\u20130.41) and that there were more men who had sex with men in the HIV-positive group (OR\u202f=\u202f3.98, 95% CI: 3.04\u20135.21). Syphilis (OR\u202f=\u202f2.66, 95% CI: 2.13\u20133.33), hepatitis B (OR\u202f=\u202f3.94, 95% CI: 2.93\u20135.30), hepatitis C (OR\u202f=\u202f5.71, 95% CI: 3.06\u201310.64), proctitis (OR\u202f=\u202f1.52, 95% CI: 1.17\u20131.98), fever (OR\u202f=\u202f1.15, 95% CI: 1.01\u20131.30), diarrhea (OR\u202f=\u202f1.69, 95% CI: 1.03\u20132.77) and pustules (OR\u202f=\u202f1.33, 95% CI: 1.08\u20131.62) were more common among HIV-positive patients. HIV coinfection seemed to be associated with a decrease in the CD4\n                      <jats:sup>+<\/jats:sup>\n                      T-cell count (SMD\u202f=\u202f\u22120.78, 95% CI: \u22121.34 to \u22120.23) and hemoglobin (SMD\u202f=\u202f\u22120.43, 95% CI: \u22120.64 to \u22120.22) and albumin (SMD\u202f=\u202f\u22120.35, 95% CI: \u22120.55 to \u22120.15) levels, whereas the CD8\n                      <jats:sup>+<\/jats:sup>\n                      T-cell count yielded the opposite statistical conclusion (SMD\u202f=\u202f0.35, 95% CI: 0.03\u20130.67). We also found that HIV-positive patients had more hospitalizations (OR\u202f=\u202f1.63, 95% CI: 1.22\u20132.19), more severe mpox (OR\u202f=\u202f1.82, 95% CI: 1.28\u20132.58), more need for tecovirimat treatment (OR\u202f=\u202f4.25, 95% CI: 1.59\u201311.4), and higher mortality (OR\u202f=\u202f3.36, 95% CI: 1.15\u20139.83).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, HIV coinfection may influence the disease process and clinical indicators of mpox patients and is associated with more severe clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251056729<\/jats:ext-link>\n                      , PROSPERO registration number: CRD420251056729.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1751445","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T13:12:18Z","timestamp":1771593138000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The impact of human immunodeficiency virus coinfection on mpox patients during the 2022 global outbreak: a systematic review and meta-analysis based on comparative observational studies"],"prefix":"10.3389","volume":"17","author":[{"given":"Yingying","family":"Han","sequence":"first","affiliation":[{"name":"Department of Neurology, China-Japan Union Hospital of Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingzhao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, China-Japan Union Hospital of Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Infection Management Department of Hospital, China-Japan Union Hospital of Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Second Hospital of Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/S1473-3099(22)00662-4","article-title":"Immunological signature in human cases of monkeypox infection in 2022 outbreak: an observational study","volume":"23","author":"Agrati","year":"2023","journal-title":"Lancet Infect. 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Infect. Dis."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"233","DOI":"10.46234\/ccdcw2025.037","article-title":"Comparative analysis of epidemiological and clinical characteristics between mpox cases with and without HIV-China, 2023","volume":"7","author":"Jin","year":"2025","journal-title":"China CDC Wkly."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e29172","DOI":"10.1002\/jmv.29172","article-title":"Comparison of clinical course of Mpox among HIV-negative and HIV-positive patients: a 2022 cohort of hospitalized patients in Central Europe","volume":"95","author":"Kowalski","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref21","first-page":"593","article-title":"A human infection caused by monkeypox virus in Basankusu territory, Democratic Republic of the Congo","volume":"46","author":"Ladnyj","year":"1972","journal-title":"Bull. World Health Organ."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"5305","DOI":"10.2147\/IDR.S485232","article-title":"An epidemiological and clinical study of monkeypox in Changsha, China: a retrospective analysis of HIV-infected and non-HIV-infected patients from June to December 2023","volume":"17","author":"Li","year":"2024","journal-title":"Infect Drug Resist."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e19","DOI":"10.3346\/jkms","article-title":"Clinical features of mpox patients in Korea: a multicenter retrospective study","volume":"39","author":"Lim","year":"2024","journal-title":"J. Korean Med. Sci."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2459136","DOI":"10.1080\/22221751.2025.2459136","article-title":"Single-cell sequencing of peripheral blood mononuclear cells reveals immune landscape of monkeypox patients with HIV","volume":"14","author":"Liu","year":"2025","journal-title":"Emerg. Microbes Infect."},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1101\/2025.02.05.25321718","article-title":"Prevalence of HIV history and associated factors in people affected by mpox in Colombia, 2022","author":"Lozada","year":"2025","journal-title":"medRxiv"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2200471","DOI":"10.2807\/1560-7917.ES.2022.27.27.2200471","article-title":"Monkeypox outbreak predominantly affecting men who have sex with men, Madrid, Spain, 26 April to 16 June 2022","volume":"27","author":"Martinez","year":"2022","journal-title":"Euro Surveill."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"100859","DOI":"10.1016\/S2666-5247(24)00074-0","article-title":"Immune responses associated with mpox viral clearance in men with and without HIV in Spain: a multisite, observational, prospective cohort study","volume":"5","author":"Moraes-Cardoso","year":"2024","journal-title":"Lancet Microbe."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1097\/QAI.0000000000003407","article-title":"Clinical features and outcomes of mpox in people with and without HIV: a national comparative study","volume":"96","author":"Nunez","year":"2024","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"100392","DOI":"10.1016\/j.lana.2022.100392","article-title":"Epidemiological and clinical characteristics of patients with human monkeypox infection in Mexico: a nationwide observational study","volume":"17","author":"Nunez","year":"2023","journal-title":"Lancet Reg. Health Americas"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e210","DOI":"10.1093\/cid\/ciaa143","article-title":"Clinical course and outcome of human monkeypox in Nigeria","volume":"71","author":"Ogoina","year":"2020","journal-title":"Clin. Infect. 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Retrovir."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"102494","DOI":"10.1016\/j.jiph.2024.102494","article-title":"Epidemiological and clinical characteristics of monkeypox among people with and without HIV in Peru: a national observational study","volume":"17","author":"Ramirez-Soto","year":"2024","journal-title":"J. Infect. Public Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1093\/infdis\/jiy326","article-title":"Effects of treatment delay on efficacy of tecovirimat following lethal aerosol monkeypox virus challenge in cynomolgus macaques","volume":"218","author":"Russo","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref36","first-page":"B5176","article-title":"Syphilis and HIV co-infection. Epidemiology, treatment and molecular typing of Treponema pallidum","volume":"62","author":"Salado-Rasmussen","year":"2015","journal-title":"Dan. Med. 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Health Am."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"5077","DOI":"10.1016\/j.vaccine.2020.04.062","article-title":"Human monkeypox - after 40 years, an unintended consequence of smallpox eradication","volume":"38","author":"Simpson","year":"2020","journal-title":"Vaccine"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3390\/v16020225","article-title":"Clinical and epidemiological characteristics of Mpox in HIV-infected and uninfected men who have sex with men: a retrospective study in Lisbon","volume":"16","author":"Sousa","year":"2024","journal-title":"Viruses"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"e334","DOI":"10.1016\/S2352-3018(21)00072-2","article-title":"SARS-CoV-2 seroprevalence, and IgG concentration and pseudovirus neutralising antibody titres after infection, compared by HIV status: a matched case-control observational study","volume":"8","author":"Spinelli","year":"2021","journal-title":"Lancet HIV."},{"key":"ref44","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1111\/hiv.13622","article-title":"The effect of HIV and mpox co-infection on clinical outcomes: systematic review and meta-analysis","volume":"25","author":"Taha","year":"2024","journal-title":"HIV Med."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/S0140-6736(22)01436-2","article-title":"Clinical presentation and virological assessment of confirmed human monkeypox virus cases in Spain: a prospective observational cohort study","volume":"400","author":"Tarin-Vicente","year":"2022","journal-title":"Lancet"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1056\/NEJMoa2207323","article-title":"Monkeypox virus infection in humans across 16 countries - April-June 2022","volume":"387","author":"Thornhill","year":"2022","journal-title":"N. 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Methodol."},{"key":"ref50","year":""},{"key":"ref51","year":""},{"key":"ref52","year":""},{"key":"ref53","year":""},{"key":"ref54","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3760\/cma.j.issn.1674-2397.2023.04.005","article-title":"Clinical characteristics of monkeypox patients with HIV positive or HIV negative","volume":"9","author":"Yan","year":"2024","journal-title":"Chin. J. Clin. Infect. Dis."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1186\/s12879-024-09537-0","article-title":"Clinical features and viral load variations of mpox: a retrospective study in Chongqing, China","volume":"24","author":"Yang","year":"2024","journal-title":"BMC Infect. Dis."},{"key":"ref56","doi-asserted-by":"publisher","first-page":"1412753","DOI":"10.3389\/fcimb.2024.1412753","article-title":"Clinical characteristics, viral dynamics, and antibody response of monkeypox virus infections among men with and without HIV infection in Guangzhou, China","volume":"14","author":"Yang","year":"2024","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"695","DOI":"10.3760\/cma.j.cn311365-20230727-00013","article-title":"Clinical and laboratory characteristics of mpox patients in Guangzhou City","volume":"41","author":"Yang","year":"2023","journal-title":"Chin. J. Infect. Dis."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/S1473-3099(19)30294-4","article-title":"Outbreak of human monkeypox in Nigeria in 2017-18: a clinical and epidemiological report","volume":"19","author":"Yinka-Ogunleye","year":"2019","journal-title":"Lancet Infect. 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Zoonoses"}],"container-title":["Frontiers in Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1751445\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T13:12:21Z","timestamp":1771593141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmicb.2026.1751445\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":60,"alternative-id":["10.3389\/fmicb.2026.1751445"],"URL":"https:\/\/doi.org\/10.3389\/fmicb.2026.1751445","relation":{},"ISSN":["1664-302X"],"issn-type":[{"value":"1664-302X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]},"article-number":"1751445"}}