Mpox and Viral Co-Infections: A Narrative Review.

BACKGROUND AND AIMS: Monkeypox (Mpox), caused by the monkeypox virus (MPXV), has emerged as a significant global public health concern, particularly following a substantial multi-country outbreak in mid-2022. The World Health Organization (WHO) reported 109,699 laboratory-confirmed Mpox cases and 236 fatalities worldwide from January 1, 2022, to September 30, 2024. This narrative review aims to evaluate the co-infections of Mpox with various viral agents and assess their implications for public health.

METHODS

We conducted a comprehensive review of the literature regarding Mpox co-infections with human immunodeficiency virus (HIV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hepatitis viruses (hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV)), and herpesviruses (including herpes simplex virus (HSV)-1, HSV-2, varicella-zoster virus (VZV), and cytomegalovirus (CMV)).

RESULTS

We analyzed epidemiological trends, clinical manifestations, preventive measures, treatment guidelines, and advanced diagnostic methodologies. The review highlights the intricate dynamics of Mpox co-infections and underscores the necessity for comprehensive diagnostic approaches, including viral load assays, to evaluate active co-infections, particularly for HIV and HBV.

CONCLUSION

Understanding the interplay between MPXV and other viral pathogens is crucial for enhancing management strategies for co-infections. By addressing these complexities, we aim to contribute valuable insights into the public health implications of Mpox co-infections and improve response strategies.