(P210) Characteristics of Mpox infections in Louisiana in the 2022 Outbreak

Introduction: The 2022 outbreak of Mpox in Louisiana was limited, in part due to an effective vaccination campaign rolled out by the Centers for Disease Control and Prevention and the Louisiana Department of Health (LDH). We aimed to describe the local outbreak within two health centers, partnering with LDH to offer further statewide data. A secondary objective was to study Mpox outcomes in our region with high prevalence of HIV/AIDS in order to better understand the impact of immunosuppression in our population.

Methods: We reviewed charts of persons testing positive for Mpox in New Orleans from July to November 2022 at two local health centers that together accounted for half of local cases. We abstracted data on HIV status, immune function (CD4 count, viral load), anti-retroviral therapy (ART) regimen, symptoms and severity of infection, vaccinations status, and whether tecovirimat was administered. We present local data relative to statewide data (July 2022-January 2023) for further context.

Results: Of 103 individuals in our network for whom charts were reviewed, 96 (93%) identified as male, 52 (50%) were Black, and 69 (67%) had HIV, including 12 (17%) with uncontrolled HIV (CD4 < 200 cells/mm³ or viral load >200 copies/ml). The most common presenting symptoms were rash (n=71, 69%), fever (n=36, 35%), and rectal pain (n=33, 32%). Of 6 (6%) patients hospitalized, 4 (67%) were living with HIV. Two were hospitalized for severe Mpox infection with more than 100 lesions at presentation; both were living with HIV, and one had uncontrolled infection. Four hospitalizations were for reasons other than Mpox with lesion counts between 5 to 10. Across the state, 307 cases have been identified and 24 have been hospitalized. Of those hospitalized, 18 (75%) were living with HIV, including 9 (50%) with uncontrolled HIV. Additional characteristics of the New Orleans and statewide cohorts are shown in Table 1.

Conclusions: The demographic data from Louisiana, a state with high prevalence of STIs and HIV/AIDS, are consistent with prior reports describing the 2022 Mpox outbreak. Our results contribute to accumulating data on the severity of infection in individuals with HIV-related immunocompromise.