Treatment with Tecovirimat for Persons with HIV and Mpox

During the 2022 mpox outbreak, most cases were among men who have sex with men (MSM), and almost half occurred in persons with HIV (PWH). Tecovirimat (TPOXX), an antiviral originally developed and approved for smallpox, was used as an expanded-access investigational new drug during this mpox outbreak, but data are lacking regarding safety and efficacy in persons with and without HIV. In a retrospective cohort study, investigators studied 196 patients treated with TPOXX; of these, 42 tested negative for mpox or did not have a positive test result available.

Among 154 participants with confirmed mpox infection, 72 were PWH and 82 were HIV negative; all were male sex at birth. PWH were older (median, 39 vs. 32 years) and more likely to be Black…