Background: Since early May 2022, outbreaks of Monkeypox (Mpox) cases have emerged and become a global concern. Studies exploring the gastrointestinal (GI) and/or liver manifestations of Mpox are still very limited. This systematic review and meta-analysis is the first to summarize the GI manifestations reported by Mpox patients. Methods: We searched for Mpox studies published until October 21, 2022, in MEDLINE, EMBASE, SCOPUS, and organization websites. Mpox studies were observational studies that reported at least one of either GI and/or liver manifestations. Meta-analysis was done to obtain the pooled prevalence of GI manifestations in Mpox patients. The quality of included studies was assessed using the NIH Quality Assessment Tool. Results: Overall, 31 studies that reported GI and/or liver manifestations in Mpox patients were included. The five most commonly reported GI manifestations by studies were abdominal pain, anorexia, diarrhea, nausea and/or vomiting, and proctitis. There is a lack of reporting for liver manifestations. The most prevalent GI manifestations in Mpox patients were anorexia (47%; 95%CI 41-53%), followed by nausea and/or vomiting (12%; 95%CI 11-13%), proctitis (11%; 95%CI 11-12%), abdominal pain (9%; 95%CI 8-10%), and diarrhea (5%; 95%CI 4-6%). Conclusion: Anorexia was the most frequently reported GI manifestation in Mpox patients, followed by nausea and/or vomiting, proctitis, abdominal pain, and diarrhea. The presentation of proctitis during the ongoing Mpox outbreak highly suggests a potential for Mpox diagnosis.

Monkeypox virus (MPXV) is a zoonotic disease endemic in the rain forest countries of Central and West Africa. Understanding the immune response in zoonosis is fundamental to prevent and contrast viral spreading. MPXV is a close relative of the Variola (smallpox) virus and vaccination with vaccinia virus give an 85% protection against MPXV. With the emergence of the recent MPXV outbreak, Jynneos vaccine has been proposed to individuals at high-risk of exposure. Comparative data on MPXV immune response in vaccinated or infected subjects is still scarce. Here we described the differences between a group of infected patients in comparison to smallpox or Jynneos vaccinated subjects. The patients’ response is stronger and faster, while the Jynneos vaccinated controls need more time to develop a good immunity. Interestingly, the historic smallpox-vaccinated controls retain a degree of protection, even after years from vaccination, which is most visible in the T-cellular memory that is comparable to the newly vaccinated subjects.

Background: We assessed whether the association between the risk of cerebrospinal fluid escape (CVE) and specific antiretroviral (ARV) classes, such as protease inhibitors, is due to suboptimal pharmacological profile generated by archived resistance-associated mutations (RAMs). Methods: A retrospective multicentric study on 300 adult people with HIV on antiretroviral therapy (ART) and available historical plasma genotype resistance testing (HGRT) for reverse transcriptase (RT) and protease genes between 2001 and 2021. The odds ratio for demographic, clinic-, and ART-related variables and CVE was estimated by multivariable modelling. HGRT-adjusted central nervous system effectiveness penetration (CPE) score was computed in modelling the risk. Results: Median age, plasma VL, and CD4 count were 49 years, <50 copies/mL, and 310 cells/μL. CVE was detected in 51 participants (17.0%). No difference in CVE prevalence was observed according to ART type, number of ARVs or ARV classes. Participants with CVE had more frequently plasma (52.9% vs 32.1%, p=0.005) and CSF RAMs in RT (n=63, 57.1% vs 28.6%, p=0.029), but not in protease gene. The presence of plasma RAMs in RT associated with increased odds of CVE in adjusted analyses (aOR 3.9, p<0.001) and in models restricted to plasma viral load ≤50 copies/mL (n=202; aOR 4.3 , p=0.003). CVE risk decreased by 40% per each point increase in HGRT-adjusted CPE score in multivariable models (p<0.001). Conclusions: Viruses harboring mutations appear to favor CVE and the impact of single ARV classes or type of ART regimens may lose significance when adjusted for the presence and effect of specific RAMs.

Background: Killer-cell immunoglobulin-like receptors 2DL4 ( KIR2DL4) and the human leukocyte antigen class I-G ( HLA-G) display vital parts in immune responses against HCV infection. We select four potentially functional SNPs of KIR/HLA to explore the associations between KIR2DL4/HLA-G genetic variants and HCV infection results. Methods: In the present case-control investigation, KIR2DL4-rs660773， KIR2DL4-rs660437， HLA-G-rs9380142, and HLA-G-rs1707 SNPs were sorted as genotype in a total of 2225 high-risk subjects, involving 1778 paid blood donors and 447 drug users. The SNPs were functionally annotated using bioinformatics analysis. Results: Following adjusting by age, sex, ALT, AST, IFNL4-rs12979860, IFNL4-rs8099917, and the infection route, the logistic regression analysis (LRA) discovered that KIR2DL4-rs660773 and HLA-G-rs9380142 were correlated with vulnerability to HCV infection (all P <0.05). In a locus-dosage way, compared with subjects carrying the rs9380142-AA or rs660773-AA genotypes, subjects with rs9380142-AG or rs660773-AG/GG (all P <0.05) were more vulnerable to HCV infection; the overall impact of their risk genotypes (rs9380142-AGrs660773-AG/GG) was correlated with an elevated incidence of HCV infection ( Ptrend<0.001). In the Haplotype analysis, patients with haplotype AG were more likely to contract HCV compared to those with the highest common AA haplotype ( P= 0.002) were higher in susceptibility to infect HCV.nThe SNPinfo web server estimated that rs660773 is a transcription factor binding site (TFBS), whereas rs9380142 is a potential microRNA-binding site. Conclusion: In the Chinese high-risk population, KIR2DL4 rs660773 and HLA-G rs9380142 polymorphisms are related to HCV susceptibility .