THAA0201 | EPIDEMIOLOGICAL TRENDS OF Mpox AND HIV CO-INFECTION IN NIGERIA: A SYSTEMATIC REVIEW AND META-ANALYSIS FROM 2017-2024

Justin Nwofe, Chiedozie Akueshi, Ekei Ekom, Emmanuel Ojo, Femi Owolagba, Eke Ofuche, Uche Okezie, Plang Jwanle, Jay Samuels | APIN Public Health Initiatives, Abuja, Nigeria

Mpox, a re-emerging zoonotic viral disease, has become a significant public health concern, particularly in vulnerable populations such as people living with HIV (PLHIV). This study seeks to evaluate the epidemiological trends of Mpox among PLHIV in Nigeria from 2014 to 2024, pinpointing factors that affect disease incidence, progression, and outcomes. Seven studies out of 115 available articles were eligible and included for this systematic review. Relevant articles were searched, screened, and included in this study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Databases such as PubMed, Scopus, and African Journals Online (AJOL) were searched using keywords including “Mpox,” “HIV,” “Nigeria,” “immunosuppression,” and “epidemiology.” Studies focusing on Mpox among PLHIV in Nigeria were included based on predefined inclusion criteria between 2014 and 2024. The risk of bias in primary studies was assessed by Cochrane’s method. Stata version 9 was used to estimate pooled prevalence and identify significant epidemiological trends over the decade. Logistic regression was conducted to identify risk factors for Mpox at a p-value of <0.05. Subgroup analyses were performed to evaluate differences according to geography, age, and gender. The incidence of Mpox among PLHIV in Nigeria exhibited a variable trend, peaking in 2017, followed by subsequent waves in 2020 and 2022. The pooled prevalence of Mpox among PLHIV was 8.3% (95% CI: 6.5%-10.2%). PLHIV with lower CD4 counts (<200 cells/mm³) exhibited more severe clinical manifestations, including prolonged illness duration, higher rates of secondary bacterial infections, and increased case fatality rates (CFRs). The CFR among Mpox cases in PLHIV was 12.6%, significantly higher than in the general population. Risky sexual behavior and exposure to confirmed cases are associated risk factors. The risk of contracting and dying from mpox was higher in those with HIV infections. The findings suggest that immunosuppression contributes to worse clinical outcomes, which reinforces the importance of targeted public health interventions. Enhanced surveillance, early diagnosis, and integrated HIV-Mpox management strategies are critical to mitigating the impact of future outbreaks. Strengthening vaccination efforts and improving healthcare access for PLHIV should be prioritized to reduce the burden of Mpox in this vulnerable group.