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on august 28, lu hongzhou, liu yingxia and others from shenzhen third people's hospital and shenzhen national clinical research center for infectious diseases published a research paper online in the journal nature communications, systematically revealing the evolutionary trajectory and characteristics of monkeypox virus cladeiib and identifying the new c.1.1 lineage for the first time.

the study included 92 monkeypox cases, accounting for 30% and 66% of the cases reported in guangdong province and shenzhen city during the same period, respectively. demographic characteristics showed that all patients were male, with a median age of 30 years, and 56.5% of patients were also infected with human immunodeficiency virus (hiv). epidemiological surveys showed that 95.7% of them had male-male sexual intercourse. patients had skin lesions in multiple parts of their bodies, and 62.2% of patients had genital lesions, indicating a high risk of transmission of monkeypox virus through sexual contact.

more than 90% of infected people have male-male sexual intercourse

"during that period, we happened to treat 92 patients infected with monkeypox, all of whom were male, and more than 90% of the infected people had male-male sexual intercourse. male-male sexual intercourse is indeed one of the high-risk factors for the transmission of viruses such as monkeypox, and male homosexuals are a high-risk group for monkeypox." lu hongzhou told the people's daily health client reporter that male-male sexual intercourse is special, and the rectal mucosa is more fragile than normal skin and vaginal mucosa, and it is possible to cause small wounds due to contact, making it more susceptible to infection.

monkeypox virus was first isolated from febrile macaques in 1958, and the first human infection was reported in congo in 1970. before 2021, the main endemic areas of monkeypox virus were confined to central and west african countries, and occasional monkeypox outbreaks in these areas were usually related to direct contact with infected animals.

since june 2023, shenzhen has seen a sustained local epidemic of monkeypox virus. the research team of shenzhen third people's hospital quickly established a clinical research cohort, and discovered the possible source of the monkeypox virus prevalent in shenzhen through whole genome amplification sequencing and other technologies, clarifying the evolutionary path and characteristics of monkeypox virus cladeiib.

more than 50% of infected people are also infected with hiv

the reporter noticed that in this study, 56.5% of the patients were also diagnosed with human immunodeficiency virus (hiv). "among these 92 patients, some did not even know that they were infected with aids, and some were already in the late stage. if patients with late stage aids are infected with monkeypox again, it will be very difficult to treat. several monkeypox patients who died were in the late stage of aids." lu hongzhou introduced that because some aids patients still have high-risk sexual behaviors, they are more likely to be infected.

zhao wei, director of the biosafety research center of the school of public health of southern medical university, also told the reporter of people's daily health client: "hiv-infected patients with monkeypox virus, especially those with low immune function, may have a relatively long course of illness and are more likely to develop severe symptoms, which should be taken seriously in clinical practice."

zhao wei reminded, "this study also reminds us that we should strengthen health education among gay men to avoid unsafe sexual behavior. secondly, residents should not have close contact with suspected infected people."​​​