Recent studies suggest that the introduction of antiretroviral agents such as integrase strand transfer inhibitors (INSTI) may lead to weight gain in people living with HIV (PLHIV). In this retrospective observational study, we report the weight changes observed in virologically suppressed HIV patients after 12 months of switching to bictegravir/emtricitabine/tenofovir alafenamide (BIC/F/TAF) due to a national change in public policy in Mexico. Patients on prior regimens based on TDF/FTC or ABC/3TC plus non-nucleoside retrotranscriptase inhibitor, INSTI, or protease inhibitor were included. In the 399 patients analyzed, a significant weight increase was found, as well as an increase in body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDL-C), glucose, creatinine, and CD4 ⁺ cells after 12 months of switching treatment (all p ≤ .001). Mean weight gain was 1.63 kg [confidence interval (95% CI): 1.14–2.11], whereas the average percentage of weight gained was 2.5% (95% CI: 1.83–3.17). After considering the confounding effect of baseline weight status, the change in weight and BMI did not present significant differences between any of the prior treatment schemes. In conclusion, PLHIV switching to BIC/F/TAF therapy experienced weight gain after the first year of switching treatment. Although this weight gain could be due to the switch in treatment regimen, it cannot be excluded that it was caused by other factors since no comparable control group could be used for comparison.

The study aims to compare the outcomes of initiating antiretroviral therapy early vs late in people with HIV and mpox. No worse outcomes were found associated with mpox-related immune reconstitution inflammatory syndrome among those who started antiretroviral treatment early, suggesting initiation as soon as possible.

Currently, neurosyphilis is an uncommon disease and may occur at any stage of syphilis. Co-infection of syphilis with HIV can affect the clinical course. We report a case of meningovascular neurosyphilis in a patient with HIV in whom basilar artery thrombosis and reactive VDRL in CSF were detected. Treatment with penicillin was instituted with adequate response showing clinical improvement. Neurosyphilis is a differential diagnosis in young patients with cerebral infarction, especially in HIV patients. (C) 2017 Published by Elsevier Limited on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license.

On 13 May 2022, a familial cluster of two cases of monkeypox was reported in the United Kingdom (UK) by the UK Health Security Agency (UKHSA). These cases had no relation to a case imported from Nigeria that was previously reported on 7 May 2022 in the UK. In the following days, several other European Union (EU) the Member States and other countries have reported cases of monkeypox not linked to travel to endemic countries. The report by the World Health Organization (WHO) until May 26, 2022, is of a total of 257 confirmed cases and 120 suspected cases, without any report of death. This outbreak involves 23 countries that are not endemic to the monkeypox virus. Latin America had no reported cases. We describe a case of imported monkeypox in Mexico City, Mexico.

Mpox-related ophthalmic disease has been reported as infrequent. We retrospectively describe the ocular manifestations present in 11 of 100 patients with confirmed mpox; 9 were people with HIV. We suggest that an ophthalmological evaluation should be performed in all patients with ocular symptoms or moderate and severe mpox disease.

Since early May 2022, cases of mpox (formerly monkeypox) have been reported in the United Kingdom and subsequently in countries where the disease is not endemic. 1,2 Classic features of the disease include macules, papules, umbilicated vesicles with a necrotic center, as well as pustular and crusting lesions. Nevertheless, new clinical presentations of mpox infection have been identified. 3 We report the case of a 38-year-old male living with HIV who presented with a clinical course of 4 days of evolution with asthenia, adynamia, fever, and rash. On physical examination, generalized and confluent maculopapular rash predominantly on the back (Figure 1A), cervical and inguinal lymphadenopa thies, and Forchheimer's spots were observed (Figure 1B). Subsequently, classic mpox pustules appeared (Figure 1C). Polymerase chain reaction (PCR) for measles and rubella were negative, and PCR for mpox was positive. The present mpox outbreak has been the largest outbreak in the history of the disease. The situation has been further complicated due to its unusual clinical presentation and evolution, including unusual morphologies and lesion sites. 3,4 Although confluent maculopapular rash and Forchheimer's spots have been reported as classic signs of rubella or measles infections, this is the first report of mpox with this clinical presentation. We may now have a new "great imitator" disease.