Treatment options for severe or refractory mpox virus infection in patients with advanced HIV

The Centers for Disease Control and Prevention (CDC) published a health advisory on the occurrence of severe cases of mpox in immunocompromised patients, namely those with advanced HIV. Treatment options are limited, and very little is known about how to optimally treat patients with severe disease. Herein we describe two cases of severe mpox in Chicago in the setting of advanced HIV and provide suggested guidance for managing cases of severe disease in immunocompromised patients based available data, CDC recommendations, and our experience managing these patients.