Our recommended screening for sexually transmitted infections in patients with mpox
| Sample site | Screening |
|---|---|
| Blood | HIV-1/HIV-2 antigen-antibody immunoassay (screening test) a Nontreponemal test (eg, rapid plasma reagin), reflexively followed by treponemal test, if positive Hepatitis C antibody b Hepatitis B surface antibody, surface antigen, and core antibody c |
| Urine | Gonorrhea and chlamydia nucleic acid amplification test |
| Rectum (if patient participates in receptive anal intercourse or has rectal symptoms) | Gonorrhea and chlamydia nucleic acid amplification test |
| Oropharynx (if patient participates in oral intercourse or has oropharyngeal symptoms) | Gonorrhea and chlamydia nucleic acid amplification test |
| Vagina, cervix (if patient participates in vaginal intercourse or has vaginal symptoms) | Gonorrhea and chlamydia nucleic acid amplification test |
| Lesion (when clinically unable to differentiate between mpox and herpesvirus) | HSV-1 and HSV-2 polymerase chain reaction test Varicella virus polymerase chain reaction test |
| Not recommended | Serologic testing for HSV-1 and HSV-2 antibodies (does not distinguish current from previous infection) Serologic HSV or varicella virus polymerase chain reaction test (insensitive and nonspecific for dermatologic infection) |
↵a HIV-1/HIV-2 antigen-antibody immunoassay will detect HIV about 17 days after HIV acquisition. For patients with a potential exposure < 17 days and concern for acute retroviral syndrome, send for HIV nucleic acid amplification testing (viral load). Caution in patients on preexposure prophylaxis, which can result in delayed seroconversion and indeterminate results on HIV differentiation assay.
↵b Sexually active men who have sex with men should undergo hepatitis C virus screening at least annually.
↵c Men who have sex with men without serologic evidence of immunity to hepatitis B should undergo vaccination.
HIV = human immunodeficiency virus; HSV = herpes simplex virus