A 36-year-old man in Italy appears to be the first person ever to be diagnosed with COVID-19, monkeypox, and HIV all at once, according to a recent study report published in the Journal of Infection.
He has started receiving treatment for HIV after his COVID-19 and monkeypox infections were successfully treated.
“Monkeypox virus and SARS-CoV-2 infections can occur simultaneously,” the study authors wrote in the report. “Flu-like symptoms and SARS-CoV-2 positivity should not exclude monkeypox in high-risk individuals.”
In the case report, infectious disease doctors in Italy reported how the man became ill on June 29, 9 days after returning from a 5-day trip to Spain, with a fever, sore throat, and headache. He tested positive for COVID-19 on July 2, and later that day, he experienced a rash on his left arm.
The rash turned into small, stinging blisters that spread throughout his face, body, legs, and glutes over the next four days. He went to the emergency room of a hospital in Catania, Italy, on July 5 and was admitted to the infectious disease unit. The doctors suspected monkeypox and collected samples based on the symptoms and the patient’s recent trip to Spain.
The man stated that he had unprotected sex with other men while in Spain, which has been a risk factor for monkeypox during the current outbreak. He tested positive for monkeypox, HIV, and COVID-19, precisely the BA.5.1 Omicron form, on July 6.
According to the incubation periods of COVID-19 and monkeypox, the patient may have contracted both simultaneously. The patient informed doctors that he tested HIV-negative in September 2021. However, his number of white blood cells in the blood was still average at the time of the positive test in July. This implies that he may have recently contracted HIV as well.
The patient’s rashes began to crust and heal by the third day of hospitalisation, and his symptoms had nearly recovered by the fifth day. He no longer tested positive for COVID-19 on July 13, and his monkeypox rash had almost healed by July 19, albeit he still tested positive. In addition, the patient began regular HIV combination therapy.
The Italian experts stated that while the COVID-19 pandemic is still occurring and monkeypox cases are increasing, health care personnel should know that co-infection is conceivable in high-risk groups.
“Healthcare systems must be aware of this eventuality, promoting appropriate diagnostic tests in high-risk subjects, which are essential to containment as there is no widely available treatment or prophylaxis,” they wrote.