A man has tested positive for Covid, monkeypox and HIV

Scientists have reported the first known case of a person testing positive for monkeypox, Covid-19 and HIV at the same time.

The patient, a 36-year-old Italian man, developed a series of symptoms – including fatigue, fever and sore throat – nine days after returning from a trip to Spain where he had unprotected sex.

He first tested positive for Covid on July 2, according to a case report published in the Journal of Infection.

The next day, small, painful vesicles surrounded by a rash appeared on the man’s torso, lower limbs, face and buttocks. By July 5, the vesicles had spread further and turned into pustules – small bumps on the skin – at which point the man took himself to a hospital in Palermo.

There he was tested for monkeypox and subsequently tested positive.

The patient was also screened for multiple STIs. He tested positive for HIV-1 and the researchers said that “given his preserved CD4 count, we can assume that the infection is relatively recent.”

The patient took an HIV test last September and it came back negative.

After recovering from Covid-19 and monkeypox, the patient was discharged from the hospital on July 11 for home isolation. By this stage his skin lesions had healed, after crusting over, leaving a small scar.

“This case highlights how the symptoms of monkeypox and Covid-19 can overlap and confirms how, in the case of co-infection, the collection of anamnestic data and sexual habits are crucial for making the correct diagnosis,” said the researchers from the University of Catania in his case report.

“Of note, the monkeypox oropharyngeal swab was still positive after 20 days, suggesting that these individuals may be infectious for several days after clinical remission,” the report said. “Therefore, physicians should promote appropriate precautions.”

The researchers added: “As this is the only reported case of co-infection with monkeypox virus, SARS-CoV-2 and HIV, there is still insufficient evidence to support that this combination can worsen the patient’s condition.” Given the current SARS-CoV-2 pandemic and the daily increase in monkeypox cases, health systems need to be aware of this possibility.”

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