In a first, man tests positive for COVID-19, HIV, monkeypox at the same time

A 36-year-old man has tested positive for COVID-19, monkeypox, and HIV simultaneously after a short trip to Spain, according to researchers from the University of Catania in Italy.

Nine days after his five-day trip to Spain the man developed fever, accompanied by sore throat, fatigue, headache and swollen lymph nodes in the groin area. On 2 July he tested positive for SARS-CoV-2. On the afternoon of the same day a rash started to develop on his left arm. The following day rashes appeared on the torso, lower limbs, face and glutes. By 5 July, the rashes had further spread and evolved into pustules As they continued to spread he went to the emergency department of the Policlinico ― G. Rodolico — San Marcoll University Hospital in Catania, Italy, and was subsequently transferred to the Infectious Diseases unit.

The patient was also screened for multiple sexually transmitted infections (STIs). He tested positive for HIV-1, and the researchers said that ‘given his preserved CD4 count, we could assume that the infection was relatively recent.’

Besides, given the high suspicion of monkeypox supported by suggestive skin lesions and a recent trip to Spain, he was tested for monkeypox, which came in positive.

The Journal of Infection report concludes that “monkeypox and COVID-19 symptoms may overlap, and corroborates how in case of co-infection, anamnestic collection and sexual habits are crucial to perform the correct diagnosis. SARS-CoV-2 BA.4 and BA.5 subvariants are currently responsible for more than 1 million COVID-19 cases per day worldwide. Hence, clinicians should be aware of the possibility of SARS-CoV-2 and monkeypox virus co-infection, particularly in subjects with a recent history of travel to monkeypox-outbreak areas.”

The researchers added, “As this is the only reported case of monkeypox virus, SARS-CoV-2 and HIV co-infection, there is still not enough evidence supporting that this combination may aggravate patient’s condition.”

“Given the current SARS-CoV-2 pandemic and the daily increase of monkeypox cases, 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,” the researchers added.

With input from agencies

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