Italian man is the first to simultaneously test positive for COVID, HIV, and monkeypox

Doctors are unsure whether the coexistence of the diseases will worsen his symptoms.
Loukia Papadopoulos
A doctor holding a patient's hand.
A doctor holding a patient's hand.


When it rains, it pours. Researchers have reported the first known case of a 36-year-old-man testing positive for COVID-19, HIV, and monkeypox all at the same time, according to a report by Global News published on Friday.

Fever, sore throat and fatigue reported

The incident first published in the Journal of Infection on August 19, indicates the patient developed a fever, sore throat and fatigue after returning from a trip to Spain earlier this summer where he had unprotected sexual intercourse, a key transmission risk for HIV.

“On admission, the patient reported being treated for syphilis in 2019. In September 2021, he performed an HIV test with a negative result. He suffered from bipolar disorder, for which he regularly took carbamazepine 200 mg daily," wrote the researchers in the journal.

"He was vaccinated for SARS-CoV-2 with two doses of Pfizer's BNT162b2 mRNA vaccine (the last in December 2021) and had already contracted COVID-19 in January 2022.”

He first received a positive test for COVID on July 2, and the following day, rash and lesions appeared on his torso, face, glutes, and lower limbs.

By July 5, the rash had continued to spread. And that's when he sought treatment at an Italian hospital, where doctors uncovered that he had also contracted monkeypox.

The doctors further tested for a series of sexually transmitted infections, including an HIV test that came back positive.

The event marks the first time the three diseases have been diagnosed in one patient at the same time.

Italian man is the first to simultaneously test positive for COVID, HIV, and monkeypox
Lesions were found all over the man's body.

The researchers also noted that monkeypox and COVID often have similar symptoms, including fever, sore throat, and headache, which made it “difficult for physicians to perform the correct diagnosis, also considering that not all patients with monkeypox develop skin lesions and that COVID-19 may rarely present with rash and vesicles.”

The authors added that there is no specific treatment to tackle all the diseases simultaneously but that they did not know whether symptoms would be worse for the patient due to the co-existence of the diseases.

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Complete STI screenings recommended

The researchers further advised that doctors should consider a patient’s previous medical history, travel history, and sexual activity when investigating diseases that have overlapping symptoms.

“Our case emphasizes that sexual intercourse could be the predominant way of transmission. Therefore, complete STI screening is recommended after a diagnosis of monkeypox,” the study noted.

According to the research, more than 16,000 persons in 74 nations had contracted monkeypox as of January 2022, and the COVID subvariants BA.4 and BA.5 were responsible for more than a million coronavirus cases per day worldwide.

The case is a reminder to be diligent not only sexually but in all interactions and to take equal precautions against monkeypox and COVID. Prevention is no doubt better than treatment especially in the case of HIV which as of now has no cure.

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