This case is not a surprise in itself, but it is the first time it has been documented in the scientific literature. A 36-year-old Italian patient was simultaneously infected with the monkeypox virus, that of Covid-19 and HIV, reports a group of Italian scientists in an article published on August 19 in the journal Journal of Infection.
This man stayed in Spain from June 16 to 20. Nine days later, having meanwhile returned to Italy, he suffered from a high fever (up to 39°C), fatigue, headache and sore throat. Tested positive for Covid-19 (variant Omicron BA.5.1) on July 2, he saw pimples appear on his left arm the same day, then the next day small painful blisters on many parts of the body. On July 5, increasingly ill, he ended up going to the emergency room of the Catania hospital.
The doctors immediately suspected a case of monkeypox, because of the lesions but also because the patient had stayed in Spain, the European country most affected by the epidemic at that time. The samples taken on July 6 were positive for the monkeypox virus, but also for HIV. In September 2021, the patient had yet taken an HIV test which turned out to be negative.
“Health systems must be aware of this possibility”
The patient was treated with sotrovimab, a monoclonal antibody administered intravenously. By July 9, most of her symptoms were gone. However, he was still positive for Covid-19 as well as monkeypox two days later, despite the absence of new lesions. The patient was still able to return home, but was forced to isolate himself there.
“Clinicians should be aware of the possibility of co-infection with SARS-CoV-2 and monkeypox virus, especially in subjects with recent travel to areas with monkeypox outbreaks” and “health systems need to be aware of this possibility,” the authors conclude. Their patient suffered from fairly marked symptoms, but “as this is the only reported case of co-infection with monkeypox virus, SARS-CoV-2 and HIV”, it is not possible to say ” that this combination may aggravate the patient’s condition”.
In France, nearly 3,000 cases of monkeypox confirmed by a positive test have been identified to date. Of those who know their HIV status, 385, or 25%, are HIV-positive.