Double-Vaccinated Italian Man Dubbed as the World’s First Man to be Diagnosed with COVID-19, Monkeypox, and HIV at the Same Time

Grindr dating app for gay men (Source: World Health Organization)

A 36-year-old man in Italy appeared to be the world’s first confirmed case of being diagnosed with COVID-19, monkeypox, and HIV at the same time, according to a recent case report in the Journal of Infection.

The unidentified man had received two doses of Pfizer’s BNT162b2 mRNA vaccine for COVID-19 last in December 2021 and had contracted COVID-19 the following month.

What does this suggest for the efficacy of the “very safe and very effective experimental vaccine” if the recipient contracts COVID-19, HIV, and monkeypox all at once?

According to the report, the man began to experience symptoms nine days after returning from Spain, where he had unprotected sex with other men.

“Our patient, an Italian 36-year-old male spent 5 days in Spain from 16 to 20 June 2022. Nine days after, he developed fever (up to 39°C), accompanied by sore throat, fatigue, headache and right inguinal lymphadenomegaly,” according to the case report.

“On 2 July he resulted positive for SARS-CoV-2. On the afternoon of the same day, a rash started to develop on his left arm. The following day small, painful vesicles surrounded by an erythematous halo appeared on the torso, lower limbs, face, and glutes.”

“On 5 July, due to a progressive and uninterrupted spread of vesicles that began to evolve into umbilicated pustules, he went to the emergency department of the Policlinico “G. Rodolico – San Marco” University Hospital in Catania, Italy, and was subsequently transferred to the Infectious Diseases Unit,” the report stated.

On July 6, swabs of pustule exudate and nasopharynx secretions were sent to the Regional Reference Laboratory. The specimens were confirmed positive to monkeypox virus.

On the same day, “serology tests for viral hepatitis, herpes simplex, gonorrhoea, chlamydia and lymphogranuloma venereum were negative. However, HIV-1 resulted positive with a viral load of 234,000 copies/mL,” according to the report.

See timeline below:

Timeline of symptoms and skin lesions, from June 20 to July 19, 2022 (Source: Journal of Infection)

According to the study finding, “Our case emphasizes that sexual intercourse could be the predominant way of transmission. Therefore, complete STI screening is recommended after a diagnosis of monkeypox. In fact, our patient tested positive for HIV-1 and, given his preserved CD4⁺ lymphocyte count, we could assume that the infection was relatively recent. To note, the monkeypox oropharyngeal swab was still positive after 20 days, suggesting that these individuals may still be contagious for several days after clinical remission. Consequently, physicians should encourage appropriate precautions. 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.”

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