Man tests positive for Covid-19, monkeypox and HIV after holiday

A man who went for a short holiday came back with some unwanted souvenirs contracting Covid, monkeypox and HIV all at once.

A man has had an exceptionally unlucky holiday after he returned home to find he had contracted Covid-19, monkeypox and HIV all in one go.

There have been no previously published reports of co-infections of monkeypox and Covid-19, let alone HIV as well.

A paper published by a group of Italian academics from the University of Catania in the Journal of Infection focused on a 36-year-old man from Italy who had spent five days in Spain from June 16-20 this year.

Spain was one of the first countries to report a monkeypox outbreak.

While on holiday, he had sex with men. Nine days later he developed a fever, sore throat, fatigue, headache and swollen lymph nodes in the groin.

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A vial of the monkeypox vaccine. (Photo by Pascal GUYOT / AFP)

On June 2 the man, who has not been named, tested positive for Covid-19.

“On the afternoon of the same day a rash started to develop on his left arm,” the paper stated.

“The following day small, painful vesicles (blisters) …. with halos appeared on the torso, lower limbs, face and glutes.”

After the blisters turned into pustules, the man went to the emergency department at a hospital in Catania.

The man had tested negative to HIV in September 2021 and had been vaccinated against Covid-19 with two doses of the Pfizer jab in the same year. He had contracted Covid in January 2022. The paper doesn’t state if he had received the monkeypox vaccine, but in June supply was very limited.

A timeline of the mans symptoms and tests. Picture: Journal of Infection.

Given the number of lesions on his skin monkeypox was suspected. The test was confirmed positive for both that and Covid.

“This case highlights how monkeypox and Covid-19 symptoms may overlap … hence, clinicians should be aware of the possibility of SARS-CoV-2 and monkeypox virus co-infection” said the paper.

As he had likely acquired monkeypox through sexual intercourse, an HIV test was then performed which also came back positive. The results indicated that he had probably contracted that virus recently as well, most likely in Spain.

HIV is a sexually transmitted infection (STI). Monkeypox is not and is mostly passed through contact with infected rashes, scabs or fluids. It can be transmitted through non-sexual contact and even from materials used by someone with monkeypox. However, sex is a successful way for this contact to occur and in the recent outbreak has accounted for most, although not all, cases.

That monkeypox is in the gay community has largely slowed its spread to heterosexuals.

“Our case emphasises that sexual intercourse could be the predominant way of transmission.

“Therefore, complete STI screening is recommended after a diagnosis of monkeypox,”

The man was discharged from hospital on July 11 and isolated at home. Most cases are mild and people make a full recovery.

Some of the lesions the man presented doctors with. Picture: Journal of Infection.

HIV can be undetectable and untransmissible

The World Health Organisation (WHO) has said that 38.4 million people are living with HIV globally.

HIV is the virus that can lead to AIDS. However, advances in medicine mean that so long as people are on appropriate treatment, HIV is a chronic but manageable condition and they may never progress to AIDS.

People living with HIV who are taking antiretroviral therapy as prescribed and who consequently maintain an undetectable level of the virus in their system are unable to pass on HIV even if they don’t use condoms during sex.

People who are HIV negative can also take a treatment known as pre-exposure prophylaxis – or PrEP – which protects them from contracting the virus.

Another treatment, called post-exposure prophylaxis, can help prevent HIV from establishing in someone’s system after exposure if that treatment is started quickly.

In Australia, these treatments have led to a 37 per cent decrease in HIV transmission among Australian born gay and bisexual men in six years, according to the Australian Federation of AIDS Organisations.

Monkeypox has been labelled a “public health emergency” by the WHO with 45,000 known cases worldwide. However there have been only a very small number of deaths outside of some parts of Africa where a more lethal variant has spread.

More than half a billion people have contracted Covid-19 with 6.5 million deaths from the virus.