Mpox Recrudescence after SARS-CoV-2 Coinfection in a Patient with AIDS

People living with HIV (PLWH) are known to exhibit more severe or prolonged symptoms of mpox (formerly monkeypox). However, the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on PLWH with mpox has not been adequately described. We report a case of mpox in an AIDS patient who had recurrent symptoms due to SARS-CoV-2 infection. The patient presented with a low CD4 + lymphocyte count (CD4 count) without antiretroviral therapy (ART) and suffered from severe mpox. The ART was initiated 17 days after the diagnosis of mpox, and the patient’s skin lesions began crusting after 1 week of ART. However, after a SARS-CoV-2 infection, the mpox flared up again. The patient presented with more severe symptoms than those during the initial bout and with rectal involvement. We speculate that SARS-CoV-2 infection might cause a recrudescence of mpox in AIDS patients, which requires further investigation.