HIV and Monkey Pox virus coinfection after autologous hematopoietic stem-cell transplantation for Hodgkin lymphoma: A case report

• Patients with a history of HIV on adequate antiretroviral therapy generally respond well to symptomatic management of Mpox. • Early immune reconstitution may explain the favorable post – transplant outcome. • In countries where mpox has high prevalence, it should not be ruled out and should be confirmed by PCR methods. Monkeypox causes a smallpox – like illness, transmitted via contact with infected skin or mucosa. Following the 2022 global outbreak, it became a public health concern. Evidence on HIV–mpox coinfection in oncology patients, particularly those receiving multiple treatment lines and undergoing autologous hematopoietic stem-cell transplantation (HSCT) remains scarce, suggesting immune status may critically shape clinical presentation and outcomes. We report the case of a 29-year-old man with HIV on antiretroviral therapy, who developed classical Hodgkin lymphoma. He achieved complete response with medical treatment, but relapsed two years later, he was then taken to autologous HSCT. On day + 92 post-transplant, he presented umbilicated papular–pustular lesions, cultures were negative. Mpox was confirmed by real-time PCR from lesion exudate. The patient was placed in isolation and managed with supportive care, showing a favorable clinical outcome. Tecovirimat was not administered due to its unavailability in the country. In the setting of effective anti-retroviral treatment and immune reconstitution after autologous HSCT, mpox may remain uncomplicated, underscoring the importance of epidemiologic risk assessment, careful differential diagnosis, and severity stratification based on immune parameters rather than transplant history alone.