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This case represents the first documented instance of such a triple infection in an individual with metastatic renal cell carcinoma undergoing combined immunotherapy with ipilimumab and nivolumab. This is the case of a 40-year-old male patient with past medical history notable for type 1 diabetes mellitus and renal cell carcinoma who exhibited liver function abnormalities suggestive of viral liver injury, particularly due to hepatitis B virus reactivation. Interestingly, despite the triple infection, the patient experienced relatively mild disease progression, with liver function tests showing a downward trend, likely due to timely intervention with tenofovir. 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