Clinical manifestations of human T lymphotropic virus type I-infected patients with systemic lupus erythematosus.
OBJECTIVE
Human T lymphotropic virus type I (HTLV-I) may be associated with some connective tissue autoimmune diseases, including systemic lupus erythematosus (SLE). To determine the relationship between HTLV-I infection and SLE, we examined the clinical manifestations of SLE patients with HTLV-I infection.


METHODS
Eighty-nine patients with SLE were screened for antibodies to HTLV-I by electrochemiluminescence immunoassay. The presence of HTLV-I proviral sequences in peripheral blood mononuclear cells (PBMC) was determined by real-time polymerase chain reaction (PCR) quantification and Southern blotting analysis. The differences in clinical manifestations between HTLV-I-seropositive and seronegative patients with SLE were analyzed statistically.


RESULTS
Fourteen of 89 (15.7%) patients were HTLV-I seropositive. All PBMC samples from 11 patients tested by PCR and 3 samples from 10 patients tested by Southern blotting analysis were positive for HTLV-I-related sequences. The age of HTLV-I-seropositive patients with SLE was significantly higher than that of seronegative patients (median 60 vs 42 yrs; p < 0.0005). The age at onset of SLE in HTLV-I-seropositive patients was also significantly higher than that of seronegative patients (median 45.5 vs 30 yrs; p <0.0005). The lymphocyte count in HTLV-I-seropositive SLE patients was significantly higher than that of seronegative patients (median 1740 vs 1066/microl; p = 0.027). The maintenance dose of prednisolone in HTLV-I-seropositive patients with SLE was significantly lower than that in seronegative patients (median 5 vs 9 mg/day; p = 0.012).


CONCLUSIONS
This is the first report of the differences in clinical manifestations between SLE patients with and without HTLV-I infection. Our results suggest some involvement of HTLV-I in the pathogenesis of SLE.
Akimoto
Masaki
M
Department of Hematology and Immunology, Kagoshima University Hospital, Kagoshima, Japan. akimoto@m3.kufm.kagoshima-u.ac.jp
Matsushita
Kakushi
K
Suruga
Yukio
Y
Aoki
Noriko
N
Ozaki
Atsuo
A
Uozumi
Kimiharu
K
Tei
Chuwa
C
Arima
Naomichi
N
D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D015490:HTLV-I Infections / Q000150:complications / Q000503:physiopathology*; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000472:pathogenicity*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000503:physiopathology* / Q000821:virology*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011239:Prednisolone / Q000008:administration & dosage; D016036:Seroepidemiologic Studies; D012698:Serologic Tests
D018501:Antirheumatic Agents; D011239:Prednisolone