Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients.
Seven hundred and four HIV-1/2-positive, antiretroviral therapy (ART) naïve patients were screened for HTLV-1 infection. Antibodies to HTLV-1 were found in 32/704 (4.5%) of the patients. Each co-infected individual was matched with two HIV mono-infected patients according to World Health Organization clinical stage, age +/-5 years and gender. Key clinical and laboratory characteristics were compared between the two groups. Mono-infected and co-infected patients displayed similar clinical characteristics. However, co-infected patients had higher absolute CD4+ T-cell counts (P = 0.001), higher percentage CD4+ T-cell counts (P < 0.001) and higher CD4/CD8 ratios (P < 0.001). Although HIV plasma RNA viral loads were inversely correlated with CD4+ T-cell-counts in mono-infected patients (P < 0.0001), a correlation was not found in co-infected individuals (P = 0.11). Patients with untreated HIV and HTLV-1 co-infection show a dissociation between immunological and HIV virological markers. Current recommendations for initiating ART and chemoprophylaxis against opportunistic infections in resource-poor settings rely on more readily available CD4+ T-cell counts without viral load parameters. These guidelines are not appropriate for co-infected individuals in whom high CD4+ T-cell counts persist despite high HIV viral load states. Thus, for co-infected patients, even in resource-poor settings, HIV viral loads are likely to contribute information crucial for the appropriate timing of ART introduction.
Bhatt
N B
NB
Department of Immunology, Instituto Nacional de Saúde, Maputo, Mozambique. nbhatt.mz@gmail.com
Gudo
E S
ES
Semá
C
C
Bila
D
D
Di Mattei
P
P
Augusto
O
O
Garsia
R
R
Jani
I V
IV
D000328:Adult; D018791:CD4 Lymphocyte Count; D016516:CD4-CD8 Ratio; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000276:immunology / Q000502:physiology*; D015498:HIV-2 / Q000276:immunology / Q000502:physiology*; D015481:HTLV-I Antibodies / Q000097:blood; D015490:HTLV-I Infections / Q000150:complications* / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000276:immunology; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology; D008218:Lymphocytosis; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D015995:Prevalence; D019562:Viral Load
D015481:HTLV-I Antibodies