title: Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis and delay in starting antiretroviral therapy for AIDS patients.
abstract: To compare the clinical characteristics and outcomes of HIV-1-HTLV-1 coinfected patients, in Bahia, Brazil.
  
  
  
  Retrospective, comparative study.
  
  
  
  Among a total of 123 consecutive HIV infected patients, 20 men (20.6%) and 6 women (23.1%) had detectable antibodies against HTLV-I/II. The major risk factor associated with coinfection by HTLV was intravenous drug use (57.7% of coinfected patient versus 9.2% of HTLV seronegative patients, p < 0.0001). Coinfected patients had higher absolute lymphocyte counts (1,921 + 762 versus 1,587 + 951, p = 0.03). Both groups of patients had similar means of CD4+ and CD8+ cell counts. However, among patients with AIDS CD4+ cell counts were significantly higher among those coinfected with HTLV-I/II (292 ± 92 cells/mm³, versus 140 ± 177 cells/mm³, p = 0.36). The frequency and type of opportunistic infections were similar for both groups, but strongyloidiasis and encephalopathy were more frequently diagnosed in coinfected patients (p < 0.05). On the other hand, patients coinfected with HTLV-I/II received significantly less antiretroviral therapy than singly infected by HIV-1.
  
  
  
  Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis for HIV patients. Higher CD4 count may lead to underestimation of immunodeficiency, and delay to initiate antiretroviral therapy.
authors.affiliation: Universidade Federal da Bahia, Salvador, Bahia, Brazil. crbrites@ufba.br
authors.forename: C
authors.initials: C
authors.lastname: Brites
authors.forename: F
authors.initials: F
authors.lastname: Goyanna
authors.forename: L G
authors.initials: LG
authors.lastname: França
authors.forename: C
authors.initials: C
authors.lastname: Pedroso
authors.forename: E M
authors.initials: EM
authors.lastname: Netto
authors.forename: S
authors.initials: S
authors.lastname: Adriano
authors.forename: J
authors.initials: J
authors.lastname: Sampaio
authors.forename: W
authors.initials: W
authors.lastname: Harrington
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016516:CD4-CD8 Ratio; D005260:Female; D015490:HTLV-I Infections / Q000150:complications / Q000175:diagnosis / Q000276:immunology; D015491:HTLV-II Infections / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013322:Strongyloidiasis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology