title: The impact of human T-cell lymphotropic virus I infection on clinical and immunologic outcomes in patients coinfected with HIV and hepatitis C virus.
abstract: BACKGROUND
  HIV, hepatitis C (HCV), and human T-cell lymphotropic virus I (HTLV-1) are associated with high global burdens of disease, notably in resource-poor locales. They share similar routes of transmission and cause chronic infections with associated morbidity. We performed a cross-sectional study to assess the impact of HTLV-1 infection on clinical outcomes in HIV/HCV-coinfected patients.
  
  
  METHODS
  We enrolled 102 (72.3%) with HIV/HCV coinfection (Group 1) and 39 (27.7%) triply infected with HIV, HCV, and HTLV-1 (Group 2). We reviewed medical records of two groups of patients followed in two outpatients services in Salvador, Brazil. We collected and compared demographic, behavioral-related information, immunologic, virologic, and histologic parameters for HIV-1 and HCV infection.
  
  
  RESULTS
  Demographics, virologic, and immunologic characteristics were similar in the two groups; a higher proportion of triply infected patients (Group 2) reported any history of injection drug use compared with dually infected (Group 1) patients (75% vs 45.8%; P = 0.003). No differences were seen between groups in HIV clinical outcomes (CD4 count and viral load). Alanine aminotransferase levels were significantly higher in HIV/HCV-coinfected patients (P = 0.045). Liver fibrosis damage based on Metavir scores was similar between groups (0.97) but was worse with lower CD4 cell count (under 200 cells/mm) (P = 0.01).
  
  
  CONCLUSIONS
  HIV/HTLV-1 and HIV/HCV coinfections may worsen clinical related outcomes, but virologic and immunologic outcomes were similar in both groups. Hepatic measures were worse in patients with more severe immunosuppression.
authors.affiliation: Centro Estadual de Diagnostico, Assistencia e Pesquisa em HIV/AIDS (CEDAP), Salvador, Bahia, Brazil. fabianna.bahia@gmail.com
authors.forename: Fabianna
authors.initials: F
authors.lastname: Bahia
authors.forename: Vinicius
authors.initials: V
authors.lastname: Novais
authors.forename: Jennifer
authors.initials: J
authors.lastname: Evans
authors.forename: Chloe
authors.initials: C
authors.lastname: Le Marchand
authors.forename: Eduardo
authors.initials: E
authors.lastname: Netto
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.forename: Carlos
authors.initials: C
authors.lastname: Brites
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001938:Brazil; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology* / Q000473:pathology / Q000821:virology; D015490:HTLV-I Infections / Q000150:complications* / Q000276:immunology* / Q000473:pathology / Q000821:virology; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology* / Q000473:pathology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D019562:Viral Load
chemical_list: D000410:Alanine Transaminase