title: Delayed liver fibrosis in HTLV-2-infected patients co-infected with HIV-1 and hepatitis C virus with suppressive antiretroviral therapy.
abstract: OBJECTIVE
  The absence of direct clinical symptoms clearly associated to HTLV-2 infection may partially explain an underestimate of the real HTLV-2 prevalence rate and its effects in patients concurrently infected with HIV-1 and hepatitis C virus (HCV). Hence, to date, the influence of HTLV-2 on hepatic fibrosis has been poorly studied.
  
  
  METHODS
  Retrospective study to clarify the influence of HTLV-2 infection in HCV infection and hepatic fibrosis among patients co-infected with HIV-1.
  
  
  METHODS
  This is a comparative cohort study including 39 HTLV-2-HIV-1-HCV co-infected patients and 42 HIV-1-HCV co-infected patients conducted in a tertiary care hospital. They were evaluated for transaminase levels, hepatic fibrosis stage, interleukin (IL)-28B genotype, Th1/Th2/Th17 cytokine levels, immune activation, inflammation, and microbial translocation.
  
  
  RESULTS
  HTLV-2-HIV-1-HCV co-infected patients had lower alanine aminotransferase levels (P = 0.023) and hepatic fibrosis (P = 0.012), compared to HIV-1-HCV co-infected patients. Moreover, Kaplan-Meier survival analysis showed a delay in hepatic fibrosis development for up to 5 years (P = 0.032). HTLV-2-HIV-1-HCV co-infected patients also had higher Th1/Th2 ratio (interferon γ/IL-4 ratio, P = 0.043; tumor necrosis factor α/IL-4 ratio, P = 0.010) and Th17 response (P = 0.015), whereas lower CD8 T-cell activation (P = 0.017) and lipopolysaccharide level (P = 0.001).
  
  
  CONCLUSIONS
  Findings strongly support that HTLV-2 co-infection might delay fibrosis development in HCV-HIV-1 co-infected patients.
authors.affiliation: aLaboratory of Molecular Immunovirology bDepartment of Infectious Diseases cDepartment of Liver-Gastroenterology, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Abad-Fernández
authors.forename: Ana
authors.initials: A
authors.lastname: Moreno
authors.forename: Fernando
authors.initials: F
authors.lastname: Dronda
authors.forename: Santos
authors.initials: S
authors.lastname: del Campo
authors.forename: Carmen
authors.initials: C
authors.lastname: Quereda
authors.forename: José Luis
authors.initials: JL
authors.lastname: Casado
authors.forename: María-Jesús
authors.initials: MJ
authors.lastname: Pérez-Elías
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.forename: Alejandro
authors.initials: A
authors.lastname: Vallejo
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D044966:Anti-Retroviral Agents; D060085:Coinfection; D016207:Cytokines / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D015497:HIV-1; D006526:Hepatitis C / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D015367:Human T-lymphotropic virus 2 / Q000276:immunology*; D006801:Humans; D007165:Immunosuppression Therapy; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000276:immunology / Q000473:pathology* / Q000821:virology; D008297:Male; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: D044966:Anti-Retroviral Agents; D016207:Cytokines; D000410:Alanine Transaminase