title: Molecular Detection and Clinical Implications of HTLV-1 Infections among Antiretroviral Therapy-Naïve HIV-1-Infected Individuals in Abuja, Nigeria.
abstract: BACKGROUND
  Individuals with human T-cell lymphotrophic virus type-1 (HTLV-1)/HIV-1 coinfection have been demonstrated to undergo CD4+ lymphocytosis even in the face of immunodeficiency and increased vulnerability to opportunistic pathogens that can lead to poor prognosis.
  
  
  OBJECTIVE
  This study investigated the prevalence as well as the effects of HIV-1/HTLV-1 coinfection on CD4+ cell counts, routine hematology, and biochemical parameters of study participants.
  
  
  METHODS
  This prospective cross-sectional study involved 184 blood samples collected from HIV-1-seropositive individuals attending HIV-special clinic of the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. These samples were analyzed for anti-HTLV-1/2 IgM antibodies using enzyme-linked immunosorbent assay, CD4+ cell counts, and some routine hematological and biochemical parameters. All samples were also tested for HTLV-1 provirus DNA using real-time polymerase chain reaction (PCR) assay.
  
  
  RESULTS
  Of the 184 subjects studied, 9 (4.9%) were anti-HTLV-1/2 IgM seropositive; however, upon real-time PCR testing, 12 (6.5%) had detectable HTLV-1 provirus DNA. The CD4+ cell count was significantly high in HTLV-1-positive (742 ± 40.2) subjects compared to their HTLV-1-negative (380 ± 28.5) counterpart (P-value = 0.025). However, there was no significant association between HTLV-1 positivity with other hematology and biochemical parameters studied (P > 0.05).
  
  
  CONCLUSIONS
  All subjects (100%) who were HTLV-1/HIV-1-coinfected had normal CD4+ counts. This gives contrasting finding on the true extent of immunodeficiency of subjects. So it is suggested to be very careful in using only CD4+ counts to monitor disease progression and as indicators for antiretroviral therapy (ART) in resource-limited settings. In such conditions, there may be a need to test for HTLV-1 alongside HIV viral loads in order to begin appropriate ART regimens that contain both pathogens.
authors.affiliation: Department of Medical Microbiology, University of Abuja Teaching Hospital, FCT Abuja, Nigeria.
authors.forename: Idris Abdullahi
authors.initials: IA
authors.lastname: Nasir
authors.affiliation: Immunology Unit, Department of Medicine, Ahmadu Bello University, Kaduna State, Nigeria.
authors.forename: Abdurrahman Elfulaty
authors.initials: AE
authors.lastname: Ahmad
authors.affiliation: Department of Medical Laboratory Science, University of Calabar, Cross River State, Nigeria.
authors.forename: Anthony Uchenna
authors.initials: AU
authors.lastname: Emeribe
authors.affiliation: Immunology Unit, Department of Medicine, Ahmadu Bello University, Kaduna State, Nigeria.
authors.forename: Muhammad Sagir
authors.initials: MS
authors.lastname: Shehu
authors.affiliation: Department of Medical Laboratory Science, University of Maiduguri, Borno State, Nigeria.
authors.forename: Jessy Thomas
authors.initials: JT
authors.lastname: Medugu
authors.affiliation: Department of Medical Microbiology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi State, Nigeria.
authors.forename: Adamu
authors.initials: A
authors.lastname: Babayo
keywords: HIV-1; HTLV-1; Nigeria; PCR; prevalence; serology