HIV co-infection in HTLV-1 carriers in Spain

• Published in: Virus research Vol. 266; pp. 48 - 51
• Main Authors: de Mendoza, Carmen, Caballero, Estrella, Aguilera, Antonio, Benito, Rafael, Maciá, Dolores, García-Costa, Juan, Soriano, Vicente
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2019
• Subjects: Adult; Adult T-cell leukemia; AIDS; Antiretroviral therapy; Carrier State - epidemiology; Carrier State - pathology; Carrier State - physiopathology; Carrier State - virology; Co-infection; Coinfection - epidemiology; Coinfection - virology; Emigrants and Immigrants; Epidemiology; Female; HIV; HIV Infections - epidemiology; HIV Infections - virology; HIV-1 - isolation & purification; HTLV; HTLV-I Infections - epidemiology; HTLV-I Infections - pathology; HTLV-I Infections - physiopathology; HTLV-I Infections - virology; Human T-lymphotropic virus 1 - isolation & purification; Humans; Late diagnosis; Male; Middle Aged; Registries; Risk Factors; Spain - epidemiology; Tropical spastic paraparesis; Spain; Co-infection; Adult T-cell leukemia; HIV; HTLV; Tropical spastic paraparesis; AIDS; Late diagnosis; Epidemiology; Antiretroviral therapy
• ISSN: 0168-1702; 1872-7492
• DOI: 10.1016/j.virusres.2019.04.004

Human retroviruses HIV and HTLV share transmission routes. HIV widely spread in Spain during the 80 s through injection drug use and sex, and nowadays HIV rates in Spain account for one of the largest in Europe. In contrast, HTLV-1 is not endemic in Spain, despite hosting huge numbers of migrants from highly endemic regions. Herein, we report the rate and main features of the HIV-HTLV co-infected population in Spain. A national registry exists in Spain for HTLV since year 1989. Data from standardized case report forms and one centralized lab repository were reviewed, especially for the subset with HTLV-HIV co-infection. Up to December 2018, a total of 369 individuals with HTLV-1 had been diagnosed in Spain. 64% of the population were females, and Latin American individuals accounted for 64.5%. Classical HTLV-associated illnesses were found in 12.7% (myelopathy) and 7.6% (leukemia). HIV coinfection was found in 12 (3.2%). Of those, 3 patients (25%) were female and 39 (75%) were of non-Spanish origin. All but two harbored HIV-1 subtype B, being non-B variants found in the two West Africans. Exposure had been sexual in most cases, being 4 homosexual men. Seven HTLV-HIV co-infected patients had developed AIDS and two had developed myelopathy. There was no evidence for increased HTLV-1 clinical pathogenicity due to HIV coinfection. HIV coinfection is infrequent (<5%) among HTLV-1 carriers in Spain. More than half of co-infected patients come from Latin America. Sexual contact is the most frequent risk behavior, being MSM one third of cases. Late diagnosis explains the high rate (9/12) of clinical manifestations in our HIV-HTLV co-infected population.