Coinfection with HIV-1 and human T-Cell lymphotropic virus type II in intravenous drug users is associated with delayed progression to AIDS

• Published in: Journal of acquired immune deficiency syndromes (1999) Vol. 41; no. 1; p. 100
• Main Authors: Turci, Marco, Pilotti, Elisabetta, Ronzi, Paola, Magnani, Giacomo, Boschini, Antonio, Parisi, Saverio G, Zipeto, Donato, Lisa, Antonella, Casoli, Claudio, Bertazzoni, Umberto
• Format: Journal Article
• Language: English
• Published: United States 01.01.2006
• Subjects: Acquired Immunodeficiency Syndrome - epidemiology; Adult; CD8-Positive T-Lymphocytes - immunology; Disease Progression; European Continental Ancestry Group; Female; HIV Infections - complications; HIV Infections - immunology; HIV Infections - transmission; HIV-1 - genetics; HIV-1 - isolation & purification; HTLV-II Infections - complications; HTLV-II Infections - immunology; HTLV-II Infections - transmission; Human T-lymphotropic virus 2 - genetics; Human T-lymphotropic virus 2 - isolation & purification; Humans; Italy; Male; Polymerase Chain Reaction; Retrospective Studies; Substance Abuse, Intravenous; T-Lymphocyte Subsets - immunology; Viremia - epidemiology; Italy
• ISSN: 1525-4135
• DOI: 10.1097/01.qai.0000179426.04166.12

Human T-cell lymphotropic virus (HTLV) type II has spread among intravenous drug users (IDUs), many of whom are coinfected with HIV-1. We have investigated the rate of HTLV-II infection in 3574 Italian IDUs screened for HIV-1, HTLV-I, and HTLV-II from 1986 to the present. HTLV-II proviral load was determined by a real-time polymerase chain reaction specifically designed for tax amplification. The frequency of HTLV-II infection was 6.7% among HIV-1-positive subjects and 1.1% among HIV-1-negative subjects (P < 0.0001). For examination of AIDS progression, a group of 437 HIV-1-monoinfected subjects and another group of 96 HIV-1/HTLV-II-coinfected subjects were monitored. Enrollees were matched at entry by CD4 cell counts and followed for an average of 13 years. HIV-1/HTLV-II coinfection was associated with older age (P < 0.0001) and higher CD4 (P < 0.0001) and CD8 (P < 0.001) cell counts compared with monoinfected IDUs. The number of long-term nonprogressors for AIDS was significantly higher (P < 0.0001) among coinfected patients (13 [13.5%] of 96 patients) than HIV monoinfected patients (5 [1.1%] of 437 patients), showing that HTLV-II exerts a protective role. An increased incidence of liver disease and hepatitis C virus positivity among coinfected IDUs was observed. Five coinfected subjects undergoing antiretroviral therapy showed a significant (P < 0.05) increase in HTLV-II proviral load concomitant to a decrease in HIV-1 viremia, suggesting that the treatment is ineffective against HTLV-II infection.