Volume 12 Supplement 1
Comparison of clinical, immunological and virological markers in patients with HTLV-1 / HIV-1 co-infection with those with mono-infection
© Dhasmana et al. 2015
Published: 28 August 2015
This is a study of the HTLV-1/HIV-1 co-infected cohort attending the National Centre for Human Retrovirology in London. In a retrospective analysis, demographic, clinical, immunological and virological data was described. A subgroup of patients on combination antiretroviral therapy (cART) for more than twelve months with an undetectable HIV viral load was identified and compared to a matched HTLV-1 mono-infected group. In an ongoing prospective study, HIV-1 mono-infected patients are recruited and virological and immunological parameters compared to the HTLV/HIV co-infected and HTLV mono-infected groups. 29 co-infected patients had a median age of 47 years, 55% were male and over 80% identified with the Black – African/Caribbean ethnic group. The median time on cART was 6 months. CD4/CD4% cell counts were lower in stable co-infected patients (508 cells/mm3, p=0.2 / 27.9%, p<0.1) than HTLV mono-infected patients (941 cells/mm3/46.2%). There was a significant trend towards increased markers of T cell activation (TCA) in co-infected patients (Table 1), when compared to TCA markers in either mono-infected group. There were no statistically significant differences in pro-inflammatory cytokines between co-infected and mono-infected patients. However, there was a trend towards higher median interleukin-2 and gamma interferon concentrations in the co-infected group. Response to cART was not blunted in co-infection, and there was normalisation of CD4 counts over 12 months. In one patient absolute HTLV pVL (pro-viral load) increased 12 months after treatment with cART. The results demonstrate that there are differences between HTLV/HIV co-infected and mono-infected patients; notably increased immune activation, despite successful treatment with cART. It is hypothesised that co-infection creates an environmental milieu, reflected by increased immune TCA, that is associated with a higher prevalence of HTLV associated myelopathy that is observed in this group.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.