Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis and delay in starting antiretroviral therapy for AIDS patients

• Published in: The Brazilian journal of infectious diseases 2011-01, Vol.15 (1), p.6-11
• Main Authors: Brites, C., Goyanna, F., França, L.G., Pedroso, C., Netto, E.M., Adriano, S., Sampaio, J., Harrington, W.
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Adult; AIDS (Disease); AIDS-Related Opportunistic Infections - complications; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - immunology; Antiretroviral Therapy, Highly Active; Antiviral agents; Care and treatment; CD4-CD8 Ratio; CD4/CD8; coinfection Strongyloidiasis; Comorbidity; Development and progression; Female; Highly active antiretroviral therapy; HIV; HIV patients; HTLV-I Infections - complications; HTLV-I Infections - diagnosis; HTLV-I Infections - immunology; HTLV-I/II; HTLV-II Infections - complications; HTLV-II Infections - diagnosis; HTLV-II Infections - immunology; Humans; Male; Retrospective Studies; Risk Factors; Strongyloidiasis - diagnosis; Strongyloidiasis - etiology; Strongyloidiasis - immunology
• ISSN: 1413-8670; 1678-4391
• DOI: 10.1016/S1413-8670(11)70132-5

To compare the clinical characteristics and outcomes of HIV-1-HTLV-1 coinfected patients, in Bahia, Brazil. Retrospective, comparative study. Among a total of 123 consecutive HIV infected patients, 20 men (20.6%) and 6 women (23.1%) had detectable antibodies against HTLV-I/II. The major risk factor associated with coinfection by HTLV was intravenous drug use (57.7% of coinfected patient versus 9.2% of HTLV seronegative patients, p < 0.0001). Coinfected patients had higher absolute lymphocyte counts (1,921 + 762 versus 1,587 + 951, p = 0.03). Both groups of patients had similar means of CD4+ and CD8+ cell counts. However, among patients with AIDS CD4+ cell counts were significantly higher among those coinfected with HTLV-I/II (292 ± 92 cells/mm3, versus 140 ± 177cells/mm3, p = 0.36). The frequency and type of opportunistic infections were similar for both groups, but strongyloidiasis and encephalopathy were more frequently diagnosed in coinfected patients (p < 0.05). On the other hand, patients coinfected with HTLV-I/II received significantly less antiretroviral therapy than singly infected by HIV-1 Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis for HIV patients. Higher CD4 count may lead to underestimation of immunodeficiency, and delay to initiate antiretroviral therapy.