TITLE

Loss of correlation between HIV viral load and CD4 + T-cell counts in HIV/HTLV-1 co-infection in treatment naïve Mozambican patients

AUTHOR(S)
Bhatt, N. B.; Gudo, E. S.; Semá, C.; Bila, D.; Di Mattel, P.; Augusto, O.; Garsia, R.; Jani, I. V.
PUB. DATE
December 2009
SOURCE
International Journal of STD & AIDS;Dec2009, Vol. 20 Issue 12, p863
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Summary: Seven hundred and four HIV-1 /2-positive, antiretroviral therapy (ART) naïve patients were screened for HTLV-1 infection. Antibodies to HTLV-1 were found in 32/704 (4.5%) of the patients. Each co-infected individual was matched with two HIV mono-infected patients according to World Health Organization clinical stage, age ± 5 years and gender. Key clinical and laboratory characteristics were compared between the two groups. Mono-infected and co-infected patients displayed similar clinical characteristics. However, co-infected patients had higher absolute CD4+ T-cell counts (P = 0.001), higher percentage CD4+ T-cell counts (P < 0.001) and higher CD4/CD8 ratios (P < 0.001). Although HIV plasma RNA viral loads were inversely correlated with CD4+ T-cell-counts in mono-infected patients (P < 0.0001), a correlation was not found in co-infected individuals (P = 0.11). Patients with untreated HIV and HTLV-1 co-infection show a dissociation between immunological and HIV virological markers. Current recommendations for initiating ART and chemoprophylaxis against opportunistic infections in resource-poor settings rely on more readily available CD4+ T-cell counts without viral load parameters. These guidelines are not appropriate for co-infected individuals in whom high CD4+ T-cell counts persist despite high HIV viral load states. Thus, for co-infected patients, even in resource-poor settings, HIV viral loads are likely to contribute information crucial for the appropriate timing of ART introduction.
ACCESSION #
47796055

 

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