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

Hdl Handle:
http://hdl.handle.net/10144/117166
Title:
Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients
Authors:
Bhatt, N B; Gudo, E S; Semá, C; Bila, D; Di Mattei, P; Augusto, O; Garsia, R; Jani, I V
Journal:
International Journal of STD & AIDS
Abstract:
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.
Affiliation:
Department of Immunology, Instituto Nacional de Saúde, Maputo, Mozambique; HIV Outpatient Clinic, Alto Mae Health Centre, Medecins Sans Frontieres, Switzerland, Maputo, Mozambique; Department of Medicine, University of Sydney, New South Wales, Australia;Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
Issue Date:
1-Dec-2009
URI:
http://hdl.handle.net/10144/117166
DOI:
10.1258/ijsa.2008.008401
PubMed ID:
19948902
Additional Links:
http://ijsa.rsmjournals.com/cgi/content/full/20/12/863
Submitted date:
2010-10-15
Type:
Article
Language:
en
ISSN:
0956-4624
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorBhatt, N Ben
dc.contributor.authorGudo, E Sen
dc.contributor.authorSemá, Cen
dc.contributor.authorBila, Den
dc.contributor.authorDi Mattei, Pen
dc.contributor.authorAugusto, Oen
dc.contributor.authorGarsia, Ren
dc.contributor.authorJani, I Ven
dc.date.accessioned2010-12-03T15:46:56Z-
dc.date.available2010-12-03T15:46:56Z-
dc.date.issued2009-12-01-
dc.date.submitted2010-10-15-
dc.identifier.citationInt J STD AIDS 2009;20(12):863-8en
dc.identifier.issn0956-4624-
dc.identifier.pmid19948902-
dc.identifier.doi10.1258/ijsa.2008.008401-
dc.identifier.urihttp://hdl.handle.net/10144/117166-
dc.description.abstractSeven 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.en
dc.language.isoenen
dc.relation.urlhttp://ijsa.rsmjournals.com/cgi/content/full/20/12/863en
dc.rightsReproduced on this site with the permission of Royal Society of Medicine Press, London ([url]http://ijsa.rsmjournals.com[/url])en
dc.subject.meshAdulten
dc.subject.meshCD4 Lymphocyte Counten
dc.subject.meshCD4-CD8 Ratioen
dc.subject.meshFemaleen
dc.subject.meshHIV Infectionsen
dc.subject.meshHIV-1en
dc.subject.meshHIV-2en
dc.subject.meshHTLV-I Antibodiesen
dc.subject.meshHTLV-I Infectionsen
dc.subject.meshHuman T-lymphotropic virus 1en
dc.subject.meshHumansen
dc.subject.meshLymphocyte Activationen
dc.subject.meshLymphocytosisen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMozambiqueen
dc.subject.meshPrevalenceen
dc.subject.meshViral Loaden
dc.titleLoss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patientsen
dc.typeArticleen
dc.contributor.departmentDepartment of Immunology, Instituto Nacional de Saúde, Maputo, Mozambique; HIV Outpatient Clinic, Alto Mae Health Centre, Medecins Sans Frontieres, Switzerland, Maputo, Mozambique; Department of Medicine, University of Sydney, New South Wales, Australia;Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, NSW, Australiaen
dc.identifier.journalInternational Journal of STD & AIDSen

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