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

J Acquir Immune Defic Syndr. 2006 Jan 1;41(1):100-6. 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / epidemiology*
  • Adult
  • CD8-Positive T-Lymphocytes / immunology
  • Disease Progression
  • 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
  • White People