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

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dc.contributor 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
dc.creator Bhatt, N B
dc.creator Gudo, E S
dc.creator Semá, C
dc.creator Bila, D
dc.creator Di Mattei, P
dc.creator Augusto, O
dc.creator Garsia, R
dc.creator Jani, I V
dc.date 2009-12-01
dc.date.accessioned 2017-01-31T07:27:28Z
dc.date.available 2017-01-31T07:27:28Z
dc.identifier Int J STD AIDS 2009;20(12):863-8
dc.identifier 0956-4624
dc.identifier 19948902
dc.identifier 10.1258/ijsa.2008.008401
dc.identifier http://hdl.handle.net/10144/117166
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/117166
dc.identifier International Journal of STD & AIDS
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/117166
dc.description 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.
dc.language en
dc.relation http://ijsa.rsmjournals.com/cgi/content/full/20/12/863
dc.rights Reproduced on this site with the permission of Royal Society of Medicine Press, London ([url]http://ijsa.rsmjournals.com[/url])
dc.title Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients
dc.type Article


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