Human T-Cell Lymphotropic Virus Type I (HTLV-I)-Associated Adult T-Cell Leukemia-Lymphoma in a Patient Infected with Human Immunodeficiency Virus Type 1 (HIV-1)

Abstract

A patient had adult T-cell leukemia-lymphoma in the unusual setting of coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type I (HTLV-I). The leukemic cells were CD4 positive and showed clonal genetic rearrangement of the T-cell receptor complex. Cytogenetic analysis showed three clonal karyotypic abnormalities: trisomy 3 and two translocations [t(1;15), (X;1)]. The patient was seropositive for HIV and HTLV-I; HTLV-I and HIV-1 DNA sequences were detected in peripheral blood leukocytes by the polymerase chain reaction. The HTLV-I sequences were detected in a relatively high proportion of mononuclear cells (at least 1 in 30 cells), whereas HIV-1 sequences were detected in a smaller proportion of cells (at least 1 in 3000 cells). Clinical remission was achieved after chemotherapy. There was a decrease in the proportion of HTLV-I positive mononuclear cells (at least 1 in 1000 cells), whereas the proportion of HIV-1 positive cells was relatively unchanged (at least 1 in 1000 cells). Adult T-cell leukemia-lymphoma in the setting of HIV coinfection may become increasingly common because asymptomatic retroviral coinfections are frequent.

Retroviral Coinfections: HIV and HTLV: Taking Stock of More Than a Quarter Century of Research

“…50 Additional case reports of dually infected patients developing aggressive lymphomas and death were in agreement with the assertion that HIV-1 and HTLV-1 coinfection leads to accelerated progression to AIDS. 51,52 A third study conducted in Miami suggested that IDUs who were coinfected with both HIV-1 and HTLV-1 or HTLV-2 were three times more likely to die from AIDS during follow-up than were those infected with HIV-1 only. 53 All three of these studies provided a consensus at that time that HTLV seropositivity adversely affected the clinical outcomes of persons with HIV-1.…”

HTLV-1/-2 and HIV-1 co-infections: retroviral interference on host immune status

“…On the contrary, other researchers observed a delayed HIV-1 disease progression in HTLV-1-co-infected patients when compared to HIV-1-mono-infected individuals (Shibata et al, 1989; Page et al, 1990; Chavance et al, 1995; Beilke et al, 2004). In according to these findings, a higher survival rate was reported for HIV-1/HTLV-1-co-infected subjects (Brites et al, 2001, 2005).…”

Effect of Repetitive Transcranial Magnetic Stimulation on Reducing Spasticity in Patients Suffering From HTLV-1–Associated Myelopathy

“…They were selected from 17 previously diagnosed patients who had consent to participate in this study and were visited in neurology ward of Shariati hospital affiliated to Tehran University of Medical Sciences, Tehran, Iran. The patients with definite HAM/ TSP according to WHO guidelines were recruited (Shibata et al, 1989). They had nonremitting progressive spastic paraparesis, positive serology (by enzyme-linked immunosorbent assay technique, confirmed by Western blot) in serum and/or detection of proviral HTLV-I DNA; in addition, other disorders were excluded.…”