CD4+ T-cell Count may not be a Useful Strategy to Monitor Antiretroviral Therapy Response in HTLV-1/HIV Co-infected Patients

Author(s): Alain Vandormael*, Filipe Rego, Siva Danaviah, Luiz Carlos Junior Alcantara, David R. Boulware, Tulio de Oliveira.

Journal Name: Current HIV Research

Volume 15 , Issue 3 , 2017

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Abstract:

Background: HTLV-1/HIV co-infection is known to elevate the CD4+ T-cell counts of treatment-naïve persons. We investigated whether HTLV-1/HIV co-infected patients continued to have elevated CD4+ T-cell counts after developing virologic failure on antiretroviral therapy (ART).

Methods: The data is taken from a drug resistance study located in the KwaZulu-Natal province of South Africa. All participants (N=383) presented for repeated CD4+ T-cell count and HIV viral load level testing between January 2006 and March 2014. We used a random-coefficient model to estimate the change in CD4+ T-cell count and HIV viral load level by HTLV-1/HIV co-infection status over time, adjusting for age, sex, and duration of virologic failure.

Results: HTLV-1/HIV co-infected participants (n=8) had higher CD4+ T-cell counts, with a positive difference of 117.2 cells/μL at the ART initiation date (p-value=0.001), 114.7 cells/μL (pvalue< 0.001) 12 months after this date, and 112.3 cells/μL (p-value=0.005) 24 months after this date, holding all else constant. In contrast, there was no difference in the HIV viral load level by HTLV-1/HIV co-infected status throughout the observation period.

Conclusion: We show that HTLV-1/HIV co-infected participants continued to have elevated CD4+ T-cell counts after developing virologic failure on ART, despite no difference in their HIV viral load levels when compared with HIV mono-infected participants. Our results indicate that CD4+ T-cell count testing may not be a useful strategy to monitor ART response in the presence of HTLV-1/HIV co-infection.

Keywords: HIV, HTLV-1, CD4+ count, co-infection, ART, treatment failure, South Africa.

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Article Details

VOLUME: 15
ISSUE: 3
Year: 2017
Page: [225 - 231]
Pages: 7
DOI: 10.2174/1570162X15666170216114917
Price: $58

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