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Session 63 Poster Abstracts
Pathogenesis: Co-Infection and Other Viruses
Thursday, 1:30 - 3:30 pm
Hall D


306    
HTLV-1/2 Viral Load and and Immunologic Parameters among HIV-1 Co-infected Individuals
Mark Beilke*1, M Sirois2, V Traina-Dorge3, J Walls1, R Lorino3, J West1, S Eloby-Childress1, and P Kissinger2
1Tulane Univ Hlth Sci Ctr, New Orleans, LA, USA; 2Tulane Univ, New Orleans, LA, USA; and 3Tulane Natl Primate Res Ctr, Tulane Univ, Covington, LA, USA

Background:  HIV/HTLV-1/2 co-infections occur frequently in large metropolitan areas, but the long-term effects of co-infection are unclear. HIV has been shown to increase HTLV-1/2 viral burden and certain HTLV-1/2 disease manifestations. Several reports also suggest that dually infected individuals have unexplained elevations in CD4 and CD8 cell counts despite longstanding HIV infection.

Methods:  HIV-infected outpatients at a clinic in New Orleans who tested positive via Western blot for HTLV-1 or -2 were included. Parameters for analysis at baseline included:  age, race, gender, use of street drugs within 3 months, CD4 and CD8 cell counts (stratified as < 200, 200 to 500, > 500), HIV viral load, HTLV type (1 or 2) as proxied by Western blot, HTLV-1/2 proviral load measurements by real-time PCR, and HTLV-1/2 p19 viral antigen detection in PBMC cultures. Significance was defined as an a < 0.05.

Results:  Of 82 patients studied, 72 were African American, 60 male, 37 drug users, mean age 46.88 (SD 10.32), 29 had > 10,000 HIV viral load, 22 had positive p19 qualitative cultures, 49 had an HTLV-1/2 proviral load of  ≤ 20,000 copies/106 PBMC, and 25 with > 20,000 copies/106 PMBC (viral load data were unavailable for some subjects). The factors associated with HTLV-1/2 viral load > 20,000 copies/106 PBMC were positive p19 assay results, an HTLV-1 Western blot, and higher strata CD4 and CD8 counts. Factors associated with a positive or negative p19 qualitative assay result were CD4 count, CD8 count ,and HTLV type (1 vs 2). Other factors considered but not found to be associated were age, race, gender, drug use within the last 3 months, antiretroviral therapy, and HIV viral load (≤ 10,000 vs > 10,000).

Conclusions:  An HTLV-1/2 viral load of > 20,000 copies/106 PBMC, a positive HTLV-1 Western blot, and a positive HTLV-1/2 p19 viral antigen determination, all correlated with higher CD4 and CD8 cell numbers, independent of HIV viral load, recent use of street drugs, or antiretroviral drug use.

Keywords: HTLV-1; HTLV-2; co-infections