CD4+ T-cell count may not be a useful strategy to monitor antiretroviral therapy response in HTLV-1/HIV co-infected patients

Alain Vandormael, Filipe Rego, Siva Danaviah, Luiz Carlos Junior Alcantara, David Boulware, Tulio de Oliveira

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Background: HTLV-1/HIV co-infection is known to elevate the CD4+ T-cell counts of treatment-naive 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.

Original languageEnglish (US)
Pages (from-to)225-231
Number of pages7
JournalCurrent HIV research
Volume15
Issue number3
DOIs
StatePublished - Jan 1 2017

Keywords

  • ART
  • CD4+ count
  • Co-infection
  • HIV
  • HTLV-1
  • South Africa
  • Treatment failure

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