HIV, HTLV AND DRUG ABUSE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. HIV/HTLV co-infections occur frequently and in the range of 1-15% among HIV-1 infected individuals. The relationship between levels of HTLV-1/2 viral burden and disease, and effects of antiretroviral treatment, however, is unknown. HTLV-1/2 ELISA-positive individuals (N=97) from the New Orleans, Louisiana, HIV Outpatient Clinic (HOP) were evaluated at baseline enrollment into a follow-up study. Variables considered were: demographics, use of street drugs, antiretroviral therapy, T cell subsets, HIV viral loads, HTLV-1/2 Western blotting, peripheral blood mononuclear cell (PBMC) cultures for detection of HTLV-1/2 p19 antigens, and real time PCR to quantify HTLV-1/2 proviral copy number. HTLV proviral load was dichotomized into ? 20,000 and 20,000 categories for ease of comparison. CD4 and CD8 were categorized into three ordinal categories, using well-established cut-points. Frequencies were computed and Chi-squared statistics or Fisher¿s Exact test were used to test for differences between groups. Hypothesis tests were two-sided and SAS version 8.2 was used to conduct statistical analysis. Among those subjects with a positive HTLV western blot confirmatory test, there was a statistically significant correlation between an HTLV-1/2 proviral copy number of 20,000 copies/106 PBMCs and a higher absolute CD4 cell count, HTLV-1 vs HTLV-2 western blot positivity, and a HTLV-1/2 p19 positive assay result. Preliminary data analysis suggested no differences with respect to race, gender, antiretroviral drug administration, or use of street drugs within the prior 3 months. These results suggest that HTLV-1/2 viral burden in PBMCs has an impact on disease staging among HIV-infected individuals.