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/disease, and effects of antiretroviral treatment, however, is unknown. HTLV1/2 and HIV ELISA positive co-infected individuals from the New Orleans HIV Outpatient Clinic (HOP), were identified and 72 patients enrolled and evaluated in the study, making this the largest co-infected patient cohort study in the United States. The variables analyzed included: HTLV-1/2 proviral load, HTLV-1/2 tax/rex mRNA expression, HIV viral load, HTLV-1/2 viral antigen detection in peripheral blood mononuclear cell (PBMC) cultures, T cell subsets, demographic variables (age, race, gender, reported use of injection drugs) and administration of highly active antiretroviral therapy (HAART). HTLV proviral load was dichotomized into d 20,000 and 20,000 categories for ease of comparison. Among subjects with HIV/HTLV-1 co-infection, an HTLV-1/2 proviral copy number of 20,000 copies/106 PBMCs was significantly associated with a higher absolute CD4 cell count, HTLV-1 vs HTLV-2 western blot positivity, positive HTLV-1/2 PBMC culture , positive tax/rex mRNA, and an HIV viral load less than 10,000 copies/ml. There was no correlation between HTLV-1/2 proviral copy number or tax/rex RNA expression and administration of antiretroviral therapy. HTLV-1/2 proviral burden was significantly higher among HIV/HTLV-1 co-infected, versus HIV/HTLV-2 co-infected individuals. These results suggest that HTLV-1/2 viral burden in PBMCs has an impact on disease staging among HIV-infected individuals. HAART may be of limited value in controlling HTLV-1/2 virus expression in patients with HIV/HTLV-1/2 co-infections.