RETROVIRAL CO-INFECTIONS: HIV, HTLV AND DRUG ABUSE

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。人类嗜T淋巴病毒1型和2型（HTLV-I、HTLV-II）共感染5- 10%的艾滋病毒感染者，特别是在静脉注射吸毒是一种获取方式的大都市地区。来自人类研究和非人灵长类动物比较研究的证据表明，HIV/HTLV合并感染的综合效应是增加HTLV- i /II病毒复制和病毒负担。这可能会增加患神经退行性疾病、淋巴增生性综合征和其他htlv相关疾病的风险。在这个项目中，与HIV/HTLV合并感染相关的病毒学、血液学、临床特征和药物滥用模式将被表征。诊所人口将包括新奥尔良艾滋病毒门诊诊所的250多名合并感染者。我们的患者群体是美国最大的。我们将确定艾滋病毒和HTLV-I/II病毒负担之间的关系和(1)过去和现在的非法药物使用模式；(2)疾病的临床和神经学表现；(3) CD4、CD8下降；（四）艾滋病的发展；(5) HTLV-I/ ii相关疾病在双重感染患者中的表达。将使用从成人疾病谱临床数据库中提取的信息，与2,500多名单独感染艾滋病毒-1的患者进行比较。将使用标本库中现有的临床标本和新获得的血液标本来确定外周血单个核细胞中HTLV-I/II病毒表达与临床疾病表达之间的关系。该项目的最终目标是确定艾滋病毒/HTLV合并感染的动态，作为疾病分期和设计适当治疗的必要步骤。

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. The human T lymphotropic viruses types 1 and 2 (HTLV-I, HTLV-II) co-infect 5-10 percent of HIV-infected individuals, especially in metropolitan areas where intravenous drug use is a mode of acquisition. Evidence from human studies and from comparative studies in nonhuman primates suggests that the composite effect of HIV/HTLV co-infection is increased HTLV-I/II viral replication and viral burden. This may accelerate the risk for neurodegenerative disease, lymphoproliferative syndromes and other HTLV-associated diseases. In this project the virologic, hematologic, clinical features and substance abuse patterns associated with HIV/HTLV co-infections will be characterized. The clinic population will include over 250 co-infected individuals at the New Orleans HIV Outpatient Clinic. Our patient cohort is the largest in the United States. We will determine the relationship between HIV and HTLV-I/II viral burden and (1) past and present patterns of illicit drug use; (2) clinical and neurologic manifestations of disease; (3) rates of CD4 and CD8 decline; (4) development of AIDS; and (5) expression of HTLV-I/II-associated illnesses in dually infected patients. Comparisons will be made with over 2,500 patients infected with HIV-1 alone, using information extracted from the Adult Spectrum of Disease Clinical Database. Existing clinical speciments available in a specimen repository and freshly obtained blood specimens will be used to determine the relationship between HTLV-I/II virus expression in peripheral blood mononuclear cells and expression of clinical disease. The ultimate goal of this project is to define the dynamics of HIV/HTLV co-infections as a necessary step in disease staging and devising appropriate treatments.