Short Communication: Failures in Detecting HTLV-1 and HTLV-2 in Patients Infected with HIV-1

Author(s)

Campos, Karoline Rodrigues ; Goncalves, Maria Gisele ; Caterino-de-Araujo, Adele

• Document type: Journal article
• Source: AIDS Research and Human Retroviruses; v. 33, n. 4, p. 4-pg., 2017-04-01.

Abstract

Changes in retrovirus acquisition/transmission behaviors have been reported in Brazil, with a concerning increase in HIV-1-infected individuals aged 15-39 years. In Sao Paulo, HIV-1/HTLV-1 and HIV-1/HTLV-2 coinfections have been associated with intravenous drug use and failure to detect HTLV-1/2 (human T cell lymphotropic virus types 1 and 2) with immunosuppression and the use of highly active antiretroviral therapy (HAART). Negative results for HTLV serologic [western blotting (WB)] and molecular [real-time PCR pol (qPCR)] confirmatory assays have been reported, whereas the best sensitivity has been found for INNO-LIA (LIA). In this study, we expand our previous data by analyzing a group of young patients (n = 1,383; median age 35.6 years) who recently acquired HIV by sexual contact, the majority of whom were HAART naive, and comparing the performances of four HTLV confirmatory assays: LIA, WB, qPCR, and PCR-RFLP (tax). We confirmed HTLV infection in 58 (4.2%) blood samples: 29 HTLV-1, 24 HTLV-2, 1 HTLV-1+HTLV-2, and 4 HTLV. LIA, WB, qPCR, and PCR-RFLP sensitivities were 94.8%, 82.8%, 79.2%, and 74.5%, respectively. Associations of HTLV infection with female gender (OR = 2.28, 1.31-4.00) and age >40 years (p < .0001) were detected. The results confirm the low sensitivities of molecular assays and the best performance of LIA in detecting HTLV-1/2 in such patients. We hypothesize that the negative PCR results are due to the presence of defective provirus and/or low proviral load circulating in such patients, with inconclusive WB coinciding with the seroconversion period. Corroborating the associations obtained, repeated exposure is required for HTLV sexual transmission/acquisition, which is more efficient from male to female. (AU)

• FAPESP's process: 16/03654-0 - Host and virus genetic markers that influenced the course of the HIV-1, HIV-1/HTLV-1 and HIV-1/HTLV-2 coinfections
• Grantee: Adele Caterino de Araújo
• Support Opportunities: Regular Research Grants
• FAPESP's process: 12/51220-8 - Surveillance and diagnosis of HTLV-1 and HTLV-2 in HIV-infected individuals (SuDiHIV/HTLV)
• Grantee: Adele Caterino de Araújo
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)