{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:55:39Z","timestamp":1791561339468,"version":"4.3.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T00:00:00Z","timestamp":1565654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coinfection with human T-cell lymphotrophic virus type 1 (HTLV-1) is associated with shorter survival for adults and children infected with human immunodeficiency virus (HIV), although the reasons remain a matter of debate. We evaluated the factors associated with survival time in a large cohort of HIV\/HTLV-1\u2013coinfected and HIV-monoinfected individuals on combination antiretroviral therapy (cART).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In a nested, retrospective case-control study (1:1), we reviewed medical records of people with HIV infection on cART in a referral AIDS center in Salvador, Brazil. We matched 149 patients coinfected with HTLV-1 (cases) by age at HIV diagnosis and sex, to an equal number of HTLV-uninfected persons (controls). Death rates, survival time, baseline and current CD4 cell count, last HIV-1 RNA plasma viral load (pVL), and causes of death were compared between groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall mortality rate was 2.1 person-years (76 deaths, 53 among coinfected patients). Survival time for cases (16.7 \u00b1 0.7 years) was significantly shorter than for controls (18.1 \u00b1 0.4 years; P = .001). Among patients with pVL &amp;gt;50 copies\/mL, coinfected patients had a shorter survival time (8.4 \u00b1 0.8 years) than monoinfected ones (12.9 \u00b1 1.4 years; P = .02), regardless of pVL magnitude. However, survival time did not differ for HIV-monoinfected (19.0 \u00b1 0.4 years) or coinfected patients (20.2 \u00b1 0.6 years) presenting with pVL &amp;lt;50 copies\/mL (P = .5). Deceased coinfected patients had higher initial CD4 count (417 \u00b1 219 cells) than monoinfected ones with the same outcome (177 \u00b1 160 cells; P = .004), while survivors had similar CD4 cell count at baseline, regardless of HTLV status.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Successful cART is able to normalize survival for coinfected patients and should be introduced for all coinfected patients, regardless of CD4 cell count.<\/jats:p>\n                  <jats:p>HIV\/human T-cell lymphotrophic virus type 1 coinfection is believed to decrease survival of coinfected patients. In this case-control study, we demonstrate that successful combination antiretroviral therapy (last HIV viral load\u00a0&amp;lt;50 copies\/mL) is able to improve survival of coinfected patients to levels observed for those monoinfected.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz756","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T19:10:53Z","timestamp":1565032253000},"page":"196-200","source":"Crossref","is-referenced-by-count":13,"title":["Early and Successful Combination Antiretroviral Therapy Normalizes Survival Time in Patients Coinfected With Human Immunodeficiency Virus and Human T-cell Lymphotrophic Virus Type 1"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4673-6991","authenticated-orcid":false,"given":"Carlos","family":"Brites","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Miranda","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estela","family":"Luz","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Martins","family":"Netto","sequence":"first","affiliation":[{"name":"Laborat\u00f3rio de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,8,13]]},"reference":[{"key":"2020062404334709000_CIT0001","doi-asserted-by":"crossref","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","article-title":"Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma","volume":"77","author":"Poiesz","year":"1980","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2020062404334709000_CIT0002","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1016\/S0140-6736(87)91172-X","article-title":"Progression to AIDS in homosexual men co-infected with HIV and HTLV-I in Trinidad","volume":"2","author":"Bartholomew","year":"1987","journal-title":"Lancet"},{"key":"2020062404334709000_CIT0003","first-page":"413","article-title":"Coinfection with HIV and HTLV-I infection and survival in AIDS stage. French Guiana Study. GECVIG (Clinical HIV Study Group in Guiana) [in French]","volume":"29","author":"Sobesky","year":"2000","journal-title":"Presse Med"},{"key":"2020062404334709000_CIT0004","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1097\/00002030-200110190-00023","article-title":"Co-infection with HTLV-1 is associated with a shorter survival time for HIV-1-infected patients in Bahia, Brazil","volume":"15","author":"Brites","year":"2001","journal-title":"AIDS"},{"key":"2020062404334709000_CIT0005","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1086\/422146","article-title":"Clinical outcomes and disease progression among patients coinfected with HIV and human T lymphotropic virus types 1 and 2","volume":"39","author":"Beilke","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2020062404334709000_CIT0006","author":"Barrios"},{"key":"2020062404334709000_CIT0007","first-page":"1096","article-title":"The risk of development of HTLV-I-associated myelopathy\/tropical spastic paraparesis among persons infected with HTLV-I","volume":"3","author":"Kaplan","year":"1990","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020062404334709000_CIT0008","doi-asserted-by":"crossref","DOI":"10.3390\/v10010001","article-title":"HTLV-1, the other pathogenic yet neglected human retrovirus: from transmission to therapeutic treatment","volume":"10","author":"Futsch","year":"2017","journal-title":"Viruses"},{"key":"2020062404334709000_CIT0009","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1001\/jama.1994.03510290035033","article-title":"Coinfection with human T-cell lymphotropic virus type I and HIV in Brazil. Impact on markers of HIV disease progression","volume":"271","author":"Schechter","year":"1994","journal-title":"JAMA"},{"key":"2020062404334709000_CIT0010","doi-asserted-by":"crossref","first-page":"S208","DOI":"10.1097\/QAI.0b013e31821e9baf","article-title":"Coinfection by HIV-1 and human lymphotropic virus type 1 in Brazilian children is strongly associated with a shorter survival time","volume":"57","author":"Pedroso","year":"2011","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020062404334709000_CIT0011","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1086\/426690","article-title":"Coinfection with HIV and human T lymphotropic virus type 1: what is the real impact on HIV disease?","volume":"40","author":"Brites","year":"2005","journal-title":"Clin Infect Dis"},{"key":"2020062404334709000_CIT0012","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/S1413-8670(11)70132-5","article-title":"Coinfection by HTLV-I\/II is associated with an increased risk of strongyloidiasis and delay in starting antiretroviral therapy for AIDS patients","volume":"15","author":"Brites","year":"2011","journal-title":"Braz J Infect Dis"},{"key":"2020062404334709000_CIT0013","first-page":"8","article-title":"HIV\/human T-cell lymphotropic virus coinfection revisited: impact on AIDS progression","volume":"11","author":"Brites","year":"2009","journal-title":"AIDS Rev"},{"key":"2020062404334709000_CIT0014","first-page":"959","article-title":"Seroepidemiology of human T-cell lymphotropic virus type I\/II in northeastern Brazil","volume":"6","author":"Moreira","year":"1993","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2020062404334709000_CIT0015","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/tmi.12659","article-title":"Seroprevalence of HTLV-1 and HTLV-2 amongst mothers and children in Malawi within the context of a systematic review and meta-analysis of HTLV seroprevalence in Africa","volume":"21","author":"Fox","year":"2016","journal-title":"Trop Med Int Health"},{"key":"2020062404334709000_CIT0016","doi-asserted-by":"crossref","first-page":"225","DOI":"10.2174\/1570162X15666170216114917","article-title":"CD4+ T-cell count may not be a useful strategy to monitor antiretroviral therapy response in HTLV-1\/HIV co-infected patients","volume":"15","author":"Vandormael","year":"2017","journal-title":"Curr HIV Res"},{"key":"2020062404334709000_CIT0017","doi-asserted-by":"crossref","first-page":"e2275","DOI":"10.1097\/MD.0000000000002275","article-title":"Immune compromise in HIV-1\/HTLV-1 coinfection with paradoxical resolution of CD4 lymphocytosis during antiretroviral therapy: a case report","volume":"94","author":"Rockwood","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"2020062404334709000_CIT0018","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1097\/QAD.0b013e3282f2dbe7","article-title":"Immune activation and AIDS pathogenesis","volume":"22","author":"Sodora","year":"2008","journal-title":"AIDS"},{"key":"2020062404334709000_CIT0019","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1097\/00002030-200309050-00006","article-title":"Persistent immune activation in HIV-1 infection is associated with progression to AIDS","volume":"17","author":"Hazenberg","year":"2003","journal-title":"AIDS"},{"key":"2020062404334709000_CIT0020","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s11904-007-0007-8","article-title":"Role of immune activation in HIV pathogenesis","volume":"4","author":"Hunt","year":"2007","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2020062404334709000_CIT0021","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/1471-2334-9-211","article-title":"Co-infection by human immunodeficiency virus type 1 (HIV-1) and human T cell leukemia virus type 1 (HTLV-1): does immune activation lead to a faster progression to AIDS?","volume":"9","author":"Gudo","year":"2009","journal-title":"BMC Infect Dis"},{"key":"2020062404334709000_CIT0022","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1258\/ijsa.2012.011446","article-title":"Performance of absolute CD4+ count in predicting co-infection with human T-lymphotropic virus type 1 in antiretroviral-naive HIV-infected patients","volume":"23","author":"Gudo","year":"2012","journal-title":"Int J STD AIDS"},{"key":"2020062404334709000_CIT0023","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1258\/ijsa.2008.008401","article-title":"Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV\/HTLV-1 co-infection in treatment naive Mozambican patients","volume":"20","author":"Bhatt","year":"2009","journal-title":"Int J STD AIDS"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciz756\/30109377\/ciz756.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/71\/1\/196\/33422803\/ciz756.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/71\/1\/196\/33422803\/ciz756.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T08:34:02Z","timestamp":1592987642000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/71\/1\/196\/5549137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,13]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,8,13]]},"published-print":{"date-parts":[[2020,6,24]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciz756","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,7,1]]},"published":{"date-parts":[[2019,8,13]]}}}