{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:34:40Z","timestamp":1773210880937,"version":"3.50.1"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Co-infection with human T-cell lymphotropic virus types 1 and 2 (HTLV-1\/2) and HIV is not routinely screened for, yet it may significantly influence clinical progression, mortality, and quality of life in affected individuals. This study aimed to estimate the prevalence of HTLV-1\/2 co-infection among adults living with HIV and to identify associated epidemiological factors in the Peruvian Amazon. A cross-sectional study was conducted including patients receiving antiretroviral therapy through the multidisciplinary TARGA program in Iquitos, Peru, during the second quarter of 2013. Screening for HTLV-1\/2 antibodies was performed using enzyme-linked immunosorbent assay, with reactive samples confirmed by Line Immunoassay. Demographic and behavioral variables were collected, and prevalence odds ratios with 95% confidence intervals were estimated using logistic regression models. Among the 284 patients included, 28 were co-infected with HIV and HTLV-1\/2, resulting in a prevalence of 10% with a 95% confidence interval of 6.5 to 14.1. In multivariable analysis, age over 35 years and having more than 10 lifetime sexual partners were independently associated with co-infection, with prevalence odds ratios of 12.4 and 3.6, respectively. HTLV-1\/2 co-infection was highly prevalent among people living with HIV in the Peruvian Amazon, and the main risk factors identified suggest that cumulative exposure and sexual behavior play a significant role in the joint transmission of both retroviruses, supporting the need to consider systematic HTLV screening in endemic settings.<\/jats:p>","DOI":"10.3390\/v18030338","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:43:31Z","timestamp":1773132211000},"page":"338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["HIV\/HTLV-1\/2 Co-Infection in the Peruvian Amazon: Prevalence and Associated Factors"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4771-6383","authenticated-orcid":false,"given":"Wieslawa-Guivanni","family":"Alava-Flores","sequence":"first","affiliation":[{"name":"Centro de Investigaci\u00f3n de Enfermedades Tropicales \u201cHugo Pesce\u2014Maxime Kuczynski\u201d, Iquitos 16001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivonne","family":"Navarro-del-Aguila","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Biochemistry, National University of the Peruvian Amazon, Iquitos 16001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7801-5072","authenticated-orcid":false,"given":"Silvia","family":"Otero-Rodriguez","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Doctor Balmis University General Hospital, 03010 Alicante, Spain"},{"name":"Institute of Healthcare and Biomedical Research (ISABIAL), 03010 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6501-9867","authenticated-orcid":false,"given":"Jos\u00e9-Manuel","family":"Ramos-Rinc\u00f3n","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Doctor Balmis University General Hospital, 03010 Alicante, Spain"},{"name":"Institute of Healthcare and Biomedical Research (ISABIAL), 03010 Alicante, Spain"},{"name":"Clinical Medicine Department, Miguel Hern\u00e1ndez University of Elche, 03202 Elche, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5972-0948","authenticated-orcid":false,"given":"Martin","family":"Casapia-Morales","sequence":"additional","affiliation":[{"name":"Faculty of Human Medicine, National University of the Peruvian Amazon, Iquitos 16001, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Branda, F., Romano, C., Pavia, G., Bilotta, V., Locci, C., Azzena, I., Deplano, I., Pascale, N., Perra, M., and Giovanetti, M. (2025). Human T-lymphotropic virus (HTLV): Epidemiology, genetics, pathogenesis, and future challenges. Viruses, 17.","DOI":"10.3390\/v17050664"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e00078-21","DOI":"10.1128\/cmr.00078-21","article-title":"Clinical and public health implications of human T-lymphotropic virus type 1 infection","volume":"35","author":"Legrand","year":"2022","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Abreu, I.N., Lima, C.N.C., Sacuena, E.R.P., Lopes, F.T., da Silva Torres, M.K., Santos, B.C., Freitas, V.d.O., de Figueiredo, L.G.C.P., Pereira, K.A.S., and de Lima, A.C.R. (2023). HTLV-1\/2 in Indigenous peoples of the Brazilian Amazon: Seroprevalence, molecular characterization and sociobehavioral factors related to risk of infection. Viruses, 15.","DOI":"10.3390\/v15010022"},{"key":"ref_4","first-page":"18101","article-title":"Human T-lymphotropic virus 1 and 2 among people who used illicit drugs in the state of Par\u00e1, northern Brazil","volume":"9","author":"Souza","year":"2019","journal-title":"Sci Rep."},{"key":"ref_5","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":"ref_6","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":"ref_7","doi-asserted-by":"crossref","first-page":"820727","DOI":"10.3389\/fpubh.2022.820727","article-title":"Clinical and Laboratory Outcomes in HIV-1 and HTLV-1\/2 Coinfection: A Systematic Review","volume":"10","year":"2022","journal-title":"Front Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Otero-Rodriguez, S., Casapia-Morales, M., de Mendoza, C., Pinedo-Cancino, V., Mego-Campos, S., Soriano, V., Merino, E., and Ramos-Rinc\u00f3n, J.-M. (2025). High rate of human T-cell lymphotropic virus-2 in patients with HIV in the Peruvian Amazon. Trop. Med. Infect. Dis., 10.","DOI":"10.20944\/preprints202508.0974.v1"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1177\/1049732313502129","article-title":"Structural factors that increase HIV\/STI vulnerability among indigenous people in the Peruvian Amazon","volume":"23","author":"Orellana","year":"2013","journal-title":"Qual. Health Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S1473-3099(07)70081-6","article-title":"Human T-lymphotropic virus 1: Recent knowledge about an ancient infection","volume":"7","author":"Verdonck","year":"2007","journal-title":"Lancet Infect. Dis."},{"key":"ref_11","first-page":"891","article-title":"Human T-cell lymphotropic virus type 1: Infection and associated diseases in Peru","volume":"44","author":"Gotuzzo","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e73","DOI":"10.1590\/s1678-9946202466073","article-title":"Seroprevalence of Strongyloides stercoralis, human T-lymphotropic virus, and Chagas disease in the Peruvian Amazon: A cross-sectional study","volume":"66","year":"2024","journal-title":"Rev. Inst. Med. Trop. Sao Paulo"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ramos-Rinc\u00f3n, J.M., Ortiz-Mart\u00ednez, S., V\u00e1squez-Chasnamote, M.E., De-Miguel-Balsa, E., Gamboa-Paredes, O.N., Talledo-Albujar, M.J., L\u00f3pez-Campana, G., Celis-Salinas, J.C., Prieto-P\u00e9rez, L., and G\u00f3rgolas-Hern\u00e1ndez, M. (2021). Screening for human T-cell lymphotropic virus (HTLV) in pregnant women in the Peruvian Amazon and systematic review with meta-analysis of HTLV infection in Peru. Pathogens, 10.","DOI":"10.3390\/pathogens10030260"},{"key":"ref_14","first-page":"529","article-title":"Human T-cell lymphotropic viruses (HTLV-I\/II) in Brazil: A review","volume":"38","author":"Proietti","year":"2005","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.3855\/jidc.14602","article-title":"Prevalence and risk factor analysis for HIV\/HTLV-1\/2 coinfection in Para\u00edba State, Brazil","volume":"15","author":"Lopes","year":"2021","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jmv.20165","article-title":"High prevalence of human T-lymphotropic virus type 1 (HTLV-1) in immigrant male-to-female transsexual sex workers with HIV-1 infection","volume":"74","author":"Zehender","year":"2004","journal-title":"J. Med. Virol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/S1473-3099(12)70144-5","article-title":"Prevalences of sexually transmitted infections in young adults and female sex workers in Peru: A national population-based survey","volume":"12","author":"Campos","year":"2012","journal-title":"Lancet Infect. Dis."},{"key":"ref_18","unstructured":"Martel, M., Gotuzzo, E., Gonz\u00e1lez, E., and Verdonck, K. (2022). Sexual transmission of human T-cell lymphotropic virus type 1 and associated risk factors in South America. Front. Public Health, 10."},{"key":"ref_19","first-page":"593","article-title":"Human T-cell lymphotropic virus-I infection in female sex workers in South America","volume":"51","author":"Gotuzzo","year":"1994","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"98","DOI":"10.20453\/rmh.v22i3.1082","article-title":"Infecci\u00f3n por HTLV-1 y HIV en pacientes con herpes zoster en Per\u00fa","volume":"22","author":"Delgado","year":"2011","journal-title":"Rev. Med. Hered."},{"key":"ref_21","first-page":"8","article-title":"HIV\/human T-cell lymphotropic virus coinfection revisited: Impact on AIDS progression","volume":"11","author":"Sampalo","year":"2009","journal-title":"AIDS Rev."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/3\/338\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:51:30Z","timestamp":1773132690000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/18\/3\/338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["v18030338"],"URL":"https:\/\/doi.org\/10.3390\/v18030338","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]}}}