Clinical and Laboratory Outcomes in HIV-1 and HTLV-1/2 Coinfection: A Systematic Review.

Iris Montaño-Castellón,Clara Saffe,Carlos Brites,Cleyde Sheyla Chachaqui Marconi

doi:10.3389/fpubh.2022.820727

Abstract

AimTo perform a systematic review to describe the available findings on clinical outcomes in HIV-1 and HTLV-1/HTLV-2 co-infected individuals since 1995.DesignThis Systematic Review used PECO criteria follow by PRISMA reporting guidelines and registered as CRD42021279062 (Prospero database). The Newcastle-Ottawa Scale assessed the methodological quality of included studies.Data Collection and AnalysisA systematical search in PubMed/MEDLINE, Embase, Web of Sciences databases for cross-sectional, case-control, or cohort studies design to identify clinical and laboratorial outcomes related to HIV-1 and HTLV-1/2 coinfection. Search strategy: [(“HIV-1” AND “HTLV-1” OR “HTLV-2”) AND (“Coinfection”) AND (1990/01/01:2021/12/31[Date- Publication])].ResultsA total of 15 articles were included on this systematic review describing data of 2,566 mono and coinfected patients, 58% male, with mean age was 35.7 ± 5.7 years. HIV-1 and HTLV-1 coinfected patients were more likely to had shorter survival and faster progression to death or mortality than monoinfected ones. Coinfected had higher CD4 cell counts and less likelihood of ART use. In addition, higher frequency of diseases like ichthyosis (22.2 vs. 6.8%), scabies (18.6 vs. 0%), candidiasis (42 vs. 12%), Strongyloidiasis (15.4 vs. 2%) and neurological manifestations like encephalopathy, peripheral neuropathy and HAM/TSP were more frequently reported in coinfected patients.ConclusionsHIV-1 and HTLV-1 coinfection and HIV-1 and HTLV-1 /2 triple coinfection were related to shorter survival, higher mortality rate, and faster progression to death, while coinfection by HIV-1/HTLV-2 seems to have neutral association with longer survival, slower AIDS progression, and lower mortality rate. The available evidence indicates an urgent need for prevention and control measures, including screening, diagnosis, and treatment of HIV-1 and HTLV-1/2 coinfected patients. Test-and-treat strategy for patients living with HIV in areas endemic for HTLV infection is mandatory, to avoid the risks of delayed therapy and death for coinfected patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021279062.

Highlights

Human T-cell lymphotropic virus (HTLV) was the first human retrovirus described [1]
human immunodeficiency virus (HIV)-1 and HTLV-1 coinfection and HIV-1 and HTLV-1 /2 triple coinfection were related to shorter survival, higher mortality rate, and faster progression to death, while coinfection by HIV-1/HTLV-2 seems to have neutral association with longer survival, slower AIDS progression, and lower mortality rate
The available evidence indicates an urgent need for prevention and control measures, including screening, diagnosis, and treatment of HIV-1 and HTLV-1/2 coinfected patients

Summary

Introduction

Human T-cell lymphotropic virus (HTLV) was the first human retrovirus described [1]. There are four types of HTLV but only two (HTLV-1 and HTLV-2) are associated with diseases. HTLV-1 is the causative agent of adult T-cell leukemia and tropical spastic paraparesis, while HTLV-2 has been associated with peripheral neuropathy and potentially with tropical spastic paraparesis [2]. The human immunodeficiency virus (HIV) causes a progressive depletion of T cells that leads to severe immunodeficiency, increasing the risk of opportunistic infections and malignant neoplasms [3]. HIV and HTLV belong to the same family (Retroviridae), share genomic organization, tropism for CD4+ and CD8+ T cells, and routes of infection (sexual, parenteral and vertical). In consequence of common routes of infection, coinfection by both viruses is frequently detected in endemic areas, with higher prevalence in large metropolitan areas [4, 5]

Objectives

Methods

Results

Discussion

Conclusion