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    HIV co-infection in HTLV-1 carriers in Spain

    Autor: 
    Mendoza, Carmen de
    Caballero, Estrella
    Aguilera, Antonio
    Benito, Rafael
    Maciá, Dolores
    García-Costa, Juan
    Soriano, Vicente (1)
    Corral, Octavio Jorge (1)
    Gómez-Gallego, Felix (1)
    ...et al.
    Morano, Luis
    Fecha: 
    06/2019
    Palabra clave: 
    HTLV; HIV; co-infection; AIDS; tropical spastic paraparesis; adult T-cell leukemia; epidemiology; antiretroviral therapy; late diagnosis; JCR; Scopus
    Tipo de Ítem: 
    Articulo Revista Indexada
    URI: 
    https://reunir.unir.net/handle/123456789/8631
    DOI: 
    https://doi.org/10.1016/j.virusres.2019.04.004
    Dirección web: 
    https://www.sciencedirect.com/science/article/abs/pii/S0168170219301704?via%3Dihub
    Resumen:
    Background: Human retroviruses HIV and HTLV share transmission routes. HIV widely spread in Spain during the 80 s through injection drug use and sex, and nowadays HIV rates in Spain account for one of the largest in Europe. In contrast, HTLV-1 is not endemic in Spain, despite hosting huge numbers of migrants from highly endemic regions. Herein, we report the rate and main features of the HIV-HTLV co-infected population in Spain. Methods: A national registry exists in Spain for HTLV since year 1989. Data from standardized case report forms and one centralized lab repository were reviewed, especially for the subset with HTLV-HIV co-infection. Results: Up to December 2018, a total of 369 individuals with HTLV-1 had been diagnosed in Spain. 64% of the population were females, and Latin American individuals accounted for 64.5%. Classical HTLV-associated illnesses were found in 12.7% (myelopathy) and 7.6% (leukemia). HIV coinfection was found in 12 (3.2%). Of those, 3 patients (25%) were female and 39 (75%) were of non Spanish origin. All but two harbored HIV-1 subtype B, being non-B variants found in the two West Africans. Exposure had been sexual in most cases, being 4 homosexual men. Seven HTLV-HIV co-infected patients had developed AIDS and two had developed myelopathy. There was no evidence for increased HTLV-1 clinical pathogenicity due to HIV coinfection. Conclusion: HIV coinfection is infrequent (< 5%) among HTLV-1 carriers in Spain. More than half of co-infected patients come from Latin America. Sexual contact is the most frequent risk behavior, being MSM one third of cases. Late diagnosis explains the high rate (9/12) of clinical manifestations in our HIV-HTLV co-infected population.
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