The prevalence of HTLV-1 co-infection among people living with HIV in a tertiary care hospital in Tehran: a cross-sectional study
More details
Hide details
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Iranian Research Center for HIV/ AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Submission date: 2021-11-13
Final revision date: 2022-04-05
Acceptance date: 2022-04-06
Online publication date: 2024-05-21
Corresponding author
SeyedAhmad SeyedAlinaghi   

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences
HIV & AIDS Review 2024;23(2):136-140
Human immunodeficiency virus (HIV) and human T cell leukemia/lymphoma virus type 1 (HTLV-1) share similar routes of transmission and both target T cells. HTLV-1 may negatively affect the course of disease in people living with HIV, but previous evidence is conflicting. Therefore, we aimed to investigate the prevalence of HIV/HTLV-1 co-infection, routes of transmission, and patients’ CD4+ counts.

Material and methods:
184 HIV-positive individuals were recruited for this cross-sectional study from the Counseling Center for Behavioral Diseases of Imam Khomeini Hospital in Tehran. Serum samples were analyzed using enzyme-linked immunosorbent assay (ELISA) for anti-HTLV-1.

The mean age of participants was 40.12 ± 11.6 years, and all cases were negative for HTLV-1 infection. Participants were diagnosed on average about 78 months (6 years) ago, and the mean CD4+ count of the participants was 669.22 cells/µl (SD = 284.2). Using ELISA screening, none of the participants from Tehran in various age groups showed concurrent HTLV-1 infection (0 percent).

Co-infection with HTLV-1 is negligible in HIV-infected patients in Tehran, Iran. Our data also showed that the most common route of HIV transmission among our study subjects was hetero­sexual contact (56.4%).

Shahmohamadi E, SeyedAlinaghi S, Karimi A, Behnezhad F, Mehraeen E, Dadras O. HIV/HTLV-1 co-infection: a systematic review of current evidence. HIV AIDS Rev 2021; 20: 158-165.
Beilke MA, Theall KP, O’Brien M, Clayton JL, Benjamin SM, Winsor EL, et al. Clinical outcomes and disease progression among patients coinfected with HIV and human T lymphotropic virus types 1 and 2. Clin Infect Dis 2004; 39: 256-263.
Brites C, Sampalo J, Oliveira A. HIV/human T-cell lymphotropic virus coinfection revisited: impact on AIDS progression. AIDS Rev 2009; 11: 8-16.
Jahagirdar D, Walters MK, Novotney A, Brewer ED, Frank TD, Carter A, et al. Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990-2019, for 204 countries and territories: the Global Burden of Diseases Study 2019. Lancet HIV 2021; 8: e633-e651. DOI: 10.1016/S2352-3018(21)00152-1.
Rosadas C, Menezes MLB, Galvão-Castro B, Assone T, Miranda AE, Aragón MG, et al. Blocking HTLV-1/2 silent transmission in Brazil: current public health policies and proposal for additional strategies. PLoS Negl Trop Dis 2021; 15: e0009717. DOI: 10.1371/journal.pntd.0009717.
Brites C, Goyanna F, França LG, Pedroso C, Netto EM, Adriano S, et al. Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis and delay in starting antiretroviral therapy for AIDS patients. Braz J Infect Dis 2011; 15: 6-11.
Ribeiro ML, Gonçales JP, Morais VMS, Moura L, Coêlho M. HTLV 1/2 Prevalence and risk factors in individuals with HIV/AIDS in Pernambuco, Brazil. Rev Soc Brasileira Med Trop 2019; 52: e20180244. DOI: 10.1590/0037-8682-0244-2018.
Richey JD, Chen BJ, Deng AC. Indolent, waxing and waning cutaneous presentation of HTLV-1-associated adult T-cell leukemia/lymphoma in an HIV-1-positive patient. J Cutaneous Pathol 2018; 45: 171-175.
Assone T, Kanashiro TM, Baldassin MPM, Paiva A, Haziot ME, Smid J, et al. In vitro basal T-cell proliferation among asymptomatic human T cell leukemia virus type 1 patients co-infected with hepatitis C and/or human immunodeficiency virus type 1. Braz J Infect Dis 2018; 22: 106-112.
de Oliveira EH, Oliveira-Filho AB, Souza LA, da Silva LV, Ishak MO, Ishak R, et al. Human T-cell lymphotropic virus in patients infected with HIV-1: molecular epidemiology and risk factors for transmission in Piaui, Northeastern Brazil. Curr HIV Res 2012; 10: 700-707.
Bhatt NB, Gudo ES, Semá C, Bila D, Di Mattei P, Augusto O, et al. Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients. Int J STD AIDS 2009; 20: 863-868.
Yazdani R, Dadmanesh M, Ghorban K. First report of the prevalence of human T-lymphotropic virus type 1 (HTLV-1) for hemodialysis patients in Tehran. Arch Clin Infect Dis 2018; 13. DOI: 10.5812/archcid.65512.
Isache C, Sands M, Guzman N, Figueroa D. HTLV-1 and HIV-1 co-infection: a case report and review of the literature. IDCases 2016; 4: 53-55.
Ramezani A, Aghakhani A, Banifazl M, Boland-Ghamat Z, Foroughi M, Gachkar L, et al. Frequency of human T-Cell lymphotropic virus (HTLV) type 1 and 2 infection in HIV infected patients. Iranian J Pathol 2012; 7: 9-13.
Alavi SM, Etemadi A. HIV/HBV, HIV/HCV and HIV/HTLV-1 co-infection among injecting drug user patients hospitalized at the infectious disease ward of a training hospital in Iran. Pak J Med Sci 2007; 23: 510-513.
Phillips I, Hyams K, Wignall F, Moran A, Gotuzzo E, Sanchez J, et al. HTLV-I coinfection in a HIV-1-infected Peruvian population. J Acquir Immune Defic Syndr 1991; 4: 301-302.
Mehraeen E, Oliaei S, SeyedAlinaghi S, Karimi A, Mirzapour P, Afsahi AM, et al. COVID-19 in pediatrics: the current knowledge and practice. Infect Disord Drug Targets 2022; 22: e290921196908. DOI: 10.2174/1871526521666210929121705.
Schechter M, Moulton LH, Harrison LH. HIV viral load and CD4+ lymphocyte counts in subjects coinfected with HTLV-I and HIV-1. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 15: 308-311.
Sobesky M, Couppie P, Pradinaud R, Godard MC, Alvarez F, Benoît B, et al. Coinfection with HIV and HTLV-I infection and survival in AIDS stage. French Guiana Study. GECVIG (Clinical HIV Study Group in Guiana). Presse Med 2000; 29: 413-416.
SeyedAlinaghi S, Karimi A, MohsseniPour M, Barzegary A, Mirghaderi SP, Fakhfouri A, et al. The clinical outcomes of COVID‐19 in HIV‐positive patients: a systematic review of current evidence. Immun Inflamm Dis 2021; 9: 1160-1185.
Gudo ES, Bhatt NB, Bila DR, Abreu CM, Tanuri A, Savino W, et al. 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? BMC Infect Dis 2009; 9: 211. DOI: 10.1186/1471-2334-9-211.
Oliaei S, SeyedAlinaghi S, Mehrtak M, Karimi A, Noori T, Mirzapour P, et al. The effects of hyperbaric oxygen therapy (HBOT) on coronavirus disease-2019 (COVID-19): a systematic review. Eur J Med Res 2021; 26: 96. DOI: 10.1186/s40001-021-00570-2.
Bessinger R, Beilke M, Kissinger P, Jarrott C, Tabak OF. Retroviral coinfections at a New Orleans HIV outpatient clinic. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 14: 67-71.
Araujo A, Sheehy N, Takahashi H, Hall W. Concomitant infections with human immunodeficiency virus type 1 and human T-lymphotropic virus types 1 and 2. In: Brogden KA, Guthmiller JM (eds.). Polymicrobial Diseases. Washington (DC): ASM Press; 2002.
Mansouri Torshizi M, Khalighi AR, Fadavi Islam M, Aram R, Sabouri E, Khalilifar H, et al. Effect of human T-cell lymphotrophic virus type 1 (HTLV-1) in seropositive infertile women on intracytoplasmic sperm injection (ICSI) outcome. Iran J Reprod Med 2014; 12: 15-18.
Kassa GM. Mother-to-child transmission of HIV infection and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Infect Dis 2018; 18: 216. DOI: 10.1186/s12879-018-3126-5.
Gessain A, Cassar O. Epidemiological aspects and world distribution of HTLV-1 infection. Front Microbiol 2012; 3: 388. DOI: 10.3389/fmicb.2012.00388.
de Souza Lopes R, Serejo Pereira MV, Macedo da Silva R, de Luna Sales JB, Lima Gardunho DC, Cortinhas Monteiro J, et al. Molecular epidemiology of HIV-1 and HTLV-1/2 among female sex workers in four cities in the state of Para, Northern Brazil. Front Microbiol 2020; 11: 602664. DOI: 10.3389/fmicb.2020.602664.
Moriuchi H, Moriuchi M. In vitro induction of HIV-1 replication in resting CD4(+) T cells derived from individuals with undetectable plasma viremia upon stimulation with human T-cell leukemia virus type I. Virology 2000; 278: 514-519.
Beilke MA, Japa S, Vinson DG. HTLV-I and HTLV-II virus expression increase with HIV-1 coinfection. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 17: 391-397.
Böhnlein E, Siekevitz M, Ballard DW, Lowenthal JW, Rimsky L, Bogérd H, et al. Stimulation of the human immunodeficiency virus type 1 enhancer by the human T-cell leukemia virus type I tax gene product involves the action of inducible cellular proteins. J Virol 1989; 63: 1578-1586.
Brites C, Sampalo J, Oliveira A. HIV/human T-cell lymphotropic virus coinfection revisited: impact on AIDS progression. AIDS Rev 2008; 11: 8-16.
Casoli C, Pilotti E, Bertazzoni U. Molecular and cellular interactions of HIV-1/HTLV coinfection and impact on AIDS progression. AIDS Rev 2007; 9: 140-149.
Moriuchi H, Moriuchi M, Fauci AS. Factors secreted by human T lymphotropic virus type I (HTLV-I)-infected cells can enhance or inhibit replication of HIV-1 in HTLV-I-uninfected cells: implications for in vivo coinfection with HTLV-I and HIV-1. J Exp Med 1998; 187: 1689-1697.
Leung K, Nabel GJ. HTLV-1 transactivator induces interleukin-2 receptor expression through an NF-κB-like factor. Nature 1988; 333: 776-778.
Journals System - logo
Scroll to top