Departement des Maladies Infectieuses, Cayenne General Hospital, French Guiana.
Am J Trop Med Hyg. 2013 Sep;89(3):549-53. doi: 10.4269/ajtmh.12-0769. Epub 2013 Aug 12.
French Guiana, the French territory most affected by human immunodeficiency virus (HIV) (1.3% of pregnant women), is also endemic for human T lymphotropic virus 1 (HTLV1). The objective of this study was to determine if the HTLV1/HIV coinfected patients had particular characteristics. All HIV-infected patients having a computerized medical file containing an HTLV1 serology were included: there were 1,333 HIV monoinfections and 76 HTLV1/VIH coinfections. The prevalence of HTLV1/HIV coinfections was 5.39%. Women (odds ratio [OR] = 1.91[1.13-3.24]), subjects > 40 years of age, and patients of Surinamese origin (OR = 2.65 [1.25-5.61]) were overrepresented among the coinfected. CD4 count at the time of diagnosis and viral loads were higher among coinfected patients. The clinical stage was not significantly different between the two groups. The number of CD4 cells was not higher among the coinfected, unlike most reports from the literature. Prevalence of HTLV1 among HIV-infected patients is high in French Guiana, and physicians seem to omit the prescription of serology for this potentially serious coinfection.
法属圭亚那是受人类免疫缺陷病毒(HIV)影响最严重的法国领土(孕妇中 HIV 感染率为 1.3%),同时也是人类 T 淋巴细胞病毒 1(HTLV1)的流行地区。本研究旨在确定 HTLV1/HIV 合并感染患者是否具有特殊特征。所有感染 HIV 且计算机病历中包含 HTLV1 血清学检查结果的患者均被纳入研究:其中有 1333 例 HIV 单一感染和 76 例 HTLV1/HIV 合并感染。HTLV1/HIV 合并感染的患病率为 5.39%。女性(比值比 [OR] = 1.91[1.13-3.24])、年龄 > 40 岁和苏里南裔患者(OR = 2.65 [1.25-5.61])在合并感染患者中更为常见。诊断时的 CD4 计数和病毒载量在合并感染患者中更高。两组患者的临床分期无显著差异。与大多数文献报道不同,合并感染患者的 CD4 细胞计数并未升高。在法属圭亚那,HIV 感染者中 HTLV1 的流行率很高,医生似乎忽略了对这种潜在严重合并感染的血清学检测。