Shibata D, Brynes R K, Rabinowitz A, Hanson C A, Slovak M L, Spira T J, Gill P
University of Southern California School of Medicine, Los Angeles.
Ann Intern Med. 1989 Dec 1;111(11):871-5. doi: 10.7326/0003-4819-111-11-871.
A patient had adult T-cell leukemia-lymphoma in the unusual setting of coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type I (HTLV-I). The leukemic cells were CD4 positive and showed clonal genetic rearrangement of the T-cell receptor complex. Cytogenetic analysis showed three clonal karyotypic abnormalities: trisomy 3 and two translocations [t(1;15), (X;1)]. The patient was seropositive for HIV and HTLV-I; HTLV-I and HIV-1 DNA sequences were detected in peripheral blood leukocytes by the polymerase chain reaction. The HTLV-I sequences were detected in a relatively high proportion of mononuclear cells (at least 1 in 30 cells), whereas HIV-1 sequences were detected in a smaller proportion of cells (at least 1 in 3000 cells). Clinical remission was achieved after chemotherapy. There was a decrease in the proportion of HTLV-I positive mononuclear cells (at least 1 in 1000 cells), whereas the proportion of HIV-1 positive cells was relatively unchanged (at least 1 in 1000 cells). Adult T-cell leukemia-lymphoma in the setting of HIV coinfection may become increasingly common because asymptomatic retroviral coinfections are frequent.
一名患者在同时感染1型人类免疫缺陷病毒（HIV-1）和I型人类嗜T细胞病毒（HTLV-I）这种不寻常的情况下患了成人T细胞白血病-淋巴瘤。白血病细胞CD4呈阳性，并显示出T细胞受体复合物的克隆性基因重排。细胞遗传学分析显示出三种克隆性核型异常：3号染色体三体以及两个易位[t(1;15), (X;1)]。该患者HIV和HTLV-I血清学检测呈阳性；通过聚合酶链反应在外周血白细胞中检测到了HTLV-I和HIV-1的DNA序列。在相对较高比例的单核细胞中检测到了HTLV-I序列（至少30个细胞中有1个），而在较小比例的细胞中检测到了HIV-1序列（至少3000个细胞中有1个）。化疗后实现了临床缓解。HTLV-I阳性单核细胞的比例下降了（至少1000个细胞中有1个），而HIV-1阳性细胞的比例相对未变（至少1000个细胞中有1个）。由于无症状逆转录病毒合并感染很常见，在HIV合并感染情况下的成人T细胞白血病-淋巴瘤可能会变得越来越普遍。
