Puerta de Hierro Research Institute & University Hospital, Madrid, Spain; Microbiology Department, CEU-San Pablo University, Madrid, Spain.
Hospital Vall d'Hebrón, Barcelona, Spain.
Virus Res. 2019 Jun;266:48-51. doi: 10.1016/j.virusres.2019.04.004. Epub 2019 Apr 15.
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.
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.
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.
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.
人类逆转录病毒 HIV 和 HTLV 具有共同的传播途径。20 世纪 80 年代，HIV 通过注射吸毒和性行为在西班牙广泛传播，如今西班牙的 HIV 感染率在欧洲属于较高水平。相比之下，尽管西班牙接待了来自高流行地区的大量移民，但 HTLV-1 并非地方性流行。在此，我们报告了西班牙 HIV-HTLV 合并感染人群的比例和主要特征。
自 1989 年以来，西班牙建立了 HTLV 国家登记系统。对标准化病例报告表和一个集中的实验室存储库的数据进行了审查，特别是针对 HTLV-HIV 合并感染的亚组。
截至 2018 年 12 月，西班牙共诊断出 369 例 HTLV-1 感染者。人群中 64%为女性，拉丁裔人群占 64.5%。发现 12 例（3.2%）存在 HIV 合并感染。其中，3 例（25%）为女性，39 例（75%）为非西班牙裔。除 2 例外，所有患者均感染 HIV-1 亚型 B，2 例西非患者为非 B 型变异株。大多数情况下暴露途径为性传播，其中 4 例为男同性恋者。7 例 HTLV-HIV 合并感染者已发展为艾滋病，2 例已发展为脊髓病。未发现 HIV 合并感染增加 HTLV-1 临床致病性。
在西班牙，HTLV-1 携带者中 HIV 合并感染发生率较低（<5%）。超过一半的合并感染患者来自拉丁美洲。性接触是最常见的风险行为，三分之一的病例为男同性恋者。晚期诊断解释了我们的 HIV-HTLV 合并感染人群中高比例（9/12）的临床表现。
