Opportunistic Infections in Patients with HTLV-1 Infection

Abstract EN

As an acquired immunodeficiency, human immunodeficiency virus (HIV) infection is primarily responsible for opportunistic infections in infected patients.

However, opportunistic infections also occur in individuals with human T cell lymphotrophic virus type 1 (HTLV-1) infection.

Here, we report opportunistic infections in two Japanese HTLV-1-seropositive patients.

The first patient was a 67-year-old male, who had cytomegalovirus infection associated with esophagogastritis and terminal ileitis.

The patient was HTLV-1-positive and was diagnosed with smoldering adult T cell leukemia (ATL).

High levels of serum soluble IL-2 receptor (sIL-2R; 4,304 U/mL) and an increased percentage of CD4+CD25+ T cells (75.5%) in peripheral blood were also detected.

The second patient was a 78-year-old female, a known asymptomatic HTLV-1 carrier, who presented with persistent herpes zoster, followed by Pneumocystis jirovecii pneumonia.

Disease progression of smoldering ATL along opportunistic infections was observed with very high levels of serum sIL-2R (14,058 U/mL) and an increased percentage of CD4+CD25+ T cells (87.2%) in peripheral blood.

In patients with suspected opportunistic infections, both HTLV-1 and HIV should be considered.

In HTLV-1-positive patients, an increase in the CD4+CD25+ T cell subset may have its value as a prognostic marker.