AEGiS-11IAC: A prospective study of HTLV-I infection.

11th International AIDS Conference


Vancouver, British Columbia — July 7-12, 1996

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A prospective study of HTLV-I infection.

Int Conf AIDS 1996 Jul 7-12; 11:219 (abstract no. Tu.A.161)
Taylor GP, Tosswill JHC, Matutes E, Daenke S, Bangham CR, Rossor M, Thomas D, Weber JN; St Mary's Hospital Medical School, London, UK. Fax: 44 171 725 6738. E-mail: GPT30@ic.ac.uk.

OBJECTIVES: To determine the natural history of HTLV-I infection in carriers, the spectrum of subclinical abnormalities and to identify prognostic markers.

METHODS: A longitudinal, prospective, clinical study of 16 HTLV-I asymptomatic carriers and 4 patients with HTLV-1 associated myelopathy between 1991 and 1995. Lymphocytes were examined in May-Grunwald-Giemsa stained peripheral blood films, immunophenotypes determined by FACScan, proviral load determined by nested PCR on serial dilutions of PBMC DNA and fresh and stimulated CTL responses measured in chromium release assays.

RESULTS: We have documented episodes of uveitis, alveolitis, polymyositis and hepatitis. Three carriers have developed mild CNS abnormalities whilst a patient presenting acutely with HAM, progressively deteriorated over 12 months and died. All patients and carriers have abnormal lymphocytes (4.2% and 2.9% respectively). Flower cells are found in patients and carriers, including those who have acquired infection in adult life. HLA-DR, CD25 and CD38, markers of lymphocyte activation are expressed by 22.5%, 18.2% and 34.9% of peripheral blood lymphocytes. The median proviral load in PBMCs was 2.8% in the carriers and varied little with time but was 1 log higher in patients and carriers developing HTLV-I associated disease. The effector frequency of tax specific cytotxic T-lymphocytes was similar in both groups.

CONCLUSIONS: HTLV-I carriage is not silent. CTL activity is the same in carriers and patients. High proviral load is associated with the development of HTLV-I associated disease and predates symptoms.

Keywords: AEGIS, HTLV-I Infections, Paraparesis, Tropical Spastic, Human T-lymphotropic virus 1, Prospective Studies, T-Lymphocytes, Polymerase Chain Reaction, Uveitis, HLA-DR Antigens, Lymphocytes, DNA Primers, Adult, Human, ICA11KWDaegis,htlv-iinfections,paraparesis,tropicalspastic,humant-lymphotropicvirus1,prospectivestudies,t-lymphocytes,polymerasechainreaction,uveitis,hla-drantigens,lymphocytes,dnaprimers,adult,human,ica11

960707
TuA161

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