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Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

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dc.contributor.author Amanzo-Vargas, Maria Pia
dc.contributor.author Arellano-Veintemilla, Tessy
dc.contributor.author González Lagos, Elsa Violeta
dc.contributor.author Echevarria Zarate, Juan Ignacio
dc.contributor.author Mejía Cordero, Fernando Alonso
dc.contributor.author Graña Espinoza, Ana Beatriz Rosario
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.coverage.spatial Perú
dc.date.accessioned 2023-09-06T20:45:07Z
dc.date.available 2023-09-06T20:45:07Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14048
dc.description.abstract BACKGROUND AND AIMS: In Peru, the estimated prevalence of human immunodeficiency virus (HIV) and human T-lymphotropic virus-1 (HTLV-1) co-infection has been reported to be as high as 18%. Despite the endemicity of HTLV-1 in Peru, few studies have assessed the impact of HIV/HTLV-1 co-infection. Our study compared socio-demographic and clinical characteristics, and mortality rates between HIV-infected and HIV/HTLV-1 co-infected patients. METHODS: We reviewed the medical records of patients aged 18 years and older belonging to the HIV and HTLV-1 cohorts in Lima during a 30-year period: 1989-2019. Each HIV/HTLV-1 co-infected patient was randomly matched with two HIV-infected patients with similar characteristics (same sex, age ± 5 years, and same year of HIV diagnosis). Allegedly co-infected patients without a confirmatory diagnosis of HIV and HTLV-1 were excluded. Most of the patients in the HIV-infected group did not have a negative test result for HTLV-1 infection, so we used two probabilistic sensitivity analysis models to correct for potential HTLV-1 exposure misclassification bias in the group of HIV-infected patients. RESULTS: Of 162 patients enrolled, 54 were HIV/HTLV-1 co-infected and 108 were HIV-infected. The median age was 42 years (IQR = 34-51 years) and the majority were male (61.1%), single (44.4%), heterosexual (71%), born in Lima (58%), educated at the secondary school level (55.6%), and receiving antiretroviral treatment (91.4%). HIV/HTLV-1 co-infection was associated with an increased risk of death (HR: 11.8; 95% CI: 1.55-89.00; p = 0.017) while antiretroviral treatment was associated with a decreased risk of death (HR: 0.03; 95% CI: 0.003-0.25; p = 0.001). The overall mortality rate was 13.6 per 100 persons and the survival time for co-infected patients (median = 14.19 years) was significantly shorter than that of HIV-infected patients (median = 23.83 years) (p < 0.001). CONCLUSIONS: HIV/HTLV-1 co-infected patients had a significantly shorter survival time compared to HIV-infected patients, suggesting that the immune alterations caused by HTLV-1 in CD4 cell count may have contributed to late initiation of antiretroviral treatment and prophylaxis against opportunistic infections over the decades, and thus reducing their benefits in these patients. en_US
dc.language.iso eng
dc.publisher MDPI
dc.relation.ispartofseries Pathogens
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject HIV en_US
dc.subject HTLV-1 en_US
dc.subject Co-infection en_US
dc.subject Mortality en_US
dc.subject Survival en_US
dc.subject Antiretroviral therapy en_US
dc.subject Peru en_US
dc.subject.mesh VIH
dc.subject.mesh Virus Linfotrópico T Tipo 1 Humano
dc.subject.mesh Infecciones por VIH
dc.subject.mesh Mortalidad
dc.subject.mesh Sobrevida
dc.subject.mesh Terapia Antirretroviral Altamente Activa
dc.subject.mesh Perú
dc.title Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.3390/pathogens12070869
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.05
dc.relation.issn 2076-0817


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