Document 2367
 DOCN  M94A2367
 TI    Does HTLV-II coinfection predict clinical progression in HIV-infected
       drug users?
 DT    9412
 AU    Hershow RC; Fukuda K; Graber J; Vlahov D; Rezza G; Klein RS; Des Jarlais
       D; Vitek C; Galai N; Khabbaz R; et al; Univ. of Illinois at Chicago,
       School of Public Health, Epi/Bio; Dept. 60612.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):320 (abstract no. PC0210). Unique
       Identifier : AIDSLINE ICA10/94370208
 AB    OBJECTIVES: To determine if coinfection with HTLV-II is associated with
       more rapid development of pre-AIDS bacterial pneumonia/sepsis (BPS),
       AIDS (1987 definition), or HIV-related mortality in HIV-infected
       injecting drug users (IDUs). METHODS: IDUs with known HIV-seroconversion
       dates (last negative to first positive < or = 2 yrs) were enrolled from
       4 longitudinal cohort studies. We assayed HTLV infection by EIA and
       confirmed and typed by Western Blot. Proportional hazards models were
       used to assess the association of each clinical outcome with HTLV-II
       coinfection, seroconversion age (SCAGE) and gender. RESULTS: In 370
       HIV-infected IDUs, 61 (16%) were HTLV coinfected; all coinfections were
       HTLV-II. Median SCAGE in coinfected persons was 39 compared to 29 yrs (p
       < 0.001) in the HIV-singly infected. AZT was used by 23% in both groups.
       Median followup was 3.1 yrs during which 38 BPS, 45 AIDS and 28
       HIV-related mortality events ensued. In univariate models, HTLV-II was
       associated with BPS (RR = 2.8, p = 0.003), mortality (RR = 2.7, p =
       0.02), but not AIDS (RR = 1.0); SCAGE was associated with BPS (RR = 1.07
       per year, p = < 0.001) and was marginally associated with mortality (RR
       = 1.04, p = 0.053); gender was not associated with any outcome. In
       models with both SCAGE and HTLV-II, HTLV-II was not significantly
       associated with BPS (RR = 1.5, p = 0.31) or mortality (RR = 2.2, p =
       0.12); SCAGE was associated with BPS (RR = 1.06, p < 0.001).
       CONCLUSIONS: HTLV-II does not significantly modify clinical progression
       to BPS, AIDS, or HIV-related mortality in HIV-infected IDUs after
       adjustment for SCAGE. Combined with results presented elsewhere, which
       revealed no HTLV-II effect on the rate of CD4 decline in this cohort,
       these findings suggest that HTLV-II does not accelerate progression of
       HIV-infection.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS  Adult  Age Factors
       AIDS-Related Opportunistic Infections  Human  HIV
       Infections/*COMPLICATIONS/MORTALITY  HIV Seropositivity  HTLV-II
       Infections/*COMPLICATIONS  Prognosis  Proportional Hazards Models
       Substance Abuse, Intravenous/*COMPLICATIONS  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).