A polyclonal CD4+ and CD8+ lymphocytosis in a patient doubly infected with HTLV-I and HIV-1: a clinical and molecular analysis

American Journal of Hematology
G D EhrlichB J Poiesz

Abstract

HTLV-I is associated with adult T-cell leukemia/lymphoma (ATL) characterized by monoclonal expansions of CD4+ T-lymphocytes. In this report we describe a histologically benign, polyclonal HTLV-I infection in a patient exhibiting both an absolute CD4+ and CD8+ lymphocytosis. Three T-cell lines containing integrated HTLV-I proviral copies established from this patient were initially polyclonal, but with time all grew out the same two clones as determined by analysis of their T-cell antigen receptor beta chain gene rearrangements. The patient subsequently developed pulmonary and nasopharyngeal nodules containing HTLV-I infected cells. Restriction analysis of the patient's HTLV-I provirus revealed no differences from prototype HTLV-I and the tax gene was normally expressed in vivo and in vitro. The patient's T-lymphocytosis and HTLV-I+ pulmonary tract nodules were put into a complete clinical remission by treatment with alkylating agents and steroids. Subsequently, the patient developed a severe immunodeficiency state and expired. Retrospective serologic and gene amplification assays for HIV-1 demonstrated that he had been doubly infected from the time of presentation. Postmortem analysis by polymerase chain reaction revealed the p...Continue Reading

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Citations

Sep 1, 1992·European Journal of Epidemiology·A R ZanettiF Mazzotta
Apr 9, 2009·Cancer Chemotherapy and Pharmacology·Karen Y WondersReid Hayward
Jan 1, 1994·Journal of Virological Methods·L Z AbbottB Poiesz
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Mar 30, 2000·The New England Journal of Medicine·B PoieszR Hutchinson
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Jan 6, 2010·AIDS Research and Human Retroviruses·Anish ThomasBernard J Poiesz
May 26, 1999·Proceedings of the National Academy of Sciences of the United States of America·J A VetF R Kramer
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Feb 1, 1994·Journal of Clinical Microbiology·L M DysterL D Papsidero

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