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Human T-Cell Lymphotropic Virus Type I (HTLV-I)-Associated Adult T-Cell Leukemia-Lymphoma in a Patient Infected with Human Immunodeficiency Virus Type 1 (HIV-1)

Darryl Shibata, MD; Russell K. Brynes, MD; Arthur Rabinowitz, MD; Curtis A. Hanson, MD; Marilyn L. Slovak, PhD; Thomas J. Spira, MD; and Parkash Gill, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Darryl Shibata, MD, Los Angeles County—USC Medical Center, 1200 North State Street, Box 736, Los Angeles, CA 90033.

Current Author Addresses: Dr. Shibata: Los Angeles County—University of Southern California Medical Center, Department of Pathology, Room 2900, 1200 North State Street, Los Angeles, CA 90033.

Dr. Brynes: University of Southern California School of Medicine, Department of Pathology, 2011 Zonal Avenue, HMR 204, Los Angeles, CA 90033.

Drs. Rabinowitz and Gill: Los Angeles County—University of Southern California Medical Center, Department of Medicine, 1200 North State Street, Los Angeles, CA 90033.

Dr. Hanson: University of Michigan Medical School, Department of Pathology, Medical Science I, M5240-0602, 1301 East Catherine, Ann Arbor, MI 48109-0602.

Dr. Slovak: City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010-0269.

Dr. Spira: Division of Host Factors, Building 1-1225 DO8, Center for Infectious Disease, Centers for Disease Control, Atlanta, GA 30333.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(11):871-875. doi:10.7326/0003-4819-111-11-871
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A patient had adult T-cell leukemia-lymphoma in the unusual setting of coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus type I (HTLV-1). The leukemic cells were CD4 positive and showed clonal genetic rearrangement of the T-cell receptor complex. Cytogenetic analysis showed three clonal karyotypic abnormalities: trisomy 3 and two translocations [t(1;15), (X;1)]. The patient was seropositive for HIV and HTLV-I; HTLV-I and HIV-1 DNA sequences were detected in peripheral blood leukocytes by the polymerase chain reaction. The HTLV-I sequences were detected in a relatively high proportion of mononuclear cells (at least 1 in 30 cells), whereas HIV-1 sequences were detected in a smaller proportion of cells (at least 1 in 3000 cells). Clinical remission was achieved after chemotherapy. There was a decrease in the proportion of HTLV-I positive mononuclear cells (at least 1 in 1000 cells), whereas the proportion of HIV-1 positive cells was relatively unchanged (at least 1 in 1000 cells). Adult T-cell leukemia-lymphoma in the setting of HIV coinfection may become increasingly common because asymptomatic retroviral coinfections are frequent.





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