Coinfection by HIV-1 and Human Lymphotropic Virus Type 1 in Brazilian Children Is Strongly Associated With a Shorter Survival Time

Coinfection by HIV-1 and human lymphotropic virus type 1 is a frequent finding in South America, the Caribbean and Africa, and its prevalence varies from 4% to 16% according to the available reports. Although the impact of coinfection on HIV disease is still controversial, there is evidence supporting the contention that it can affect the natural history of both infections. No information is available on coinfection in children. In a nested case-control study, we evaluated 35 coinfected children matched by age, gender, and time of diagnosis to HIV monoinfected control subjects. At the first evaluation, coinfected children were more likely to present any signs and symptoms of disease (P < 0.001) than monoinfected ones despite having significantly higher CD4(+) cells count (1429 +/- 608 vs 928 +/- 768 cells/mm(3); P = 0.003). The proportion of deaths was higher (80%) for coinfected children than for HIV-1-infected ones (20%; relative risk, 2.1; 95% confidence interval, 1.4-3.1; P = 0.01). Survival was also significantly shorter for coinfected children (P = 0.001). Coinfection by HIV-1 and human lymphotropic virus type 1 in Brazilian children was strongly associated with higher mortality and shorter survival time despite coinfected patients having a higher baseline CD4(+) cells count.