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A clinical, hematologic, and immunologic analysis of 21 HTLV-II- infected
intravenous drug users [published erratum appears in Blood 1990 Nov
1;76(9):1901]
JD Rosenblatt, S Plaeger-Marshall, JV Giorgi, P Swanson, IS Chen, E Chin, HJ Wang, M Canavaggio, MA Hausner and AC Black
Department of Medicine, UCLA School of Medicine 90024-1678.
Infection with human T-cell leukemia virus type II (HTLV-II) has been
associated with rare chronic T-cell malignancies and has recently been
demonstrated in a significant proportion of American intravenous drug
abusers (IVDA). Identification of an HTLV-II-infected cohort of IVDA has
allowed analysis of the HTLV-II carrier state. We analyzed clinical,
hematologic, and immunologic parameters in 21 HTLV-II- infected IVDA, two
HTLV-I-infected IVDA, and 20 uninfected control IVDA identified by
serologic screening and by analysis of peripheral blood mononuclear cell
(PBMC) DNA by polymerase chain reaction (PCR). An elevated absolute
lymphocyte count was observed in 4 of 21 HTLV-II- infected IVDA, 1 of 2
HTLV-I-infected IVDA, and 1 of 20 control IVDA. CD8+ T-cell elevation was
observed in three of four HTLV-II IVDA with lymphocytosis and one of two
HTLV-I-infected IVDA. Activation of CD8+ T cells in HTLV-II-infected IVDA
was suggested by an overall increase in CD8+/HLA-DR+ lymphocytes. Cell
fractionation and analysis by PCR of HTLV-II-infected carrier blood showed
high levels of HTLV-II provirus in unfractionated PBMC and purified T cells
and little or no detectable HTLV-II DNA in B cells or monocytes, indicating
that T cells were the most likely target of infection in vivo. The
frequency of HTLV-II- infected cells was estimated at approximately 1 in
500 cells or less using dilution analysis by PCR of PBMC DNA. Most
HTLV-II-infected IVDA are asymptomatic and have no overt hematologic or
immunologic abnormalities, although some manifest benign lymphocytosis.
Volume 76,
Issue 2,
pp. 409-417,
07/15/1990
Copyright © 1990 by The American Society of Hematology

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