Dolutegravir use is related to lower HTLV-1 proviral load in people co-infected by HIV-1

Infection by human T-cell lymphotropic virus type 1 (HTLV-1) affects millions of people worldwide and causes severe diseases. To date, no specific treatment is available for HTLV infection. The purpose of this study was to determine the impact of Dolutegravir use in reducing HTLV-1 proviral load (PVL) in HIV-HTLV1 coinfected subjects on stable antiretroviral therapy.

In this cross-sectional study we quantified HTLV-1 PVL in HIV-HTLV1 coinfected patients and HTLV-1 mono-infected ones. We compared HTLV-1 proviral load across groups, adjusting for age and sex, antiretroviral therapy use and CD4/CD8 cells count. We used a propensity score derived from a regression model for Dolutegravir use and HTLV-1 PVL, that included covariates like age and antiretroviral therapy duration.

Eighty-eight patients were included, 44 coinfected by HIV and HTLV-1 and 44 controls. Linear regression shows an association between Dolutegravir use and lower HTLV-1 proviral load values (p = 0.042). Participants using Dolutegravir are significantly more likely to have an HTLV-1 proviral load below the median (205 DNA copies/mm³) than those antiretroviral therapy -naïve (p = 0.003). In logistic regression, Dolutegravir use is significantly associated with undetectable HTLV-1 proviral load (<50 DNA copies/mm³, p = 0.015), and HTLV-1 proviral load lower than quartile 75 values (945 DNA copies/mm³, p = 0.021).

Dolutegravir use is consistently associated with lower HTLV-1 proviral load in HIV-HTLV-1 coinfected patients. This indicates that Dolutegravir may be an effective treatment for HTLV-1 infection.