Monoclonal integration of HTLV‐I proviral DNA in patients with strongyloidiasis

Abstract

The relationship between strongyloidiasis and HTLV‐I was investigated in Okinawa, an area where both conditions are endemic. Thirty‐six patients with strongyloidiasis were sero‐positive for HTLV‐I and suffered from several related clinical complications. Fourteen of these patients (39%) were shown to have monoclonal integration of HTLV‐I proviral DNA in their blood lymphocytes, a condition designated as “smouldering” adult T‐cell leukaemia (ATL). Monoclonal integration of proviral DNA correlated with an increased CD4/CD8 ratio and the presence of abnormal lymphocytes in the peripheral blood, and with a trend for greater severity of the parasitic infection. Although the immunodeficiency caused by HTLV‐I could predispose to hyper infestation by Strongyloides, it is also possible that both the parasitic and the retroviral infestations are important co‐factors leading to the development of ATL.