HIV HTLV-I COINFECTION AND CLINICAL GRADE AT DIAGNOSIS

A total of 963 HIV-infected patients have been identified or followed up in Martinique since 1985. Medical files were used to retrieve infor mation about age, sex, circumstances of diagnosis, HTLV-I status, and HIV clinical grade at first examination according to CDC criteria from 1987. Complete information was available for 774 patients. At the fir st clinical examination, the clinical grade of 65 coinfected patients was more severe than that of the monoinfected patients (GIV versus GII , OR = 2.60, p < 0.01), but after adjustment for age and sex, this odd s ratio was reduced 1.57. Although this study cannot invalidate the hy pothesis of a faster progression toward AIDS of coinfected than of mon oinfected patients, it shows that one or several other mechanisms cont ribute to the different grades of severity at the first clinical exami nation observed between these two categories of patients. We believe t hat HTLV-I infection acquired during adulthood is a marker of high-ris k behavior and that it might be associated with early or multiple HIV infections.