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

## TL;DR

Dolutegravir, an HIV drug, may lower HTLV-1 levels in people co-infected with HIV and HTLV-1.

## Contribution

This study shows Dolutegravir is associated with reduced HTLV-1 proviral load in co-infected patients.

## Key findings

- Dolutegravir use is linked to lower HTLV-1 proviral load (p = 0.042).
- Patients on Dolutegravir are more likely to have undetectable HTLV-1 levels (<50 DNA copies/mm³, p = 0.015).

## Abstract

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.

Human T-cell lymphotropic virus type 1 (HTLV-1) may lead to serious illness, yet there is no specific treatment. Dolutegravir is a medication that is used to treat people with human immunodeficiency virus (HIV). The aim of this study was to determine if Dolutegravir use could reduce HTLV-1 levels in patients who are coinfected with both HIV and HTLV-1 and receiving treatment for HIV. We analyzed the HTLV-1 levels of 44 people who were coinfected with HIV-HTLV-1 who were receiving Dolutegravir, and 44 people infected with HTLV-1 only (not receiving Dolutegravir). We demonstrated that Dolutegravir use is associated with lower HTLV-1 levels. Dolutegravir use may potentially be an effective treatment for HTLV-1 infection.

Fernandez et al. compare the HTLV-1 proviral load in people with HIV-1-HTLV-1 coinfection on stable antiretroviral therapy or people with HTLV-1 single infection without antiretroviral therapy. Dolutegravir use for longer than six months is associated with lower HTLV-1 proviral load.