Human T-cell lymphotropic virus (HTLV) infection lacks effective treatment. This review describes the virological, immunological and clinical outcomes of antiretroviral therapy (ART) in people with HTLV infection.
This systematic review followed PRISMA reporting guidelines and was registered in PROSPERO: CRD42022350076. The Newcastle-Ottawa Scales, adapted for cross-sectional studies, and Rob-2 were employed to assess the methodological quality of studies. A systematic search was conducted in Medline (PubMed), Scopus (Elsevier), Cochrane Library, and Web of Science (Clarivate Analytics) databases.
We retrieved data from 08 methodologically diverse articles, on treatment of patients infected by HTLV-1 or HTLV-2 alone, or coinfected by HIV-1 with Raltegravir, Tenofovir, Lamivudine and Zidovudine. Proviral load decreased in 3 of 7 studies, during 4 to 48 weeks of antiretrovirals use. Cellular immune response (CD4, CD8, CD25, CD69 and CD71 cells) were evaluated in six studies. There was no significant clinical improvement in the studies but all of them detected clinical stability during treatment.
Despite the demonstrated antiviral activity of ART, in vitro, clinical improvement was not proven. Most studies showed disease stability during ART use, suggesting potential clinical benefits. There is a need of larger, well-controlled trials, to define the role of ART for treatment of HTLV infection.