[Adult T-cell leukemia associated with HTLV-1 in a HIV-2 seropositive African]

Abstract

Introduction: The aim of this report is to describe an HIV-2 seropositive patient from Mali who had adult-T cell Leukaemia/Lymphoma associated with HTLV-I infection.

Case report: The patient presented with erythroderma and foliate lymphocyte leukaemia. Skin biopsy showed an epidermotropic lymphoma. Tumoural cells expressed a mature T-cell phenotype CD4+/CD25+. High anti-HTLV-I titers and the evidence of monoclonal integration of HTLV-I provirus within circulating lymphoid cells led to the confirmation of HTLV-I as the causal agent in tumour cell transformation. HIV-2 serology was positive.

Discussion: Sub-Saharan Africa is a vast reservoir of HTLV-I virus with at least 5 million infected persons. Cases of adult-T cell Leukaemia/Lymphoma in Africans are exceptional. Lack of sufficient knowledge of the disease could partially explain this discrepancy. The main differential diagnosis in dermatology is primary T-cell lymphomas of the skin, particularly mycosis fungoides and Sézary syndrome.