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HIV virological failure in a patient with human T-lymphotropic virus type 1-associated leukemia.

The aim of combined antiretroviral therapy (cART) in HIV-infected patients is viral load suppression below the limit of assay detection, also known as undetectable viral load, attainable only if an appropriate cART regimen is administered and adhered to [1]. Virological failure is defined as a viral load more than 200 copies/ml at 24 weeks of initiating ART or as having two consecutive detectable viremia more than 50 copies/ml after initial viral load suppression [1]. Although the two most common causes of virological failure are suboptimal adherence to treatment and viral resistance, less frequent causes have been described. We report a case of an HIVinfected patient with virological failure, probably mediated by at least two mechanisms secondary to human T-lymphotropic virus type 1 (HTLV-1)-associated adult T-cell leukemia/lymphoma (ATL)