Provirus Load in Patients with Human T‐Cell Leukemia Virus Type 1 Uveitis Correlates with Precedent Graves' Disease and Disease Activities

We previously demonstrated the increased provirus load in the peripheral blood of patients with human T‐cell leukemia virus type 1 (HTLV‐1) uveitis (HU). To delineate the relevance of the increased provirus load to clinical and immunologic parameters, we studied the correlation between them. Seventy‐nine HU patients (24 male and 55 female) were included in the study, with their informed consent. Plasma samples and genomic DNA of the peripheral blood mononuclear cells were isolated and the provirus load was estimated by semi‐quantitative polymerase chain reaction of the gag region sequence. Serum levels of anti‐HTLV‐1 antibodies and soluble IL‐2R were determined by electrochemiluminescence immuno assay and by ELISA, respectively. Disease activities were assessed and graded 0 to 4 according to the evaluation system. Recurrence of the disease during the follow‐up period was diagnosed ophthalmologically. The provirus load was significantly higher in the HU patients after Graves' disease (GD) than in those without GD (P<0.05). It correlated with disease activities assessed in terms of vitreous inflammation and interval to recurrence (both P<0.05). In the HU patients without GD, it correlated with the serum levels of soluble IL‐2 receptor (P<0.01), and nearly with those of HTLV‐1 antibody (P=0.063). These correlations were not found in the HU patients after GD under methimazole treatment. The results suggested a direct involvement of HTLV‐1‐infected cells in the pathogenesis of uveitis, and raise the possibility that hyperthyroidism may contribute to the clonal expansion of HTLV‐1‐infected cells.