CD4 and coinfection: Although South Africa has recently adopted the World Health Organization (WHO) recommendation with regards the initiation of ART in all individuals living with HIV, irrespective of the CD4 cell count or the degree of immune suppression [50,51], the falsely raised CD4 cell count in individuals with concurrent ATLL/HTLV-1 co-infection may have implications with regards to the initiation of antiretroviral therapy in other resource limited-settings such as sub-Saharan Africa which bears the brunt of the global HIV burden [3,4].