1
|
Ramesh N, Cockbain B, Taylor GP, Rosadas C. How do socioeconomic determinants of health affect the likelihood of living with HTLV-1 globally? A systematic review with meta-analysis. Front Public Health 2024; 12:1298308. [PMID: 38327581 PMCID: PMC10848500 DOI: 10.3389/fpubh.2024.1298308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Human T Lymphotropic Virus type 1 (HTLV-1) is a neglected retrovirus associated with many clinical disorders, most notably Adult T-cell Leukemia/Lymphoma and HTLV-1-Associated Myelopathy (HAM). Found in endemic clusters across the world, high prevalence has been reported in minoritized groups who suffer from health inequities. This study investigates the association between HTLV-1 prevalence and the following socioeconomic determinants of health: education, income, and employment, which are markers of health inequity. Methods A systematic review was conducted by searching the following databases: Ovid/Medline, Embase, Global Health Database, Web of Science, LILACS and SciELO. Primary studies in English, Spanish and Portuguese mentioning HTLV-1 and one of education, income and/or employment were included. A random-effects meta-analysis was performed, and odds ratios (OR) were calculated to determine the association between these socioeconomic determinants of health and HTLV-1 prevalence. Results 42 studies were included. The likelihood of having HTLV-1 was higher in individuals with less than completed primary education compared to those who completed primary education (OR 1.86 [95% CI 1.34-2.57]; p < 0.01). This may be because individuals with low education have reduced access to and understanding of health information, thus increasing the prevalence of risk factors associated with HTLV-1 infection. No other determinants were found to be statistically significant. Conclusion Fewer years of schooling are associated with increased likelihood of contracting HTLV-1. Therefore, health promotion materials and public health policies regarding HTLV-1 must consider those with lower educational levels to effectively reduce disease transmission. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335004, identifier (CRD42022335004).
Collapse
Affiliation(s)
- Nydile Ramesh
- School of Public Health, Imperial College London, London, United Kingdom
| | - Beatrice Cockbain
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
2
|
Nunes da Silva A, Araújo THA, Boa-Sorte N, Farias G, Galvão-Barroso AK, de Carvalho A, Vicente AC, Galvão-Castro B, Rios Grassi MF. Epidemiological and molecular evidence of intrafamilial transmission through sexual and vertical routes in Bahia, the state with the highest prevalence of HTLV-1 in Brazil. PLoS Negl Trop Dis 2023; 17:e0011005. [PMID: 37769013 PMCID: PMC10593241 DOI: 10.1371/journal.pntd.0011005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 10/23/2023] [Accepted: 09/19/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Familial clustering of HTLV-1 and related diseases has been reported in Brazil. However, intrafamilial transmission of HTLV-1 based on molecular analysis has been studied only in a few communities of Japanese immigrants and African-Brazilians. OBJECTIVE To investigate the familial clustering of HTLV-1 infection and to determine the likely routes of transmission through epidemiological and genetic analyzes. METHODS Medical records of 1,759 HTLV-1+ patients from de the Center for HTLV in Salvador, Brazil, were evaluated to identify first-degree relatives previously tested for HTLV-1. Familial clustering was assumed if more than one member of the same family was HTLV-1+. LTR regions of HTLV-1 sequences were analyzed for the presence of intrafamilial polymorphisms. Family pedigrees were constructed and analyzed to infer the likely transmission routes of HTLV-1. RESULTS In 154 patients at least one other family member had tested positive for HTLV-1 (a total of 182 first-degree relatives). Of the 91 couples (182 individuals), 51.6% were breastfed, and 67.4% reported never using a condom. Of the 42 mother-child pairs, 23.8% had a child aged 13 years or younger; all mothers reported breastfeeding their babies. Pedigrees of families with 4 or more members suggests that vertical transmission is a likely mode of transmission in three families. Three families may have had both vertical and sexual transmission routes for HTLV-1. The genetic signatures of the LTR region of 8 families revealed 3 families with evidence of vertical transmission, another 3 families (spouses) with sexual transmission, and one family with both transmission routes. HTLV-1 sequences belonged to Cosmopolitan subtype HTLV-1a Transcontinental subgroup A. CONCLUSION Sexual and vertical transmission routes contribute to the intrafamilial spread of HTLV-1 in the state of Bahia.
Collapse
Affiliation(s)
| | | | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
| | - Giovanne Farias
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
| | | | | | | | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brasil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brasil
| |
Collapse
|
3
|
de Aquino Firmino A, Filho PRTG, Martins ALL, Araújo TH, Gois LL, da Silva Batista E, Araújo JPL, Galvão-Castro B, Grassi MFR. HTLV-1 Proviral Load in Vaginal Fluid Correlates with Levels in Peripheral Blood Mononuclear Cells. Pathogens 2023; 12:pathogens12050682. [PMID: 37242352 DOI: 10.3390/pathogens12050682] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The prevalence of human T-lymphotropic virus type-1 (HTLV-1) infection is higher in women, and sexual intercourse has been described as an important route of male-to-female transmission. The present study aimed to quantify HTLV-1 proviral load (PVL) in vaginal fluid, and to investigate correlations with PVL in peripheral blood mononuclear cells (PBMCs). In addition, cytopathological alterations and vaginal microbiota were evaluated. METHODS HTLV-1-infected women were consecutively recruited at a multidisciplinary center for HTLV patients in Salvador, Brazil. All women underwent gynecological examinations to obtain cervicovaginal fluid and venipuncture for blood collection. PVL, as measured by real-time quantitative polymerase chain reaction (RT-qPCR), was expressed as the number of copies of HTLV-1/106 cells in blood and vaginal fluid samples. Light microscopy was used to assess cervicovaginal cytopathology and vaginal microbiota. RESULTS In the 56 included women (43 asymptomatic carriers and 13 diagnosed with HTLV-1-associated myelopathy/tropical spastic paraparesis-HAM/TSP), mean age was 35.9 (SD ± 7.2) years. PVL was higher in PBMCs (median: 23,264 copies/106 cells; IQR: 6776-60,036) than in vaginal fluid (451.9 copies/106 cells; IQR: 0-2490) (p < 0.0001). PVL in PBMCs was observed to correlate directly with PVL in vaginal fluid (R = 0.37, p = 0.006). PVL was detected in the vaginal fluid of 24 of 43 (55.8%) asymptomatic women compared to 12 of 13 (92.3%) HAM/TSP patients, p = 0.02. Cytopathologic analyses revealed no differences between women with detectable or undetectable PVL. CONCLUSION HTLV-1 proviral load is detectable in vaginal fluid and correlates directly with proviral load in peripheral blood. This finding suggests that sexual transmission of HTLV-1 from females to males may occur, as well as vertical transmission, particularly in the context of vaginal delivery.
Collapse
Affiliation(s)
- Alisson de Aquino Firmino
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Paulo Roberto Tavares Gomes Filho
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Adenilda Lima Lopes Martins
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Department of Health (DSAU), State University of Feira de Santana (UEFS), Feira de Santana 44036-900, Bahia, Brazil
| | - Thessika Hialla Araújo
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Luana Leandro Gois
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Department of Biointeraction Sciences, Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador 40110-902, Bahia, Brazil
| | - Everton da Silva Batista
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Jean Paulo Lacerda Araújo
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Bernardo Galvão-Castro
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Advanced Laboratory of Public Health (LASP), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador 40296-710, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Advanced Laboratory of Public Health (LASP), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador 40296-710, Bahia, Brazil
| |
Collapse
|
4
|
Landim C, Dias CMCC, Nascimento C, Goes ALB, Araújo THA, Ribeiro A, Oliveira FTD, Castro-Lima H, Boa-Sorte N, Galvão-Castro B. Impaired flexibility in patients with tropical spastic paraparesis/HTLV-associated myelopathy: evaluation via pendulum fleximeter. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:271-283. [PMID: 37059437 PMCID: PMC10104761 DOI: 10.1055/s-0043-1764417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Flexibility is crucial to the harmonious execution of joint movements. While skeletal muscle dysfunction in patients with HTLV-1 can interfere with mobility, it is unclear whether these patients experience reduced flexibility. OBJECTIVE To evaluate the differences in flexibility between HTLV-1-infected individuals with and without myelopathy compared with uninfected controls. We also investigated whether age, sex, body mass index (BMI), physical activity level, or lower back pain influence flexibility in HTLV-1-infected individuals. METHODS The sample consisted of 56 adults, of which 15 did not have HTLV-1, 15 had HTLV-1 without myelopathy, and 26 had TSP/HAM. Their flexibility was assessed using the sit-and-reach test and a pendulum fleximeter. RESULTS No differences in flexibility were observed between the groups with and without myelopathy and controls without HTLV-1 infection using the sit-and-reach test. The pendulum fleximeter results of individuals with TSP/HAM presented the lowest flexibility among the groups with respect to trunk flexion, hip flexion and extension, knee flexion, and ankle dorsiflexion, even after adjusting for age, sex, BMI, level of physical activity, and lower back pain using multiple linear regression models. Additionally, HTLV-1-infected individuals without myelopathy demonstrated reduced flexibility in movements: knee flexion, dorsiflexion, and ankle plantar flexion. CONCLUSIONS Individuals with TSP/HAM demonstrated reduced flexibility in most of the movements evaluated by the pendulum fleximeter. Additionally, HTLV-1-infected individuals without myelopathy demonstrated reduced knee and ankle flexibility, potentially representing a marker of myelopathic development.
Collapse
Affiliation(s)
- Caroline Landim
- Escola Bahiana de Medicina e Saúde Pública, Salvador BA, Brazil
| | | | | | | | | | - Adriele Ribeiro
- Escola Bahiana de Medicina e Saúde Pública, Salvador BA, Brazil
| | | | | | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador BA, Brazil
- Universidade Federal da Bahia, Salvador BA, Brazil
| | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador BA, Brazil
- Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Laboratório Avançado de Saúde Pública, Salvador BA, Brazil
| |
Collapse
|
5
|
Sampaio GCL, Ribeiro JR, de Almeida CN, Boa-Sorte N, Galvão-Castro B, Grassi MFR, Nunes Sá K, Dias CMCC. Human T Cell Lymphotropic Virus Type 1 Global Prevalence Associated with the Human Development Index: Systematic Review with Meta-Analysis. AIDS Res Hum Retroviruses 2023; 39:145-165. [PMID: 36571250 DOI: 10.1089/aid.2021.0230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In 2012, the number of people infected with human T cell lymphotropic virus type 1 (HTLV-1) was estimated to be 10 million worldwide. Prevalence varies according to geographic location, ethnic factors, sex, age, populations exposed to risk factors, income, and education, reaching countries with the worst socioeconomic scenarios. There is a need to determine the current global prevalence of HTLV-1 and examine its association with countries' human development index (HDI) to provide data for global health policy. Systematic review with meta-analysis is according to PRISMA 2020 recommendations. It was registered at PROSPERO, CRD42021223146. Prevalence or cross-sectional studies of HTLV-1 infection with at least 100 participants, screening, and confirmatory serologic testing were included. Studies with incomplete or unavailable results or with duplicate information were excluded. Data were selected by two independent investigators and analyzed using R software, a metapackage that generated the forest plots [95% confidence interval (CI)]. Heterogeneity was assessed using the I2 statistic, and funnel plot asymmetry was assessed using Egger's test. Countries were compared using an HDI cutoff ≥0.8. Methodological quality was assessed using Joanna Briggs Institute (JBI) criteria. The overall prevalence of HTLV-1 infection was 0.91% (95% CI: 0.80-1.02, p < .0001) and was higher in low HDI countries [1.18% (95% CI: 1.03-1.34)] than in high HDI countries [0.41% (95% CI: 0.27-0.57)]. Prevalence varied according to the populations studied: it was higher in the general population [1.65% (95% CI: 1.08-2.34)] compared to pregnant women [0.34% (95% CI: 0.17-0.57)] and blood donors [0.04% (95% CI: 0.01-0.08)]. Consistently, prevalence for each population group was higher in low HDI countries than in high HDI countries. The worldwide prevalence of HTLV-1 infection is highly heterogeneous, with a global prevalence of 0.91%. In high HDI countries, the observed prevalence is approximately three times lower than in low HDI countries. In the general population, the observed prevalence is about 5 times higher than in pregnant women and 41 times higher than in blood donors.
Collapse
Affiliation(s)
- Gleice Castor Lins Sampaio
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | - Jéssica Ramos Ribeiro
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | | | - Ney Boa-Sorte
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Health Technology Assessment Unit, Universidade Federal da Bahia (UFBA), Bahia, Brazil
| | - Bernardo Galvão-Castro
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Advanced Public Health Laboratory, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Advanced Public Health Laboratory, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | | |
Collapse
|
6
|
Rahimzadeh G, Safar MJ, Rezai S, Rezai MS, Movahedi FS. Seroepidemiology of HBV, HCV, HIV, HTLV, and CMV in Pregnant Women Referring to Sari Birth Cohort. Adv Biomed Res 2022; 11:97. [PMID: 36660762 PMCID: PMC9843599 DOI: 10.4103/abr.abr_334_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/25/2022] [Accepted: 10/29/2022] [Indexed: 11/23/2022] Open
Abstract
Background Congenital infections are among the most important conditions threatening human fetal health, the majority of which are caused by viral agents. Screening pregnant women for viral infections is essential because such infections can cause serious consequences for both the mother and the infant. So, this study aimed to serologically investigate sexually transmitted viral infections in pregnant women and also find the association between the prevalence of viral infections and epidemiological parameters in pregnant women of Sari, Iran. Materials and Methods This descriptive, observational study was performed in pregnant women referring to Sari Birth Cohort Center between 2018 and 2020. A total of 1092 blood samples were investigated for hepatitis B (HBV), hepatitis C (HCV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), and cytomegalovirus (CMV) serological markers by enzyme-linked immunosorbent assay (ELISA). Results The prevalence of HBsAg positivity, HCV, HIV, and HTLV was 0.2%, 0.09%, 0.09%, and 0.2%, respectively. The percentage of participants with CMV-IgM and -IgG antibody titers above normal was 0.2% and 91.8%, respectively. Pregnant women whose educational level was bachelor's degree or lower, those who did not use a male condom before pregnancy, or those with a family history of infectious disease were found to be more likely to have HBV, HCV, HIV, HTLV, and CMV infections. Conclusion Family history, maternal age, pregnancy stage, and not using a male condom are among the risk factors for sexually transmitted viral infections in pregnant women in Sari.
Collapse
Affiliation(s)
- Golnar Rahimzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Jafar Safar
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shaghayegh Rezai
- Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran,Address for correspondence: Prof. Mohammad Sadegh Rezai, Professor, Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran. E-mail:
| | | |
Collapse
|
7
|
Costa DA, Carvalho FM, Vieira NM, Falcão GGSC, Sarmento VA, Brites C, Lins-Kusterer L. Work ability and associated factors in people living with human T-cell leukemia virus type 1. Rev Soc Bras Med Trop 2022; 55:e0111. [PMID: 35946625 PMCID: PMC9344948 DOI: 10.1590/0037-8682-0111-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an
estimated 10-15 million people worldwide. However, knowledge of the impact
of HTLV-1 infection on work ability is lacking. This study aimed to measure
the frequency and identify factors associated with poor work ability in
patients living with HTLV-1. Methods: This cross-sectional study included 207 individuals infected with HTLV-1 who
attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1
antibodies were detected in the participants’ blood by enzyme-linked
immunosorbent assay (ELISA) and confirmed by western blotting. Participants
answered a questionnaire on sociodemographic data, personal habits, clinical
data, health-related quality of life, and work ability, evaluated using the
work ability index questionnaire. A Poisson regression model with a robust
variance estimate was used to identify the factors associated with the
prevalence of poor work ability. Results: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females,
100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1
associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual
was classified as having excellent work ability. Poor work ability
prevalence was strongly associated (prevalence ratio; 95% confidence
interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms
(1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98;
0.97-0.99) component summaries of health-related quality of life. Conclusions: Poor work ability among people living with HTLV-1 is associated with
sedentarism, neurologic symptoms, and low health-related quality of
life.
Collapse
Affiliation(s)
- Dayana Alves Costa
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | - Nicolle Melo Vieira
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | | | - Carlos Brites
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Liliane Lins-Kusterer
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| |
Collapse
|
8
|
Galvão-Castro B, Grassi MFR, Galvão-Castro AV, Nunes A, Galvão – Barroso AK, Araújo THA, Rathsam-Pinheiro RH, Nunes CLX, Ribeiro A, Lírio M, Gonçalves NL, Rangel SL, Dias CMCC, Ozores DP, Dubois-Mendes SM, Lima I, Silva ALP, de Jesus WLA, Santos FLN, de Oliveira JGR, de Moraes YVP, de Jesus AO, Daltro F, Boa-Sorte N, Castro-Lima H, Soliani MLC. Integrative and Multidisciplinary Care for People Living With Human T-Cell Lymphotropic Virus in Bahia, Brazil: 20 Years of Experience. Front Med (Lausanne) 2022; 9:884127. [PMID: 35746949 PMCID: PMC9210980 DOI: 10.3389/fmed.2022.884127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022] Open
Abstract
Brazil is home to the highest absolute number of human T-cell lymphotropic virus type-1 (HTLV-1)-infected individuals worldwide; the city of Salvador, Bahia, has the highest prevalence of HTLV-1 infection in Brazil. Due to the complex nature of several diseases associated with this retrovirus, a multidisciplinary health care approach is necessary to care for people living with HTLV-1. The Bahia School of Medicine and Public Health’s Integrative Multidisciplinary HTLV Center (CHTLV) has been providing support to people living with HTLV and their families since 2002, striving to ensure physical and mental well-being by addressing biopsychosocial aspects, providing clinical care and follow-up, including to pregnant/postpartum women, as well as comprehensive laboratory diagnostics, psychological therapy, and counseling to family members. To date, CHTLV has served a total of 2,169 HTLV-infected patients. The average patient age is 49.8 (SD 15.9) years, 70.3% are female, most are considered low-income and have low levels of education. The majority (98.9%) are HTLV-1 cases, and approximately 10% have been diagnosed with tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM), while 2.2% have infective dermatitis and 1.1% have adult T-cell lymphoma. In all, 178 pregnant/postpartum women [mean age: 32.7 (±6.5) years] have received care at CHTLV. Regarding vertical transmission, 53% of breastfed infants screened for HTLV tested positive in their second year of life, nearly 18 times the rate found in non-breastfed infants. This article documents 20 years of experience in implementing an integrative and multidisciplinary care center for people living with HTLV in Bahia, Brazil. Still, significant challenges remain regarding infection control, and HTLV-infected individuals continue to struggle with the obtainment of equitable and efficient healthcare.
Collapse
Affiliation(s)
- Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- *Correspondence: Bernardo Galvão-Castro,
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Aidê Nunes
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | | | - Regina Helena Rathsam-Pinheiro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira, Salvador, Brazil
| | - Ceuci Lima Xavier Nunes
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Instituto Couto Maia, Secretaria da Saúde do Estado da Bahia, Salvador, Brazil
| | - Adriele Ribeiro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Monique Lírio
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Noilson Lázaro Gonçalves
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | | | | | - Isabela Lima
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | | | - Fred Luciano Neves Santos
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | | | | | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | | |
Collapse
|
9
|
Clinical and Public Health Implications of Human T-Lymphotropic Virus Type 1 Infection. Clin Microbiol Rev 2022; 35:e0007821. [PMID: 35195446 PMCID: PMC8941934 DOI: 10.1128/cmr.00078-21] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is estimated to affect 5 to 10 million people globally and can cause severe and potentially fatal disease, including adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The burden of HTLV-1 infection appears to be geographically concentrated, with high prevalence in discrete regions and populations. While most high-income countries have introduced HTLV-1 screening of blood donations, few other public health measures have been implemented to prevent infection or its consequences. Recent advocacy from concerned researchers, clinicians, and community members has emphasized the potential for improved prevention and management of HTLV-1 infection. Despite all that has been learned in the 4 decades following the discovery of HTLV-1, gaps in knowledge across clinical and public health aspects persist, impeding optimal control and prevention, as well as the development of policies and guidelines. Awareness of HTLV-1 among health care providers, communities, and affected individuals remains limited, even in countries of endemicity. This review provides a comprehensive overview on HTLV-1 epidemiology and on clinical and public health and highlights key areas for further research and collaboration to advance the health of people with and at risk of HTLV-1 infection.
Collapse
|
10
|
Pereira Vieira Barreto NM, Brito Farias MM, Oliveira CDL, Almeida Costa Araujo W, Rios Grassi MF, Nascimento de Souza J, Soares Jacobina B, Aquino Teixeira MC, Galvão-Castro B, Matos Soares N. Evaluation of Strongyloides stercoralis infection in patients with HTLV-1. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2022; 42:31-40. [PMID: 35471168 PMCID: PMC9041088 DOI: 10.7705/biomedica.5888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response. OBJECTIVE To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil. MATERIALS AND METHODS We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot. RESULTS The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S. stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178). CONCLUSIONS HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.
Collapse
Affiliation(s)
- Nilo Manoel Pereira Vieira Barreto
- Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Universidade Federal da Bahia, Bahia, Brasil.
| | - Marina Morena Brito Farias
- Instituto de Ciências da Saúde, Programa de Pós-graduação em Processos Interativos dos Órgãos e Sistemas, Universidade Federal da Bahia, Bahia, Brasil.
| | - Cíntia de Lima Oliveira
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Bahia, Brasil.
| | - Weslei Almeida Costa Araujo
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Bahia, Brasil.
| | | | - Joelma Nascimento de Souza
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Bahia, Brasil.
| | | | | | | | - Neci Matos Soares
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Bahia, Brasil.
| |
Collapse
|
11
|
Pereira FM, Santos FLN, Silva ÂAO, Nascimento NM, Almeida MDCC, Carreiro RP, Galvão-Castro B, Rios Grassi MF. Distribution of Human Immunodeficiency Virus and Human T-Leukemia Virus Co-infection in Bahia, Brazil. Front Med (Lausanne) 2022; 8:788176. [PMID: 35083245 PMCID: PMC8784416 DOI: 10.3389/fmed.2021.788176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Human Immunodeficiency Virus (HIV) and Human T-Leukemia Virus (HTLV) are retroviruses that share similar routes of transmission. In Brazil, the prevalence of HIV and HTLV varies according to geographic region. The state of Bahia, located in the Northeast region, is considered endemic for both retroviruses. The present study aimed to characterize the frequency of HIV/HTLV coinfection and evaluate the geographic distribution of coinfection throughout the state. This cross-sectional study was conducted at the state's Central Laboratory of Public Health (LACEN-BA) and included all samples from 2004 to 2013 submitted to serological testing for anti-HIV and anti-HTLV-1/2, screened by chemiluminescence/ELISA and confirmed by Western blot. Infection rates are expressed as the number of infected individuals per 100,000 inhabitants from each municipality. A total of 129,158 samples originating from 358/417 (85.8%) municipalities in Bahia were evaluated. HTLV was detected in 2.4% of the HIV-positive samples (n = 42) compared to 0.5% of those with negative HIV serology (n = 677) (OR: 4.65; CI: 3.39–6.37). HIV/HTLV coinfection was more frequent in women (69.0%); the median age of coinfected individuals was 47.2 years [interquartile range (IQR): 41.6–55.4 years]. In the 14/417 (3.4%) municipalities where at least one case of HIV/HTLV coinfection was detected, the overall HTLV coinfection rate in HIV-positive samples was 0.25 (range: 0.17–13.84) per 100,000 inhabitants. Most cases of HIV/HTLV-1 coinfection (21/37, 57%) were concentrated in the municipality of Salvador. Isolated instances (one or two cases) of HIV/HTLV-1 coinfection were distributed across municipalities known to be endemic for HTLV infection.
Collapse
Affiliation(s)
- Felicidade Mota Pereira
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Gonçalo Moniz Public Health Central Laboratory, Laboratório Central (LACEN), Salvador, Brazil
| | - Fred Luciano Neves Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Ângelo Antônio Oliveira Silva
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Nathan Menezes Nascimento
- Bahiana School of Medicine and Public Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | | | - Roberto Perez Carreiro
- Center for Integration of Data and Health Knowledge, Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Gonçalo Moniz Institute, FIOCRUZ-BA, Salvador, Brazil
| | - Bernardo Galvão-Castro
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Bahiana School of Medicine and Public Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Maria Fernanda Rios Grassi
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Bahiana School of Medicine and Public Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| |
Collapse
|
12
|
Dos Santos DN, Sá KN, Queirós FC, Paixão AB, Santos KOB, de Andrade RCP, Camatti JR, Baptista AF. Pain, psychoaffective symptoms, and quality of life in human T cell lymphotropic virus type 1 (HTLV-1): a cross-sectional study. J Neurovirol 2021; 27:838-848. [PMID: 33405200 DOI: 10.1007/s13365-020-00914-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/02/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022]
Abstract
The objective of this study is to describe the chronic pain characteristics in individuals infected with human T cell lymphotropic virus type 1 (HTLV-1) per subgroup (asymptomatic, oligosymptomatic, and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP)) compared with controls with chronic pain without HTLV-1. This is a cross-sectional study investigating associations between pain profile, psychopathological symptoms, and quality of life. Individuals infected with HTLV-1 refer high-intensity pain compared with controls, with more severe characteristics being present in oligosymptomatic and HAM/TSP individuals. Oligosymptomatic individuals have a tendency of diffuse and frequent pain, mainly in the head/neck region and more depressive symptoms, resembling nociplastic pain. Neuropathic pain was localized in the lower limbs in all infected groups, worse in HAM/TSP individuals, and associated with a worse perception of quality of life. Pain was associated to higher levels of TNF-alpha and interferon-gamma. HTLV-1 pain is generally more severe when compared with other chronic pain syndromes, being present mainly in the lower limbs. Certain characteristics are typical, depending on the affected group. Oligosymptomatic and HAM/TSP individuals present more diffuse pain, with higher intensity and greater impact in quality of life. Increased levels of inflammatory cytokines are associated with HTLV-1-related pain.
Collapse
Affiliation(s)
- Dislene Nascimento Dos Santos
- Graduate, Program on Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
- Immunology Service, Professor Edgard Santos Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Fernanda C Queirós
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Alaí Barbosa Paixão
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | | | - Janine Ribeiro Camatti
- Graduate Program on Neuroscience and Cognition, Federal University of ABC, Sao Paulo, Santo Andre, Brazil
| | - Abrahão Fontes Baptista
- Graduate, Program on Medicine and Health, Federal University of Bahia, Salvador, Bahia, Brazil.
- Nucleus of Studies on Health and Functionality, Federal University of Bahia, Salvador, Bahia, Brazil.
- Center for Mathematics, Computation and Cognition, Federal University of ABC, Santo Andre, Sao Paulo, Brazil.
- Graduate Program on Neuroscience and Cognition, Federal University of ABC, Sao Paulo, Santo Andre, Brazil.
| |
Collapse
|
13
|
Falcão GGVSC, Sarmento VA, Dutra BS, Russoni B, de Oliveira LS, Costa DA, Brites C, Bouqout JE, Lins-Kusterer L. Oral health and quality of life of people living with human T-cell leukemia virus-1 in Salvador, Brazil: a cross-sectional study. Clin Oral Investig 2021; 26:2565-2573. [PMID: 34665340 DOI: 10.1007/s00784-021-04226-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/12/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the oral health status and oral health-related quality of life (OHRQoL) in symptomatic and asymptomatic patients with human T-cell leukemia virus-1 (HTLV-1). MATERIAL AND METHODS This cross-sectional study included 204 seropositive patients, classified into two groups, symptomatic and asymptomatic. The first group included patients with neurological symptoms associated with HTLV-1 (n = 69), and the second group, asymptomatic HTLV-1 carriers (n = 135). We evaluated the total unstimulated saliva flow, oral mucosa, the Decayed, Missing, Filled Teeth (DMFT) index, and Periodontal Screening and Recording (PSR). The Oral Health Impact Profile (OHIP14) measured the oral health-related quality of life. General health-related quality of life was measured by the 36-Item Short-Form Health Survey (SF-36). Variables with a value of p < 0.25 in bivariate analysis were selected, together with SF-36 summaries' scores and total OHIP-14, for composing a logistic regression model that had symptomatology as the dependent variable. RESULTS The OHIP-14 total score was poor in symptomatic and asymptomatic groups, but with no marked difference between them. Symptomatic patients showed significantly lower SF-36 scores (P ≤ 0.05) compared to asymptomatic ones, except for mental component summary (MCS). Family income (1-2.99 minimal wages), reduced salivary flow, flossing, and lower physical component summary (PCS) were associated (P ≤ 0.05) with symptomatology. CONCLUSIONS Symptomatic individuals living with HTLV-1 showed lower HRQoL and poorer OHRQoL compared to asymptomatic ones. Family income, flossing, reduced salivary flow, and lower PCS were associated with symptomatic HTLV-1 individuals. CLINICAL RELEVANCE In the present study, symptomatic individuals with HTLV-1 showed higher family income, poorer oral health status, lower salivary flow, poorer OHRQoL, and lower HRQoL compared to asymptomatic ones.
Collapse
Affiliation(s)
| | | | - Brenda Soares Dutra
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - Bruno Russoni
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | | | - Dayana Alves Costa
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - Carlos Brites
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil
| | - Jerry E Bouqout
- Department of Diagnostic Sciences, School of Dentistry, University of Texas, Houston, TX, USA
| | - Liliane Lins-Kusterer
- Postgraduate Program in Medicine and Health, School of Medicine, Federal University of Bahia, Bahia, Brazil. .,Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Rua Doutor Augusto Viana, s/n - Canela, Salvador, BA, 40110-060, Brazil.
| |
Collapse
|
14
|
Epidemiological and molecular profile of blood donors infected with HTLV-1/2 in the state of Pará, northern Brazil. Braz J Microbiol 2021; 52:2001-2006. [PMID: 34498218 DOI: 10.1007/s42770-021-00609-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The Human T-lymphotropic virus (HTLV) is a retrovirus of the genus Deltaretrovirus, which belongs to the family Retroviridae. The most important types are HTLV-1 and HTLV-2. It is estimated that between five and 10 million individuals are infected with HTLV-1, worldwide. Studies in the state of Pará indicate that it has the third highest prevalence of HTLV infections of any Brazilian state. The present study describes the epidemiological, serological, and molecular profile of blood donors from the state of Pará that were classified as unfit due to infection by HTLV-1 and 2. METHODS The present study is based on a descriptive, retrospective, and cross-sectional review of the epidemiological, serological, and molecular data on blood donations, between January 2015 and December 2019. The data were obtained from the blood bank system and were digitalized to form a database in the Statistical Package for Social Sciences program, version 20. Descriptive statistics were used to determine the absolute and relative frequencies of the qualitative variables. For the quantitative variables, the mean, standard deviation, and minimum and maximum values were calculated. A p < 0.05 significance level was adopted for all analyses. RESULTS A total of 632 samples were analyzed, of which 496 (78%) had no detectable proviral DNA and 136 (22%) had detectable HTLV. The HTLV-1 was detected in most (78%; 106/136) of these samples, while only 30 (22%) were detected for HTLV-2. The HTLV proviral DNA was detected primarily in females (69.1%), with a mean age of 40 years, with the highest frequencies of detection being recorded in single individuals (66.2%), first-time donors (74.3%), and individuals that had graduated high school (44.1%). The molecular confirmation of HTLV showed that three-quarters (78%) of the serologically reactive individuals were negative for either types 1 or 2, so the epidemiological profile of these individuals was significantly different from their detectable profile. CONCLUSIONS The HTLV is neglected in Brazil; there is thus a clear need for further research in the area of regional hemotherapy and hematology services, in order to contribute to the definition of regional infection profiles, that will be fundamental to the development of effective prophylactic practices for the prevention of the infection and the dissemination of knowledge on the dangers of HTLV in the community.
Collapse
|
15
|
Novel Genetic Constructs for Production of Recombinant HTLV-1/2 Antigens and Evaluation of Their Reactivity to Plasma Samples from HTLV-1-Infected Patients. J Clin Microbiol 2021; 59:JCM.02701-20. [PMID: 33504592 DOI: 10.1128/jcm.02701-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/20/2021] [Indexed: 11/20/2022] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) can cause life-threatening diseases for which there are no effective treatments. Prevention of HTLV-1 infection requires massive testing of pregnant women, blood for transfusion, and organs for transplantation, as well as safe sex. In this context, serological assays are widely used for monitoring HTLV-1 infections. Despite the necessity for recombinant antigens to compose serological tests, there is little information available on procedures to produce recombinant HTLV-1/2 antigens for serological diagnostic purposes. In this work, we tested a series of genetic constructions to select those more amenable for production in bacterial systems. To overcome the constraints in expressing sections of viral envelope proteins in bacteria, we have used the p24 segment of the gag protein as a scaffold to display the immunogenic regions of gp46 and gp21. Nine recombinant antigenic proteins derived from HTLV-1 and five derived from HTLV-2 were successfully purified. The HTLV-1 antigens showed high efficiency in discriminating HTLV-positive samples from HTLV-negative samples using enzyme-linked immunosorbent assays. Interestingly, HTLV-1-positive samples showed a high level of cross-reaction with HTLV-2 antigens. This finding is explained by the high sequence conservation between the structural proteins of these two highly related viruses. In summary, the results presented in this work provide a detailed description of the methods used to produce recombinant HTLV-1 and HTLV-2 antigens, and they demonstrate that the HTLV-1 antigens show strong potential for serological diagnosis of HTLV-1 infections.
Collapse
|
16
|
Henrique-Araújo R, Quarantini LC, Morais-de-Jesus M, Jesus-Nunes AP, Dantas-Duarte A, Caribé AC, Argolo FC, Marback RF, Costa TV, Oliveira IRD. Comparative study of impulsiveness and risk behaviors among infected individuals with hepatitis C virus and human T-cell lymphotropic virus type 1. Ann Hepatol 2021; 19:166-171. [PMID: 31711914 DOI: 10.1016/j.aohep.2019.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 08/27/2019] [Accepted: 09/10/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Hepatitis C virus (HCV) and human T-cell lymphotropic virus type 1 (HTLV-1) infections have chronic courses. HCV is primarily transmitted via the hematogenous route, whereas HTLV-1 is primarily transmitted sexually, although it can also be transmitted by blood. Individuals chronically infected with either HTLV-1 or HCV can differ in terms of behavioral characteristics and personality traits. This study compared the occurrence of risk behaviors and impulsivity aspects between HCV and HTLV-1 carriers. MATERIALS AND METHODS Observational, comparative and cross-sectional study that involved a sample of outpatients who had HCV or HLTV-1, by way of a sociodemographic and behavioral questionnaire and the Barratt Impulsiveness Scale - BIS-11. 143 individuals with HCV and 113 individuals with HTLV-1 were evaluated. RESULTS There was a difference with regards to gender among patients, with mostly males affected in the HCV group. Risk behaviors commonly mediated by impulsiveness were significantly more frequent in the HCV group. Similarly, overall impulsiveness and domain nonplanning were higher in the HCV group. Multivariate analysis showed that increased age, male gender, higher nonplanning scores and HCV infection were independent factors for the occurrence of risk behaviors. Both groups presented high rates of other sexually transmitted diseases and a low rate of condom use in sexual relations. CONCLUSIONS This study confirms the higher rate of risk behaviors and the levels of impulsiveness commonly observed in patients with HCV, along with comparisons to patients with HTLV-1.
Collapse
Affiliation(s)
- Ricardo Henrique-Araújo
- Postgraduate Program in Interactive Processes of Organs and Systems, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil; Nova Esperança Medical School, João Pessoa, Brazil; Hospital Complex of Infectious Diseases Clementino Fraga, João Pessoa, Brazil.
| | - Lucas C Quarantini
- Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; Psychiatry Service, University Hospital (Com-HUPES), Federal University of Bahia, Salvador, Brazil
| | - Mychelle Morais-de-Jesus
- Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; Psychiatry Service, University Hospital (Com-HUPES), Federal University of Bahia, Salvador, Brazil
| | - Ana Paula Jesus-Nunes
- Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; Psychiatry Service, University Hospital (Com-HUPES), Federal University of Bahia, Salvador, Brazil
| | - Adriana Dantas-Duarte
- Psychiatry Service, University Hospital (Com-HUPES), Federal University of Bahia, Salvador, Brazil
| | - André C Caribé
- Psychiatry Service, University Hospital (Com-HUPES), Federal University of Bahia, Salvador, Brazil
| | - Felipe C Argolo
- Postgraduate Program in Psychiatry and Medical Psychology, Federal University of São Paulo, São Paulo, Brazil
| | - Roberta F Marback
- Psychiatry Service, University Hospital (Com-HUPES), Federal University of Bahia, Salvador, Brazil
| | | | - Irismar Reis de Oliveira
- Postgraduate Program in Interactive Processes of Organs and Systems, Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil; Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil
| |
Collapse
|
17
|
Carvalho de Assis I, Rodrigues Alberti JG, Criado PR. Case Report: An Uncommon Clinical Case of Fatal Adult T-Cell Leukemia/Lymphoma Associated with HTLV-1 and Suspected due to Cutaneous Lesions and Epidemiologic Data. Am J Trop Med Hyg 2021; 103:2113-2115. [PMID: 32783798 DOI: 10.4269/ajtmh.20-0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a peripheral T-cell neoplasm caused by the human T-cell leukemia virus type 1 (HTLV-1). It is characterized by a short survival time and lack of response to chemotherapy. We report a case of a 56-year-old woman, from the Brazilian northeast state of Bahia, who presented with a 2-month history of infiltrated papular and nodular skin lesions, especially on her forehead and also on her lower and upper limbs. Laboratory tests revealed positive serology for HTLV-1. Histopathological findings and the immunohistochemical profile confirmed the diagnosis of adult T-cell lymphoma/leukemia. A month after the diagnosis, the patient presented acute fatigue and pronounced paleness of the skin, dying of septic shock after her first chemotherapy cycle. The aim of this case report was to emphasize the importance of maintaining high clinical suspicion for ATLL, considering the epidemiological profile of the disease, especially for patients whose only early symptoms are cutaneous lesions.
Collapse
|
18
|
Galvão-Castro B, Rios Grassi MF, Nunes A, Galvão-Barroso AK, Galvão-Castro AV, Lírio M, Ribeiro A, de Faria Junqueira T, Silva AL, Cerqueira M, Rangel SL, Araujo THA, Boa-Sorte N, Dourado I, Castro-Lima H, Soliani MLC. Challenges in establishing telehealth care during the COVID-19 pandemic in a neglected HTLV-1-infected population in northeastern Brazil. PLoS Negl Trop Dis 2021; 14:e0008922. [PMID: 33382699 PMCID: PMC7774827 DOI: 10.1371/journal.pntd.0008922] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- * E-mail:
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Aidê Nunes
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Ana Karina Galvão-Barroso
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Ana Verena Galvão-Castro
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Monique Lírio
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Adriele Ribeiro
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Thiago de Faria Junqueira
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - André Luís Silva
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Maíara Cerqueira
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Sonia Lucia Rangel
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Ney Boa-Sorte
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
| | - Humberto Castro-Lima
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | |
Collapse
|
19
|
Chabay P, Lens D, Hassan R, Rodríguez Pinilla SM, Valvert Gamboa F, Rivera I, Huamán Garaicoa F, Ranuncolo SM, Barrionuevo C, Morales Sánchez A, Scholl V, De Matteo E, Preciado MV, Fuentes-Pananá EM. Lymphotropic Viruses EBV, KSHV and HTLV in Latin America: Epidemiology and Associated Malignancies. A Literature-Based Study by the RIAL-CYTED. Cancers (Basel) 2020; 12:E2166. [PMID: 32759793 PMCID: PMC7464376 DOI: 10.3390/cancers12082166] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 02/06/2023] Open
Abstract
The Epstein-Barr virus (EBV), Kaposi sarcoma herpesvirus (KSHV) and human T-lymphotropic virus (HTLV-1) are lymphomagenic viruses with region-specific induced morbidity. The RIAL-CYTED aims to increase the knowledge of lymphoma in Latin America (LA), and, as such, we systematically analyzed the literature to better understand our risk for virus-induced lymphoma. We observed that high endemicity regions for certain lymphomas, e.g., Mexico and Peru, have a high incidence of EBV-positive lymphomas of T/NK cell origin. Peru also carries the highest frequency of EBV-positive classical Hodgkin lymphoma (HL) and EBV-positive diffuse large B cell lymphoma, not otherwise specified (NOS), than any other LA country. Adult T cell lymphoma is endemic to the North of Brazil and Chile. While only few cases of KSHV-positive lymphomas were found, in spite of the close correlation of Kaposi sarcoma and the prevalence of pathogenic types of KSHV. Both EBV-associated HL and Burkitt lymphoma mainly affect young children, unlike in developed countries, in which adolescents and young adults are the most affected, correlating with an early EBV seroconversion for LA population despite of lack of infectious mononucleosis symptoms. High endemicity of KSHV and HTLV infection was observed among Amerindian populations, with differences between Amazonian and Andean populations.
Collapse
Affiliation(s)
- Paola Chabay
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Daniela Lens
- Flow Cytometry and Molecular Biology Laboratory, Departamento Básico de Medicina, Hospital de Clínicas/Facultad de Medicina, Universidad de la República, CP 11600 Montevideo, Uruguay;
| | - Rocio Hassan
- Oncovirology Laboratory, Bone Marrow Transplantation Center, National Cancer Institute “José Alencar Gomes da Silva” (INCA), Ministry of Health, 20230-130 Rio de Janeiro, Brazil;
| | | | - Fabiola Valvert Gamboa
- Department of Medical Oncology, Cancer Institute and National League against Cancer, 01011 Guatemala City, Guatemala;
| | - Iris Rivera
- Department of Hematology, Salvadoran Institute of Social Security, Medical Surgical and Oncological Hospital (ISSS), 1101 San Salvador, El Salvador;
| | - Fuad Huamán Garaicoa
- Department of Pathology, National Cancer Institute—Society to Fight Cancer (ION-SOLCA), Santiago de Guayaquil Catholic University, Guayaquil 090615, Ecuador;
| | - Stella Maris Ranuncolo
- Cell Biology Department, Institute of Oncology “Angel H. Roffo” School of Medicine, University of Buenos Aires, C1417DTB Buenos Aires, Argentina;
| | - Carlos Barrionuevo
- Department of Pathology, National Institute of Neoplastic Diseases, National University of San Marcos, 15038 Lima, Peru;
| | - Abigail Morales Sánchez
- Research Unit in Virology and Cancer, Children’s Hospital of Mexico Federico Gómez, 06720 Mexico City, Mexico;
| | - Vanesa Scholl
- Department of Integrated Genomic Medicine, Conciencia-Oncohematologic Institute of Patagonia, 8300 Neuquén, Argentina;
| | - Elena De Matteo
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Ma. Victoria Preciado
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Ezequiel M. Fuentes-Pananá
- Research Unit in Virology and Cancer, Children’s Hospital of Mexico Federico Gómez, 06720 Mexico City, Mexico;
| |
Collapse
|
20
|
Effectiveness of virtual reality games for falls, postural oscillations, pain and quality of life of individual HAM/TSP: a randomized, controlled, clinical trial. J Neurovirol 2020; 26:676-686. [PMID: 32737862 DOI: 10.1007/s13365-020-00880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/17/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
People with HTLV-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP) have sensorimotor losses and postural instability, resulting in frequent falls. These findings stimulate the use of exercise protocols associated with postural control. This study investigated the effectiveness of a balance training exercise protocol through a virtual game. This is a randomized crossover clinical trial performed in subjects with imbalance disorders (HAM/TSP). To evaluate postural oscillations by baropodometry (total area, anterior, posterior and lateral projection), the Footwork® system was used and by cinemetry (angle of the body, hip and ankle alignment in the lateral view), the CVMob system. In addition, the Brief Pain Inventory and the WHOQoL Bref were used to measure pain intensity and quality of life. Comparison tests of the averages (intra and inter groups) and correlations were applied considering an alpha of 5% and power of 80%. The study was approved by the Ethics Committee of the Catholic University of Salvador and registered in the Clinical Trials database (NCT02877030). The final sample consisted of 26, predominantly female subjects. An increase in the postural oscillations of the control subjects (p < 0.05), a reduction in the occurrence of falls (p = 0.039) and an improvement in the quality of life of the control-test group (p < 0.05) were observed. Virtual game training did not improve the static balance, promoting an increase in postural oscillations. Immediately after the application of the protocol, there was a reduction in fall occurrence and improvement in the quality of life.
Collapse
|
21
|
Distribution of Human T-Lymphotropic Virus (HTLV) and Hepatitis C Co-infection in Bahia, Brazil. PLoS One 2020; 15:e0223087. [PMID: 32692782 PMCID: PMC7373273 DOI: 10.1371/journal.pone.0223087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
Both Human T-lymphotropic virus type 1 (HTLV-1) and hepatitis C virus (HCV) are endemic in Brazil. In Salvador, the capital of the state of Bahia, 2% and 1.5% of the general population is infected with HTLV-1 or HCV. This study aimed to estimate the prevalence and the distribution of HTLV/HCV coinfection in Bahia. This cross-sectional study was conducted at the Central Laboratory of Public Health for the state of Bahia (LACEN-BA). All samples in the LACEN database submitted to serological testing for anti-HCV (chemiluminescence) and anti-HTLV-1/2 (chemiluminescence/ELISA and Western blot) from 2004 to 2013 were included. Infection rate was expressed as the number of infected individuals per 100,000 inhabitants in a given municipality; municipalities were grouped by microregion for further analysis. A total of 120,192 samples originating from 358 of the 417 municipalities in Bahia (85.8%) were evaluated. The overall HCV coinfection rate in HTLV-positive was 14.31% [2.8 (ranging from 0.4 to 8.0) per 100,000 inhabitants.] Twenty-one (5%) of the municipalities reported at least one case of HTLV/HCV coinfection. Most cases (87%) were concentrated in three microregions (Salvador: 79%, Ilhéus/Itabuna: 5%, Porto Seguro: 3%). Coinfection occurred more frequently in males (51%) with a mean age of 59 [(IQR): 46–59] years. HTLV/HCV coinfection in the state of Bahia was more frequently found among males living in the microregions of Salvador, Ilhéus/Itabuna and Porto Seguro, all of which are known to be endemic for HTLV infection.
Collapse
|
22
|
The reasons to include the serology of human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) in the clinical follow-up of patients with viral hepatitis B and C in Brazil. PLoS Negl Trop Dis 2020; 14:e0008245. [PMID: 32453768 PMCID: PMC7274452 DOI: 10.1371/journal.pntd.0008245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/05/2020] [Accepted: 03/24/2020] [Indexed: 01/29/2023] Open
Abstract
Background The WHO established targets for 2030 to globally reduce new viral hepatitis B and C infections by 90% and deaths by 65% and recommends searching for coinfections that increase the progression of chronic liver infections towards cirrhosis and hepatocellular carcinoma. Aims and methodology This study aimed to add information concerning the influence of human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2) infections in hepatitis B and C, since in Brazil, these human retroviruses are endemic but neglected. Serum samples from 1,910 patients with hepatitis B and 1,315 with hepatitis C from São Paulo, southeast Brazil, that were previously tested and grouped for HIV and HTLV-1/-2 coinfections were analyzed for hepatitis B virus (HBV) and hepatitis C virus (HCV) loads measurements and subsequent clearance using data from laboratory records. Key results Briefly, the lowest HBV viral load (VL) was detected in HBV/HTLV-2 coinfected patients, regardless of whether they were infected with HIV (all comparisons p<0.05). In contrast, higher HCV VL was detected in HCV/HIV, HCV/HIV/HTLV-1/-2 coinfected patients (all p<0.05), and the lowest HCV VL was detected in HCV/HTLV-2 coinfected patients. Curiously, 61.1% of the patients with HBV/HTLV-2 coinfection had an undetectable HBV VL at the beginning of the study versus 21.4% in the patients with HBV/HTLV-1 coinfection. Although the percentages of undetectable HCV loads in HCV/HTLV-1 and HCV/HTLV-2 coinfected patients were quite similar, during follow-up, more HCV clearance was detected in patients with HCV/HTLV-2 coinfection [OR 2.65; 95% IC (1.17–5.99)]. Major conclusions HTLV-2 positively impacts HBV and HCV viral loads and HCV clearance, while HIV and/or HTLV-1 negatively impacts HCV viral load. Thus, the search for HTLV-1/-2 in viral hepatitis B and C infected patients has virological prognostic value, which is a strong reason to suggest including HTLV serology in the follow-up of patients. The human T-lymphotropic viruses type 1 (HTLV-1) and type 2 (HTLV-2) are endemic and neglected in Brazil, and although these viruses were considered to have prognostic value when associated with HIV, e.g., HTLV-1 has been associated with fast progression and death to AIDS and more cases of lymphoma and neurological disorders, and HTLV-2 has been associated with slow progression to AIDS, their impact on hepatitis B virus (HBV) and hepatitis C virus (HCV) outcomes remain unknown. The present study analyzed the influence of HTLV-1 and HTLV-2 coinfection on HBV and HCV virological outcomes (viral load levels and virus clearance during follow-up) in serum samples from 1,910 patients with hepatitis B and 1,315 patients with hepatitis C from São Paulo, southeast Brazil. The results obtained confirmed the positive impact of HTLV-2 on HBV and HCV virological outcomes (lower HBV and HCV viral loads and increased HCV clearance when compared with HCV-monoinfected patients) and the opposite effect of HTLV-1; these findings are similar to the effects observed in HIV/AIDS patients. Taking into consideration these results and the differential impact of HTLV-1 and HTLV-2 in viral hepatitis B and C, we suggest including the serology of HTLV-1/2 in the follow-up of such patients in Brazil.
Collapse
|
23
|
Santana GO, Libório AM, Galvão AV, Pondé MP, Sá KN. Signs, meanings and practices of people living with human t-cell lymphotropic virus type 1 or tropical spastic myelopathy. J Patient Rep Outcomes 2020; 4:31. [PMID: 32367401 PMCID: PMC7198688 DOI: 10.1186/s41687-020-00198-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 04/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Human T-cell lymphotropic virus type 1 (HTLV-1) spreads silently in the world’s population and causes several syndromes. Among these, HTLV-1 associated myelopathy, also called tropical spastic paraparesis (HAM/TSP), affects the nervous system. It causes sensorimotor losses, spasticity, muscle weakness, voiding and sexual dysfunction, pain, and balance disorders. There is limited knowledge of the feelings, experiences, and coping mechanisms associated with this neglected disease. The objective of the present qualitative study was to investigate the signs, meanings, and practices of people with HAM/TSP, through narratives obtained from focus groups and individual semi-structured face-to-face interviews. Results Thirty-eight individuals diagnosed with HAM/TSP participated in the study. The following categories and subcategories emerged from the participants: Signs—physical signs, symptoms, and discovery of the disease; Meanings—reaction to diagnosis and knowledge of disease, fears, and expectations; Practices—daily life, leisure, religious, and treatment activities. Conclusions People with HAM/TSP suffer from symptoms that limit their social participation, and they are affected by complex and multidimensional feelings. This awareness can contribute to the implementation of public policies—focused on the real perspective of these patients—that provide more directed, empathic, and harmonious care for these individuals.
Collapse
Affiliation(s)
| | - Ana Mary Libório
- Department of Post Graduate, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Ana Verena Galvão
- Multidisciplinary Reference Center for Assistance and Research for Family and Patients with HTLV the Assisting Teaching the Bahia School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Milena Pereira Pondé
- Department of Post Graduate, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Department of Post Graduate, Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| |
Collapse
|
24
|
Mota RDS, Macêdo MC, Corradini S, Patrício NA, Baptista AF, Sá KN. The effect of home exercise on the posture and mobility of people with HAM/TSP: a randomized clinical trial. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:149-157. [PMID: 32236329 DOI: 10.1590/0004-282x20190169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 10/18/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Physical therapy has positive results in people with tropical spastic paraparesis (TSP). However, mobility and distance from rehabilitation centers limit the participation in outpatient programs. OBJECTIVE To evaluate the impact of a home exercise program on the posture and functional mobility of people with TSP. METHODS A randomized controlled trial comparing three groups of people who performed guided exercises from a guidebook for six months: supervised (SG), unsupervised (WG), and control (CG). Primary outcomes: postural angles (SAPO®) and functional mobility (TUG). SECONDARY OUTCOMES gait parameters (CVMob®). RESULTS The protocol described in the guidebook improved postural angles and functional mobility. There were also positive gait parameter effects (p<0.05). SG presented better responses than WG did, but both were preferable to CG. CONCLUSION Home exercises oriented by a guidebook may benefit posture, functional mobility and gait parameters in people with TSP, and physiotherapist supervision can ensure better results.
Collapse
Affiliation(s)
- Renata de Sousa Mota
- Centro de Ciência e Tecnologia em Energia e Sustentabilidade, Universidade Federal do Recôncavo da Bahia, Feira de Santana, BA, Brazil
| | - Maíra Carvalho Macêdo
- Fundação para Neurologia e Neurocirurgia, Instituto do Cérebro, Salvador, BA, Brazil
| | | | - Naiane Araújo Patrício
- Departamento de Tecnologias de Saúde, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| | - Abrahão Fontes Baptista
- Centro de Matemática, Computação e Cognição, Universidade Federal do ABC, São Paulo, SP, Brazil
| | - Katia Nunes Sá
- Departamento de Fisioterapia, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
| |
Collapse
|
25
|
Caterino-de-Araujo A, Campos KR, Petrucci TVB, da Silva RX, Lemos MF, Moreira RC. Surveillance of human retroviruses in blood samples from patients with hepatitis B and C in São Paulo, Brazil. Rev Soc Bras Med Trop 2020; 53:e20190378. [PMID: 32049201 PMCID: PMC7083377 DOI: 10.1590/0037-8682-0378-2019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 12/10/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Human retroviruses and the hepatitis B and C viruses (HBV and HCV, respectively) share routes of transmission; thus, coinfections occur and could alter subsequent disease outcomes. A preliminary study on human T-lymphotropic virus types 1 and 2 (HTLV-1/2) in serum samples from HBV- and HCV-infected individuals in São Paulo revealed 1.3% and 5.3% rates of coinfection, respectively. These percentages were of concern since they were detected in HTLV-endemic regions and in high-risk individuals in Brazil. The present study was conducted to extend and confirm these data. METHODS HTLV-1/2 and human immunodeficiency virus (HIV) infection status were identified in 1,984 sera for HBV and HCV viral load quantification - 1,290 samples from HBV-infected individuals (53.3% men, mean age: 47.1 years) and 694 samples from HCV-infected individuals (56.3% men, mean age: 50.1 years). HTLV-1/2 antibodies were detected by enzyme immunoassay, followed by western blotting and line immunoassay; HIV infection was detected by enzyme immunoassay. RESULTS HTLV-1/-2 infection was detected in 1.9% HBV-infected individuals (0.7% HTLV-1 and 1.2% HTLV-2) and in 4.0% (2.4% HTLV-1 and 1.6% HTLV-2) HCV-infected individuals; HIV infection was detected in 9.2% and 14.5%, respectively. Strong associations with HTLV and HIV, male sex, and older age were found in HBV/HTLV and HCV/HTLV-coinfected individuals (p<0.05). CONCLUSIONS HTLV-1 and HTLV-2 were confirmed to be prevalent in individuals with HBV and HCV in São Paulo; coinfected individuals deserve further clinical and laboratory investigation.
Collapse
Affiliation(s)
- Adele Caterino-de-Araujo
- Laboratório de Pesquisa em HTLV, Centro de Imunologia, Instituto
Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de
São Paulo, São Paulo, SP, Brasil
| | - Karoline Rodrigues Campos
- Laboratório de Pesquisa em HTLV, Centro de Imunologia, Instituto
Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de
São Paulo, São Paulo, SP, Brasil
| | - Tamirez Villas Boas Petrucci
- Laboratório de Pesquisa em HTLV, Centro de Imunologia, Instituto
Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de
São Paulo, São Paulo, SP, Brasil
| | - Rafael Xavier da Silva
- Laboratório de Pesquisa em HTLV, Centro de Imunologia, Instituto
Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de
São Paulo, São Paulo, SP, Brasil
| | - Marcílio Figueiredo Lemos
- Laboratório de Hepatites, Núcleo de Doenças de Transmissão
Sanguínea e Sexual, Centro de Virologia, Instituto Adolfo Lutz, Coordenadoria de
Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP,
Brasil
| | - Regina Célia Moreira
- Laboratório de Hepatites, Núcleo de Doenças de Transmissão
Sanguínea e Sexual, Centro de Virologia, Instituto Adolfo Lutz, Coordenadoria de
Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP,
Brasil
| |
Collapse
|
26
|
Lago V, Conceição CSD, Pinto EBC, Costa JV, Sá KN. Center of gravity oscillations in HTLV-1-associated myelopathy/tropical spastic paraparesis. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Postural control in individuals with HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP) is usually compromised, which increases the risk of falls, makes it difficult to perform activities of daily living, and impairs the quality of life. The profile of the center of gravity oscillations in this population is unknown and may aid in clinical follow-up and research. Objective: To compare the stabilometric values between HAM/TSP and uninfected individuals and verify the existence of correlations between stabilometric variables and the Berg Balance Scale (BBS). Method: A cross-sectional observational study was performed with infected individuals, classified as defined and likely (WHO criteria), compared to accompanying persons and seronegative relatives. A baropodometry platform (Footwork®) was used to obtain the oscillation values of the body’s center of gravity in total oscillation area (TOA), anterior-posterior oscillation (APO) and lateral oscillation (LO). Mean values were correlated with BBS by Spearman’s Correlation (5% alpha). Approved by the ethical committee of Escola Bahiana de Medicina e Saúde Pública under Opinion 49634815.2.0000.5628. Results: An asymmetric distribution of all the stabilometric variables analyzed in the HAM/TSP population was found, different from the uninfected group (p < 0.05). It was also possible to verify strong to moderate and inverse correlations between the variables of center of gravity oscillation with the scores obtained in BBS, especially for TOA and LO. Conclusion: People with HAM/TSP presented higher values for the center of gravity oscillations and these were correlated with the BBS in the balance evaluation.
Collapse
|
27
|
Araújo THA, Barreto FK, Menezes ADL, Lima CPSD, Oliveira RSD, Lemos PDS, Galvão-Castro B, Kashima S, Farre L, Bittencourt AL, Carvalho EMD, Santos LA, Rego FFDA, Mota-Miranda ACA, Nunes MRT, Alcântara LCJ. Complete genome sequence of human T-cell lymphotropic type 1 from patients with different clinical profiles, including infective dermatitis. INFECTION GENETICS AND EVOLUTION 2019; 79:104166. [PMID: 31883457 DOI: 10.1016/j.meegid.2019.104166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/16/2019] [Accepted: 12/24/2019] [Indexed: 12/12/2022]
Abstract
The HTLV-1 is the first human retrovirus and is associated with several clinical syndromes, however, the pathogenesis of these clinical manifestations is still not fully understood. Furthermore, there are few complete genomes publicly available, about 0.12 complete genomes per 10,000 infected individuals and the databases have a major deficiency of sequences information. This study generated and characterized 31 HTLV-1 complete genomes sequences derived from individuals with Tropical Spastic Paraparesis/HTLV-1-Associated Myelopathy (TSP/HAM), Adult T-cell leukemia/lymphoma (ATL), infective dermatitis associated to HTLV-1 (IDH) and asymptomatic patients. These sequences are associated to clinical and epidemiological information about the patients. The sequencing data generated on Ion Torrent PGM platform were assembled and mapped against the reference HTLV-1 genome. These sequences were genotyped as Cosmopolitan subtype, Transcontinental subgroup. We identified the variants in the coding regions of the genome of the different clinical profiles, however, no statistical relation was detected. This study contributed to increase of HTLV-1 complete genomes in the world. Furthermore, to better investigate the contribution of HTLV-1 mutations for the disease outcome it is necessary to evaluate the interaction of the viral genome and characteristics of the human host.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Lourdes Farre
- Fundação Oswaldo Cruz, Brazil; Catalan Institute of Oncology, Bellvitge Biomedical Research Institute, Barcelona, Spain
| | | | | | - Luciane Amorim Santos
- Fundação Oswaldo Cruz, Brazil; Escola Bahiana de Medicina e Saúde Pública Salvador, Brazil
| | | | | | | | | |
Collapse
|
28
|
Line Immunoassay for Confirmation and Discrimination of Human T-Cell Lymphotropic Virus Infections in Inconclusive Western Blot Serum Samples from Brazil. J Clin Microbiol 2019; 58:JCM.01384-19. [PMID: 31597749 PMCID: PMC6935901 DOI: 10.1128/jcm.01384-19] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 10/07/2019] [Indexed: 01/04/2023] Open
Abstract
Difficulties in confirming and discriminating human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 infections by serological Western blot (WB) assays (HTLV Blot 2.4; MP Biomedicals) have been reported in Brazil, mainly in HIV/AIDS patients, with a large number of WB-indeterminate and WB-positive but HTLV-untypeable results. Nonetheless, a line immunoassay (LIA) (INNO-LIA HTLV-I/II; Fujirebio) provided enhanced specificity and sensitivity for confirming HTLV-1/2 infections. Difficulties in confirming and discriminating human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 infections by serological Western blot (WB) assays (HTLV Blot 2.4; MP Biomedicals) have been reported in Brazil, mainly in HIV/AIDS patients, with a large number of WB-indeterminate and WB-positive but HTLV-untypeable results. Nonetheless, a line immunoassay (LIA) (INNO-LIA HTLV-I/II; Fujirebio) provided enhanced specificity and sensitivity for confirming HTLV-1/2 infections. To add information concerning the improved ability of the LIA in relation to WB when applied to samples of individuals from different risk groups from Brazil, we performed the present study. Three groups were analyzed: group 1 (G1), with 62 samples from HIV/AIDS patients from São Paulo, SP (48 WB indeterminate and 14 HTLV untypeable); group 2 (G2), with 24 samples from patients with hepatitis B or hepatitis C from São Paulo (21 WB indeterminate and 3 HTLV untypeable; 17 HIV seropositive); and group 3 (G3), with 25 samples from an HTLV outpatient clinic in Salvador, Bahia (16 WB indeterminate and 9 HTLV untypeable; all HIV seronegative). Overall, the LIA confirmed HTLV-1/2 infection (HTLV-1, HTLV-2, or HTLV) in 66.1% (G1), 83.3% (G2), and 76.0% (G3) of samples. Interestingly, the majority of WB-indeterminate results were confirmed by the LIA as being HTLV-2 positive in G1 and G2 but not in G3, in which the samples were defined as being HTLV-1 or HTLV positive. These results agree with the virus types that circulate in such patients of different regions in Brazil and emphasize that the LIA is the best serological test for confirming HTLV-1 and HTLV-2 infections, independently of being applied in HTLV-monoinfected or HTLV-coinfected individuals.
Collapse
|
29
|
Oliveira TSS, Andrade RCPD, Santos DND, Orrico KF, Abraão Neto J, Oliveira CJVD, Rocha PN, Carvalho EMD. Prevalence of Bowel Symptoms in Patients Infected with Human T-Lymphotropic type 1 Virus. Rev Soc Bras Med Trop 2019; 52:e20180486. [PMID: 31778419 DOI: 10.1590/0037-8682-0486-2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Bowel dysfunction is frequent in patients with spinal cord diseases, but little is known about the prevalence of bowel symptoms in human T-lymphotropic virus-(HTLV-1) infected individuals. The purpose of this study is to determine the frequency of bowel symptoms in HTLV-1 infected individuals and their correlation with the degree of neurologic disease. METHODS This is a cross-sectional study comparing the frequency of bowel symptoms in HTLV-1-infected individuals* and seronegative donors (controls). Patients answered a questionnaire, the Rome III Criteria was applied, and stool consistency was evaluated by the Bristol Stool Form Scale. The individuals were classified as HTLV-1 carriers, probable HTLV-1 myelopathy and definitive HTLV-1 associated myelopathy or tropical spastic paraparesis (definitive HAM / TSP)**. RESULTS We studied 72 HTLV-1 infected individuals and 72 controls with equal age and gender distribution. Constipation was the most frequent complaint, occurring in 38 % of HTLV-1 individuals and in 15 % of the controls. In comparison to the seronegative controls, the probability of constipation occurrence was approximately 18 times higher in definitive HAM / TSP patients. Straining, lumpy or hard stools, sensation of anorectal obstruction/blockage, fewer than 3 defecations per week, flatulence, soiling, evacuation pain, and bleeding were also more frequent in the HTLV-1 patients than in the controls. Moreover, bowel symptoms were more frequent in patients with definitive or probable HAM / TSP than in carriers. CONCLUSIONS Bowel symptoms were more frequent in HTLV-1-infected patients than in seronegative controls and the frequency of bowel symptoms correlated with the severity of neurologic disease.
Collapse
Affiliation(s)
- Tatiane Souza Soares Oliveira
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Reabilitação, Salvador, BA, Brasil.,Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Rosana Cristina Pereira de Andrade
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Reabilitação, Salvador, BA, Brasil.,Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Dislene Nascimento Dos Santos
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Reabilitação, Salvador, BA, Brasil
| | - Keith Froes Orrico
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - José Abraão Neto
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Cassius José Vitor de Oliveira
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil
| | - Paulo Novis Rocha
- Universidade Federal da Bahia, Escola de Medicina, Departamento de Medicina Interna e Apoio Diagnóstico, Salvador, BA, Brasil
| | - Edgar Marcelino de Carvalho
- Universidade Federal da Bahia, Complexo Hospitalar Professor Edgard Santos, Departamento de Imunologia, Salvador, BA, Brasil.,Fundação Oswaldo Cruz-Bahia, Instituto Gonçalo Moniz, Laboratório de Pesquisas Clínicas, Salvador, BA, Brasil.,Ministério da Ciência, Tecnologia, Inovações e Comunicações, Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, BA, Brasil
| |
Collapse
|
30
|
Human T-lymphotropic virus 1 and 2 among people who used illicit drugs in the state of Pará, northern Brazil. Sci Rep 2019; 9:14750. [PMID: 31611600 PMCID: PMC6791863 DOI: 10.1038/s41598-019-51383-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/28/2019] [Indexed: 11/09/2022] Open
Abstract
People who used illicit drugs (PWUDs) represent an important population group for acquisition and viral dispersion. In Brazil, high rates of the human T lymphotropic virus 1 (HTLV-1) and 2 (HTLV-2) have been reported in epidemiological studies. However, the epidemiological scenario of HTLV-1/2 infections in PWUDs is still poorly understood. Thus, this cross-sectional study determined the prevalence, frequency of subtypes and factors associated with HTLV-1/2 infections among PWUDs in the Brazilian state of Pará, an area considered endemic for this virus and with poor health services. Among 826 PWUDs, 53 (6.4%) presented anti-HTLV-1/2 antibodies by EIA and 44 (5.3%) presented proviral DNA by PCR. HTLV-1 and HTLV-2 were detected in 25 (3.0%) and 19 (2.3%) PWUDs, respectively. Subtypes 1a (25/44), transcontinental (23/44) and Japanese subgroups (2/44), 2b (6/44) and 2c (13/44) were identified. Involvement in illicit/criminal activity, daily use of illicit drugs, illicit drug use over 12 years, unprotected sex with other PWUDs, changes in genitalia (including ulcers and wounds), and more than 12 sexual partners were associated with HTLV-1/2 in PWUDs. This high prevalence and intense circulation of subtypes and subgroups of HTLV-1/2 is very worrying, and indicate the need for urgent actions for its control, prevention and treatment.
Collapse
|
31
|
Puccioni-Sohler M, Grassi MFR, Galvão-Castro B, Caterino A, Proietti ABDFC, Vicente ACP, Galvão-Castro AV, Vallinoto AC, Paiva A, Penalva A, Rosadas C, Miyashiro D, Barbosa EF, Carvalho EMD, Batista EDS, Smid J, Casseb J, Vidal J, Sousa MS, Viana MGDC, Bastos MDS, Lírio M, Boa-Sorte N, Ferreira OC, Takayanagui O, Moura P, Rocco R, Cunha RG, Haddad SK, Assone T, Araújo THA. Increasing awareness of human T-lymphotropic virus type-1 infection: a serious, invisible, and neglected health problem in Brazil. Rev Soc Bras Med Trop 2019; 52:e20190343. [PMID: 31618310 DOI: 10.1590/0037-8682-0343-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/21/2019] [Indexed: 11/22/2022] Open
Affiliation(s)
- Marzia Puccioni-Sohler
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro, RJ, Brasil.,Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Rio de Janeiro, RJ, Brasil
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina, Salvador, BA, Brasil.,Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, BA, Brasil
| | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina, Salvador, BA, Brasil.,Fundação Oswaldo Cruz, Instituto Gonçalo Moniz, Salvador, BA, Brasil
| | | | | | | | | | | | - Arthur Paiva
- Universidade Federal do Alagoas, Maceió, AL, Brasil
| | - Augusto Penalva
- Instituto de Infectologia Emilio Ribas, São Paulo, SP, Brasil
| | | | | | | | | | - Everton da Silva Batista
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro, RJ, Brasil
| | - Jerusa Smid
- Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brasil
| | - Jorge Casseb
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Jose Vidal
- Instituto de Infectologia Emilio Ribas/ Universidade de São Paulo, São Paulo, SP, Brasil
| | - Maisa Silva Sousa
- Universidade Federal do Pará/ Instituto Evandro Chagas, Belém, PA, Brasil
| | | | | | - Monique Lírio
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro, RJ, Brasil
| | - Ney Boa-Sorte
- Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Rio de Janeiro, RJ, Brasil
| | | | - Osvaldo Takayanagui
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | | | - Regina Rocco
- Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | | | - Simone Kashima Haddad
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Tatiane Assone
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, SP, Brasil
| | | |
Collapse
|
32
|
Henrique-Araújo R, Quarantini LC, Caribé AC, Argolo FC, Jesus-Nunes AP, Morais-de-Jesus M, Dantas-Duarte A, Moreira TM, Oliveira IRD. Quality of life, risk behaviors and depression among carriers of hepatitis C virus and human T-cell lymphotropic virus type 1: a comparative study. Braz J Infect Dis 2019; 23:224-230. [PMID: 31344356 PMCID: PMC9427947 DOI: 10.1016/j.bjid.2019.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/31/2019] [Accepted: 06/08/2019] [Indexed: 02/07/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) has low prevalence rates, but is endemic in some regions of the world. It is usually a chronic asymptomatic infection, but it can be associated with serious neurologic and urinary conditions. Hepatitis C virus (HCV) is broadly spread out worldwide. The majority of these infections have a chronic course that may progress to cirrhosis and hepatocellular carcinoma. Objectives To compare sociodemographic and mental health (risk behaviors, depression, and suicide) aspects, and quality of life among patients with HCV or HTLV-1. Methods Observational, comparative and cross-sectional study involving outpatients with HCV or HLTV-1 infection. Sociodemographic characteristics, risk behaviors and quality of life were assessed through the questionnaires Mini International Neuropsychiatric Interview – MINI Plus (depression and suicide) and Medical Outcomes Study 36-Item Short-Form Health Survey (quality of life). Univariate and multivariate statistical analyses (hierarchical logistic regression) were conducted. Results 143 individuals with HCV and 113 individuals with HTLV-1 infection were included. Males were predominant in the HCV group (68.8%) and females in the HTLV-1 group (71.7%). The frequency of risk behaviors (sexual and drug use) was greater in those with HCV (p < 0.05). A past depressive episode was more common in the HTLV-1 group (p = 0.037). Quality of life was significantly worse in the physical functioning, vitality, mental health, and social functioning domains in those with HTLV-1 (p < 0.05). HTLV-1 infection remained independently associated with worse quality of life in multivariate analysis. Conclusions Risk behaviors are frequent among those infected with HCV. Additionally, despite HTLV-1 being considered an infection with low morbidity, issues related to mental health (depressive episode) and decreased quality of life are relevant.
Collapse
Affiliation(s)
- Ricardo Henrique-Araújo
- Federal University of Bahia, Institute of Health Sciences, Postgraduate Program in Interactive Processes of Organs and Systems, Salvador, BA, Brazil; Nova Esperança Medical School, João Pessoa, PB, Brazil; Hospital Complex of Infectious Diseases Clementino Fraga, João Pessoa, PB, Brazil.
| | - Lucas C Quarantini
- Federal University of Bahia, Postgraduate Program in Medicine and Health, Salvador, BA, Brazil; Federal University of Bahia, Psychiatry Service, University Hospital (Com-HUPES), Salvador, BA, Brazil
| | - André C Caribé
- Federal University of Bahia, Psychiatry Service, University Hospital (Com-HUPES), Salvador, BA, Brazil
| | - Felipe C Argolo
- Federal University of São Paulo, Postgraduate Program in Psychiatry and Medical Psychology, São Paulo, SP, Brazil
| | - Ana Paula Jesus-Nunes
- Federal University of Bahia, Postgraduate Program in Medicine and Health, Salvador, BA, Brazil; Federal University of Bahia, Psychiatry Service, University Hospital (Com-HUPES), Salvador, BA, Brazil
| | - Mychelle Morais-de-Jesus
- Federal University of Bahia, Postgraduate Program in Medicine and Health, Salvador, BA, Brazil; Federal University of Bahia, Psychiatry Service, University Hospital (Com-HUPES), Salvador, BA, Brazil
| | - Adriana Dantas-Duarte
- Federal University of Bahia, Psychiatry Service, University Hospital (Com-HUPES), Salvador, BA, Brazil
| | - Tayne Miranda Moreira
- Federal University of Bahia, Psychiatry Service, University Hospital (Com-HUPES), Salvador, BA, Brazil
| | - Irismar Reis de Oliveira
- Federal University of Bahia, Institute of Health Sciences, Postgraduate Program in Interactive Processes of Organs and Systems, Salvador, BA, Brazil; Federal University of Bahia, Postgraduate Program in Medicine and Health, Salvador, BA, Brazil
| |
Collapse
|
33
|
Eusebio-Ponce E, Candel FJ, Anguita E. Human T-Cell Lymphotropic Virus Type 1 and associated diseases in Latin America. Trop Med Int Health 2019; 24:934-953. [PMID: 31183938 DOI: 10.1111/tmi.13278] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This narrative review, which is based on a systematic literature search following the PRISMA guidelines, provides a general overview of Human T-cell Lymphotropic Virus type 1 (HTLV-1) and associated diseases: Adult T-cell Leukaemia-Lymphoma (ATLL) and HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) in Latin America, focusing on epidemiology and prevention. Using the published information on HTLV-1, ATLL and HAM/TSP prevalence, we present comprehensive and accurate maps and tables, and developed an algorithm to assist in the prevention of HTLV-1 transmission through breastfeeding while considering socio-economic status. Latin America is an interesting scenario to study HTLV-1 because of the diverse origin of its population. Apart from the expected high prevalence in inhabitants of African ancestry, the presence of endemic foci affecting indigenous populations is particularly striking. ATLL prevention is the biggest challenge in this field. Most ATLL cases are transmitted through breastfeeding; thus, prevention methods to avoid ATLL in endemic countries have to be focused on this. In view of the high inequality in most Latin American countries, reduction in breastfeeding duration, freezing/thawing and pasteurisation of breastmilk can be suitable interventions in poor settings, considering that avoiding the risk of malnutrition and infant mortality must be the priority.
Collapse
Affiliation(s)
- Emiliana Eusebio-Ponce
- Research Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic.,Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Francisco Javier Candel
- Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Clinical Microbiology and Infectious Diseases Department, Transplant Coordination Unit, IdISSC and IML Institutes, Hospital Clínico San Carlos, Study Group of Infections in Emergency Departments (Infurgsemes, SEMES), Madrid, Spain
| | - Eduardo Anguita
- Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Hematology Department, Instituto de Medicina de Laboratorio (IML), Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
34
|
Pereira FM, de Almeida MDCC, Santos FLN, Carreiro RP, Regis-Silva CG, Galvão-Castro B, Grassi MFR. Evidence of New Endemic Clusters of Human T-Cell Leukemia Virus (HTLV) Infection in Bahia, Brazil. Front Microbiol 2019; 10:1002. [PMID: 31156570 PMCID: PMC6528468 DOI: 10.3389/fmicb.2019.01002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 04/18/2019] [Indexed: 12/01/2022] Open
Abstract
Background Salvador, Bahia (northeastern Brazil), has been identified as the epicenter of Human T-cell leukemia virus Human T-cell leukemia virus (HTLV) type 1 infection in the country. This study aims to estimate the rate of HTLV infection and the geographical distribution of this virus in this state. Methods All HTLV tests (chemiluminescence/ELISA assays/Western Blotting) performed in the Central Laboratory of Public Health of Bahia (LACEN) from 2004 to 2013 were included. Data was extracted from LACEN’s database using high volume extract, transformation and load throughput. Infection rate was expressed as the number of infected individuals per 100,000 inhabitants considering municipalities grouped in microregions and/or mesoregions as the unit of analysis. Results A total of 233,876 individuals were evaluated. Individuals were from 394 out of 417 municipalities of Bahia (94.5%). HTLV chemiluminescence/ELISA assay was found to be reactive for 3,138 individuals from whom 2,323 had WB results (1,978 positives, 62 negative and 282 indeterminate). Out of 1978 reactive samples, 1,813 (91.7%) were positive for HTLV-1, 58 (2.9%) for HTLV-2 and 107 (5.4%) were for both HTLV-1 and HTLV-2. The cumulative mean rate of HTLV-positive cases in Bahia was 14.4 per 100,000 inhabitants. Three microregions presented rates >20 HTLV-positive cases/100,000 inhabitants: Barreiras (24.83 cases per 100,000 inhabitants), Salvador (22.90 cases per 100,000 inhabitants), and Ilhéus-Itabuna (22.60 cases per 100,000 inhabitants). Conclusion HTLV infection is disseminated in the state of Bahia, with an overall moderate rate of infection. Further studies should be conducted to characterize the epidemiological and clinical profile of HTLV-infected individuals better and to propose effective prevention measures.
Collapse
Affiliation(s)
- Felicidade Mota Pereira
- Laboratório Avançado de Saúde Pública, Fundação Oswaldo Cruz, Salvador, Brazil.,Laboratório Central de Saúde Pública Prof. Gonçalo Moniz - Secretaria da Saúde do Estado da Bahia, Salvador, Brazil
| | | | | | - Roberto Perez Carreiro
- Centro de Integração de Dados e Conhecimentos para Saúde, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Bernardo Galvão-Castro
- Laboratório Avançado de Saúde Pública, Fundação Oswaldo Cruz, Salvador, Brazil.,Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Maria Fernanda Rios Grassi
- Laboratório Avançado de Saúde Pública, Fundação Oswaldo Cruz, Salvador, Brazil.,Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| |
Collapse
|
35
|
Rathsam-Pinheiro RH, Boa-Sorte N, Grassi MFR, Copello ÚC, Rios KTSG, Araújo T, Galvão-Castro B. Revisiting Keratoconjunctivitis sicca associated with Human T-Cell Lymphotropic Virus Type 1: prevalence, clinical aspects and proviral load. Braz J Infect Dis 2019; 23:95-101. [PMID: 31059675 PMCID: PMC9425656 DOI: 10.1016/j.bjid.2019.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/03/2019] [Accepted: 04/05/2019] [Indexed: 12/14/2022] Open
Abstract
Background The prevalence of keratoconjunctivitis sicca (KCS) associated with Human T-Cell Lymphotropic Virus Type 1 (HTLV-1) (HTLV-1/KCS) has been estimated at around 37%, but its clinical manifestations are poorly described. Purpose To determine the prevalence and associated factors of HTLV-1/KCS in a large cohort of HTLV-1-infected individuals living in Salvador, Brazil. Methods A cross-sectional study was conducted between June 2004 and September 2017 at the Integrative and Multidisciplinary Center for HTLV in Salvador, Bahia-Brazil. Data from 758 HTLV-1-infected patients was collected. A complete ophthalmologic examination was performed in both eyes. Lacrimal function was evaluated by breakup time, Rose Bengal and Schirmer I Tests. KCS diagnosis was considered in the presence of at least two out of three positive tests. HTLV-1 proviral load Crude and Adjusted Prevalence Rates (PR) with 95% Confidence Intervals (95% CI) were estimated using multivariate Poisson Regression with robust error variance. Results The overall prevalence of KCS was 31.7%, with higher rates observed in HTLV-1-associated myelopathy/tropical spastic paraparesis patients (crude PR: 1.84; CI95%: 1.50–2.26) even after adjusting for age, sex, time of HTLV-1 diagnosis and schooling (adjusted PR: 1.63; CI95%: 1.31–2.02). Proviral load, low corrected visual acuity, burning and/or pain and itching were all significantly higher in patients with KCS. Conclusion Burning and/or pain and itching and low corrected visual acuity were the most common alterations of HTLV-1/KCS. High Proviral load was found to be associated with the presence of KCS. It is strongly recommended that HTLV-1 patients undergo periodic ophthalmologic examination to promote the early diagnosis of KCS and prevent the consequences associated with dry eye disease.
Collapse
Affiliation(s)
- Regina Helena Rathsam-Pinheiro
- Escola Bahiana de Medicina e Saúde Pública, Centro Integrativo e Interdisciplinar de HTLV, Salvador, BA, Brazil; Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira, Salvador, BA, Brazil
| | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Centro Integrativo e Interdisciplinar de HTLV, Salvador, BA, Brazil
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina e Saúde Pública, Centro Integrativo e Interdisciplinar de HTLV, Salvador, BA, Brazil; Fundação Oswaldo Cruz/Bahia, Instituto Gonçalo Moniz, Salvador, BA, Brazil
| | - Úrsula Cury Copello
- Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira, Salvador, BA, Brazil
| | | | - Thessika Araújo
- Escola Bahiana de Medicina e Saúde Pública, Centro Integrativo e Interdisciplinar de HTLV, Salvador, BA, Brazil
| | - Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Centro Integrativo e Interdisciplinar de HTLV, Salvador, BA, Brazil; Fundação Oswaldo Cruz/Bahia, Instituto Gonçalo Moniz, Salvador, BA, Brazil.
| |
Collapse
|
36
|
Evaluation of the cervicovaginal environment in asymptomatic Human T-cell lymphotropic virus type 1 infected women. Braz J Infect Dis 2019; 23:27-33. [PMID: 30849331 PMCID: PMC9428004 DOI: 10.1016/j.bjid.2019.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/29/2019] [Accepted: 02/07/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction Human T-cell lymphotropic virus type 1 (HTLV-1) is sexually transmitted and causes persistent infection. This virus induces activation of the immune system and production of inflammatory cytokines. This study aimed to assess the cytokine profile and cytopathological findings in the cervicovaginal fluid of asymptomatic HTLV-1-infected women. Methods HTLV-1-infected and uninfected women were selected at the Centro de Atendimento ao Portador de HTLV in Salvador-Brazil. None of the included HTLV-1-infected women reported any HTLV-1-associated diseases. All volunteers underwent gynecological examination to collect cervicovaginal fluid. Cytokine quantification was performed using the Cytometric Bead Array (CBA) Human Th1/Th2/Th17 kit. Light microscopy was used to evaluate cervicovaginal cytopathology. In addition, proviral load in cervicovaginal fluid and peripheral blood was measured by real-time quantitative polymerase chain reaction. Results 112 women (63 HTLV-1-infected and 49 uninfected) were evaluated. No differences were found with respect to cytopathological cervicovaginal findings between the groups. IL-2, TNF, IL-4, IL-10, and IL-17 levels were significantly higher in cervicovaginal fluid of the HTLV-1-infected women than in uninfected women (p < 0.05). Conversely, IFN-γ was found to be lower in the HTLV-1-infected women (p < 0.001) compared to uninfected individuals. Cervicovaginal proviral load was detectable in 53% of the HTLV-1-infected women and was found to be consistently lower than the proviral load in peripheral blood. Conclusions HTLV-1 infection induces immune activation in cervicovaginal environment, characterized by elevated concentrations of Th1, Th2, and IL17 in the cervicovaginal fluid.
Collapse
|
37
|
Local and systemic production of proinflammatory chemokines in the pathogenesis of HAM/TSP. Cell Immunol 2018; 334:70-77. [DOI: 10.1016/j.cellimm.2018.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022]
|
38
|
Silva IC, Pinheiro BT, Nobre AFS, Coelho JL, Pereira CCC, Ferreira LDSC, Almeida CPSD, Viana MDNDSDA, Almeida DSD, Falcão JR, Santos YCVD, Araújo MWLD, Borges MDS, Nascimento LD, Valentim LS, Casseb JSDR, Costa CAD, Sousa MSD. Moderate endemicity of the human T-lymphotropic virus infection in the metropolitan region of Belém, Pará, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180018. [PMID: 30328937 DOI: 10.1590/1980-549720180018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/14/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The spread of the HTLV infection in families living in the metropolitan area of Belém, Pará, Brazil, and the lack of studies in the general population requires studies to better understand its prevalence in the region. METHODS An anti-HTLV-1/HTLV-2 antibodies test was carried out on random adults in public places in Belém between November 2014 and November 2015. A proviral DNA test detected if the person was infected, and then a clinical evaluation and an intrafamilial investigation were carried out. RESULTS Of the 1059 individuals being investigated, 21 (2.0%) had seroreagent samples, 15 (1.4%) had HTLV-1, 5 (0.5%) had HTLV-2, and proviral DNA was undetectable in one case. The mean age of the infected people (57.2) was higher than that of those that were uninfected (46.2) (p = 0.0010). The prevalence of infection increased with age, especially in individuals with a family income equal to or less than a minimum wage. Intrafamilial transmission seems to have occurred in all of the families being studied. Among the patients with HTLV-1, 30% (3/10) already had some symptom related to the infection. DISCUSSION The increase in prevalence rates according to age may be due to late seroconversion of a previously acquired infection, or the cumulative risk of new infections, especially in women. CONCLUSION There was a moderate prevalence of the HTLV infection among adult individuals from the metropolitan area of Belém, with a predominance of HTLV-1. This infection was associated with low income and increasingly older women. It also presented intrafamily spread and negligence in the diagnosis of associated diseases.
Collapse
Affiliation(s)
- Ingrid Christiane Silva
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Bruna Teles Pinheiro
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Akim Felipe Santos Nobre
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Jaciana Lima Coelho
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Cássia Cristine Costa Pereira
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Louise de Souza Canto Ferreira
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Camila Pâmela Santos de Almeida
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | | | - Danilo Souza de Almeida
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Jairo Ribeiro Falcão
- Mestrado Profissionalizante em Análises Clínicas, Instituto de Ciências Biológicas, Universidade Federal do Pará - Belém (PA), Brasil
| | | | | | - Mariza da Silva Borges
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Lisandra Duarte Nascimento
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Lorena Saldanha Valentim
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | | | - Carlos Araújo da Costa
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Maísa Silva de Sousa
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| |
Collapse
|
39
|
Human T-Lymphotropic Virus-1-Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age. Sex Med 2018; 6:324-331. [PMID: 30181035 PMCID: PMC6302128 DOI: 10.1016/j.esxm.2018.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 06/14/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022] Open
Abstract
Introduction Human T-lymphotropic virus (HTLV)-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurological disorder that mostly affects women. This disease is characterized by a progressive loss of motor function and disruptions in sensory function in the lower limbs. HTLV-1 is also associated with isolated neurologic dysfunctions, overactive bladder, and erectile dysfunction. The occurrence of sexual dysfunction in HTLV-1–infected women remain unclear. Aim To investigate associations between HTLV-1 infection and sexual dysfunction in both asymptomatic infected women and those diagnosed with HAM/TSP compared with uninfected women. Methods HTLV-1–infected and uninfected women were assessed for sexual dysfunction using the Female Sexual Function Index instrument. Sexual dysfunction was considered if global Female Sexual Function Index scores were <26.5. Crude and adjusted prevalence ratios (PR) with 95% CI were calculated to identify associations between sexual dysfunction (outcome) and HTLV infection status–asymptomatic or HAM/TSP (main exposure), compared with uninfected women, and adjusted by sociodemographic and/or clinical characteristics (covariables). Results HTLV-1–infected women (n = 72; 57 asymptomatic; 15 HAM/TSP) and HTLV-1 uninfected women (n = 49) were evaluated. The overall sexual dysfunction prevalence was 53.7% (65/121), which was higher in the HAM/TSP group (80.0%; adjusted PR 1.89; 95% CI 1.23–2.90) when compared with non-infected individuals (44.9%). Sexual dysfunction was found in 54.4% of the HTLV-1–infected asymptomatic women (PR 1.21; 95% CI 0.82–1.79). Sexual dysfunction was associated with income lower than 1 minimal wage (∼US $300, October 2017) and number of previous birthday. Conclusion The obtained results indicate that sexual dysfunction is associated with HAM/TSP in women infected with HTLV-1 of reproductive age. Lima Lopes Martins A, Rios Grassi MF, de Aquino Firmino A, et al. Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age. Sex Med 2018;6:324–331.
Collapse
|
40
|
Kengne M, Tsata DCW, Ndomgue T, Nwobegahay JM. Prevalence and risk factors of HTLV-1/2 and other blood borne infectious diseases among blood donors in Yaounde Central Hospital, Cameroon. Pan Afr Med J 2018; 30:125. [PMID: 30374371 PMCID: PMC6201601 DOI: 10.11604/pamj.2018.30.125.14802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/11/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Transfusion-transmissible infectious microorganisms including bacteria and viruses are among the greatest threats to blood safety for the recipient. The prevalence and risk factors of HTLV-1/2 and other blood borne infectious diseases were determined among blood donors in Yaounde Central Hospital, Cameroon. Methods Design: cross sectional study. Setting: The blood bank unit of Yaounde Central Hospital, Cameroon. Subjects: a consecutive sample of 265 apparently healthy adult blood donors. Investigations: Search for the presence of hepatitis B surface antigen (AgHBs) and antibodies to human T-lymphotropic virus type 1 (anti-HTLV-1/2), human immunodeficiency virus (anti-HIV), hepatitis C virus (anti-HCV) and syphilis and to determine the epidemiological correlates, if any, in the occurrence of HTLV infection. Results 77 (29.05%) of the blood donors had serological evidence of infection with at least one pathogen and 4 (5.2%) had dual infections with HTLV-1/2. The overall prevalence of HTLV-1/2, HIV, HCV, HBV and syphilis were 5.7%, 5.3%, 2.6%, 11.7%, 3.8% respectively. Surgical history (Chi2=4.785; P=0.029), scarification (Chi2=6.359; P = 0.012), piercing (Chi2 = 16.353; P = 0.000) and intravenous drug use (Chi2 = 15.660; P = 0.000) were identified as risk factors for HTLV-1/2 infection. Conclusion A relative high prevalence of viral infections and syphilis was recorded among the study participants especially for HTLV-1/2 for which none blood donation is routine screened in our set up. Therefore, a routine screen of blood prior to transfusion should include anti-HTLV-1/2 tests.
Collapse
Affiliation(s)
- Michel Kengne
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon
| | - Dorine Carol Wouado Tsata
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon
| | - Thérèse Ndomgue
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon.,Assistant Laboratory Technicians School, Yaoundé, Cameroon
| | - Julius Mbekem Nwobegahay
- Department of Medical Microbiology and Immunology, School of Health Sciences-Catholic University of Central Africa, Yaoundé Cameroon.,Military Health Research Center (CRESAR), Yaounde, Cameroon
| |
Collapse
|
41
|
Socorro de Almeida Viana MDND, Santos Nobre AF, Costa Jr E, Silva IC, Pinheiro BT, Pereira CCC, de Souza Canto Ferreira L, de Almeida DS, de Araújo MWL, da Silva Borges M, da Costa CA, Ishikawa EAY, Ferrari SF, Silva de Sousa M. Stability of the HTLV-1 glycoprotein 46 (gp46) gene in an endemic region of the Brazilian Amazon and the presence of a significant mutation (N93D) in symptomatic patients. Virol J 2018; 15:80. [PMID: 29716616 PMCID: PMC5930498 DOI: 10.1186/s12985-018-0984-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 04/12/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The human T-lymphotropic virus type 1 (HTLV-1) affects 2-5 million people worldwide, and is associated with a number of degenerative and infectious diseases. The Envelope glycoproteins (gp) are highly conserved among the different HTLV-1 isolates, although nucleotide substitutions in the region that codifies these proteins may influence both the infectivity and the replication of the virus. The gp46 gene has functional domains which have been associated with the inhibition of the formation of the syncytium, cell-cell transmission, and the production of antibodies. The present study investigated the genetic stability of the gp46 gene of HTLV-1 in an endemic region of Brazilian Amazonia. METHODS Index case (IC - a sample of a given family group) carriers of HTLV-1 were investigated in the metropolitan region of Belém (Pará, Brazil) between January 2010 (registered retrospectively) and December 2015. The sequences that codify the gp46 were amplified by PCR, purified and sequenced (MF084788-MF084825). The gene was characterized using bioinformatics and Bayesian Inference. RESULTS The 40 patients analyzed had a mean age of 45.2 years and 70% presented some type of symptom, with a predominance of pain and sensitivity, dysautonomia, and motor disorders. All patients presented the aA (Transcontinental Cosmopolitan) genotype, with an extremely low mutation rate, which is characteristic of the codifying region (aA - 1.83 × 10-4 mutations per site per year). The gp46 gene had a nucleotide diversity of between 0.00% and 2.0%. Amino acid mutations were present in 66.6% of the samples of individuals with signs/symptoms or diseases associated with HTLV-1 (p = 0.0091). Of the three most frequent mutations, the previously undescribed N93D mutant was invariably associated with symptomatic cases. CONCLUSIONS The aA HTLV-1 subtype is predominant in the metropolitan region of Belém and presented a high degree of genetic stability in the codifying region. The rare N93D amino acid mutation may be associated with the clinical manifestations of this viral infection. IMPORTANCE Little is known of the phylogeny of HTLV-1 in the endemic region of Brazilian Amazonia, and few complete gene sequences are available for the gp46 glycoprotein from the local population. The nucleotide sequences of the viral gp46 gene recorded in the present study confirmed the genetic stability of the region, and pointed to a homogeneous viral group, with local geographic characteristics. Further research will be necessary to more fully understand the molecular diversity of this protein, given the potential of this codifying region as a model for an effective HTLV-1 vaccine. The identification of a rare mutation (N93D), present only in symptomatic patients, should also be investigated further as a potential clinical marker. TRIAL REGISTRATION ISRCTN 12345678, registered 28 September 2014.
Collapse
Affiliation(s)
| | - Akim Felipe Santos Nobre
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Edivaldo Costa Jr
- Virology Section, Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Ananindeua, Pará Brazil
| | - Ingrid Christiane Silva
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Bruna Teles Pinheiro
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Cássia Cristine Costa Pereira
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Louise de Souza Canto Ferreira
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Danilo Souza de Almeida
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | | | | | - Carlos Araujo da Costa
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Edna Aoba Yassui Ishikawa
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | | | - Maísa Silva de Sousa
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| |
Collapse
|
42
|
Low genetic diversity of the Human T-cell Lymphotropic Virus (HTLV-1) in an endemic area of the Brazilian Amazon basin. PLoS One 2018; 13:e0194184. [PMID: 29558516 PMCID: PMC5860735 DOI: 10.1371/journal.pone.0194184] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 02/26/2018] [Indexed: 11/19/2022] Open
Abstract
The Human T-cell Lymphotropic Virus (HTLV-1) is a Deltaretrovírus that was first isolated in the 1970s, and associated with Adult T-cell Leucemia-Lymphoma (ATLL), and subsequently to Tropical Spastic Paraparesis-Myelopathy (TSP/HAM). The genetic diversity of the virus varies among geographic regions, although its mutation rate is very low (approximately 1% per thousand years) in comparison with other viruses. The present study determined the genetic diversity of HTLV-1 in the metropolitan region of Belém, in northern Brazil. Blood samples were obtained from patients at the UFPA Tropical Medicine Nucleus between January 2010 and December 2013. The DNA was extracted and the PX region of the HTLV was amplified using nested PCR. The positive samples were then digested using the Taq1 enzyme for the identification and differentiation of the HTLV-1 and HTLV-2. The 5'LTR region of the positive HTLV-1 samples were amplified by nested PCR, and then sequenced genetically. The phylogenetic analysis of the samples was based on the maximum likelihood method and the evolutionary profile was analyzed by the Bayesian approach. Overall, 78 samples tested positive for HTLV-1, and 44 were analyzed here. The aA (cosmopolitan-transcontinental) subtype was recorded in all the samples. The following evolutionary rates were recorded for the different subtypes-a: 2.10-3, b: 2.69. 10-2, c: 6.23. 10-2, d: 3.08. 10-2, e: 6. 10-2, f: 1.78. 10-3, g: 2.2. 10-2 mutations per site per year. The positive HTLV-1 samples tested in the present study were characterized by their low genetic diversity and high degree of stability.
Collapse
|
43
|
Caterino-de-Araujo A, Alves FA, Campos KR, Lemos MF, Moreira RC. Making the invisible visible: searching for human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) in Brazilian patients with viral hepatitis B and C. Mem Inst Oswaldo Cruz 2018; 113:130-134. [PMID: 29236927 PMCID: PMC5722269 DOI: 10.1590/0074-02760170307] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 10/06/2017] [Indexed: 12/14/2022] Open
Abstract
With this study, the authors hope to alert clinicians regarding the presence of human T-cell lymphotropic virus type 1 and 2 (HTLV-1/-2) infections in patients with viral hepatitis B and C in Brazil. HTLV-1/-2 were detected in 1.3% of hepatitis B virus (HBV)- and 5.3% of hepatitis C virus (HCV)-infected blood samples sent for laboratory viral load measurements. A partial association of human immunodeficiency virus (HIV)-1 and HTLV-1/-2 infection was detected in patients with HCV (HIV+, 27.3%), whereas this association was almost 100% in HBV-infected patients (HIV+, all except one). The high prevalence of HTLV-1/-2 infection among patients with hepatitis C was of concern, as HTLV-1/-2 could change the natural course of subsequent liver disease. The authors suggest including HTLV-1/-2 serology in the battery of tests used when following patients with viral hepatitis in Brazil, regardless of the HIV status.
Collapse
Affiliation(s)
- Adele Caterino-de-Araujo
- Centro de Imunologia, Laboratório de Pesquisa em HTLV, Instituto Adolfo Lutz, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil
| | - Fabiana Aparecida Alves
- Centro de Imunologia, Laboratório de Pesquisa em HTLV, Instituto Adolfo Lutz, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil
| | - Karoline Rodrigues Campos
- Centro de Imunologia, Laboratório de Pesquisa em HTLV, Instituto Adolfo Lutz, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil
| | - Marcílio Figueiredo Lemos
- Centro de Virologia, Instituto Adolfo Lutz, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil
| | - Regina Célia Moreira
- Centro de Virologia, Instituto Adolfo Lutz, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
44
|
Khouri R, Silva-Santos G, Dierckx T, Menezes SM, Decanine D, Theys K, Silva AC, Farré L, Bittencourt A, Mangino M, Roederer M, Vandamme AM, Van Weyenbergh J. A genetic IFN/STAT1/FAS axis determines CD4 T stem cell memory levels and apoptosis in healthy controls and Adult T-cell Leukemia patients. Oncoimmunology 2018; 7:e1426423. [PMID: 29721391 PMCID: PMC5927537 DOI: 10.1080/2162402x.2018.1426423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 01/04/2018] [Accepted: 01/07/2018] [Indexed: 11/22/2022] Open
Abstract
Adult T-cell leukemia (ATL) is an aggressive, chemotherapy-resistant CD4+CD25+ leukemia caused by HTLV-1 infection, which usually develops in a minority of patients several decades after infection. IFN + AZT combination therapy has shown clinical benefit in ATL, although its mechanism of action remains unclear. We have previously shown that an IFN-responsive FAS promoter polymorphism in a STAT1 binding site (rs1800682) is associated to ATL susceptibility and survival. Recently, CD4 T stem cell memory (TSCM) Fashi cells have been identified as the hierarchical cellular apex of ATL, but a possible link between FAS, apoptosis, proliferation and IFN response in ATL has not been studied. In this study, we found significant ex vivo antiproliferative, antiviral and immunomodulatory effects of IFN-α treatment in short-term culture of primary mononuclear cells from ATL patients (n = 25). Bayesian Network analysis allowed us to integrate ex vivo IFN-α response with clinical, genetic and immunological data from ATL patients, thereby revealing a central role for FAS -670 polymorphism and apoptosis in the coordinated mechanism of action of IFN-α. FAS genotype-dependence of IFN-induced apoptosis was experimentally validated in an independent cohort of healthy controls (n = 20). The same FAS -670 polymorphism also determined CD4 TSCM levels in a genome-wide twin study (p = 7 × 10-11, n = 460), confirming a genetic link between apoptosis and TSCM levels. Transcriptomic analysis and cell type deconvolution confirmed the FAS genotype/TSCM link and IFN-α-induced downregulation of CD4 TSCM-specific genes in ATL patient cells. In conclusion, ex vivo IFN-α treatment exerts a pleiotropic effect on primary ATL cells, with a genetic IFN/STAT1/Fas axis determining apoptosis vs. proliferation and underscoring the CD4 TSCM model of ATL leukemogenesis.
Collapse
Affiliation(s)
- Ricardo Khouri
- KU Leuven – University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
- Instituto Gonçalo Moniz (IGM) - Fundação Oswaldo Cruz (FIOCRUZ), Salvador-Bahia, Brazil
| | | | - Tim Dierckx
- KU Leuven – University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| | - Soraya Maria Menezes
- KU Leuven – University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| | - Daniele Decanine
- Instituto Gonçalo Moniz (IGM) - Fundação Oswaldo Cruz (FIOCRUZ), Salvador-Bahia, Brazil
| | - Kristof Theys
- KU Leuven – University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| | - Aline Clara Silva
- Instituto Gonçalo Moniz (IGM) - Fundação Oswaldo Cruz (FIOCRUZ), Salvador-Bahia, Brazil
| | - Lourdes Farré
- Instituto Gonçalo Moniz (IGM) - Fundação Oswaldo Cruz (FIOCRUZ), Salvador-Bahia, Brazil
| | - Achiléa Bittencourt
- Department of Pathology, Complexo Hospitalar Universitário Prof Edgard Santos, Universidade Federal da Bahia (UFBA), Salvador-Bahia, Brazil
| | - Massimo Mangino
- Department of Twin Research & Genetic Epidemiology, King's College, London, UK
| | - Mario Roederer
- Immunotechnology Section, Vaccine Research Center, NIAID, NIH, Bethesda-MD, USA
| | - Anne-Mieke Vandamme
- KU Leuven – University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
- Center for Global Health and Tropical Medicine, Unidade de Microbiologia, Instituto de Highne e Medicina Tropical, Universidade, Nova de Lisboa, Lisbon, Portugal
| | - Johan Van Weyenbergh
- KU Leuven – University of Leuven, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
| |
Collapse
|
45
|
Carvalho NB, de Lourdes Bastos M, Souza AS, Netto EM, Arruda S, Santos SB, Carvalho EM. Impaired TNF, IL-1β, and IL-17 production and increased susceptibility to Mycobacterium tuberculosis infection in HTLV-1 infected individuals. Tuberculosis (Edinb) 2018. [DOI: 10.1016/j.tube.2017.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
46
|
de Aguiar SA, de Souza França SA, Santana BB, Santos MB, Freitas FB, Ferreira G, Cayres-Vallinoto I, Ishak MOG, Ishak R, Vallinoto ACR. Human T-lymphotropic virus 1aA circulation and risk factors for sexually transmitted infections in an Amazon geographic area with lowest human development index (Marajó Island, Northern Brazil). BMC Infect Dis 2017; 17:758. [PMID: 29216835 PMCID: PMC5721473 DOI: 10.1186/s12879-017-2859-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/26/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This cross-sectional study evaluated the prevalence of infection with human T-lymphotropic virus 1 and 2 (HTLV-1 and HTLV-2) in a population from the municipalities of Anajás, Chaves, São Sebastião da Boa Vista (SSBV) and Portel in the Marajó Archipelago and correlated these data with the epidemiological characteristics of the study population. METHODS A total of 1899 biological samples were evaluated. The samples were screened for the presence of anti-HTLV antibodies using an enzyme-linked immunosorbent assay (ELISA), and infection was confirmed using conventional polymerase chain reaction (PCR), real-time PCR and nucleotide sequencing. RESULTS Eleven samples (0.58%) were seropositive for HTLV, but molecular analysis confirmed positivity in only two samples (0.11%). Nucleotide sequencing and phylogenetic analysis indicated that the two samples positive for HTLV-1 that were isolated in Chaves belonged to the Cosmopolitan subtype 1 (HTLV-1a) and Transcontinental subgroup (A). CONCLUSION Our results confirmed the presence of Cosmopolitan Transcontinental HTLV-1 in the Marajó Archipelago, Amazon region, and the majority of the population revealed a lack of knowledge about sexually transmitted infections, which increases the risk of dissemination of HTLV and other agents.
Collapse
Affiliation(s)
- Samantha Assis de Aguiar
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Samires Avelino de Souza França
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Barbara Brasil Santana
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Mike Barbosa Santos
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Felipe Bonfim Freitas
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Glenda Ferreira
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Izaura Cayres-Vallinoto
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Marluísa O G Ishak
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Ricardo Ishak
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Federal University of Pará, Institute of Biological Sciences, Laboratory of Virology, Professor José da Silveira Netto Campus, Rua Augusto Correa s/no., Guama, Belém, Pará, 66075-110, Brazil.
| |
Collapse
|
47
|
Souza A, Carvalho N, Neves Y, Braga Santos S, Bastos MDL, Arruda S, Netto EM, Glesby MJ, Carvalho E. Association of Tuberculosis Status with Neurologic Disease and Immune Response in HTLV-1 Infection. AIDS Res Hum Retroviruses 2017; 33:1126-1133. [PMID: 28540757 DOI: 10.1089/aid.2015.0340] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The human T cell lymphotropic virus type 1 (HTLV-1) is the etiologic agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-1 infected individuals have increased susceptibility to Mycobacterium tuberculosis infection but the influence of tuberculosis (TB) on the course of HTLV-1 infection is unknown. The aim of this study was to evaluate the influence of TB on immunological, virologic, and neurologic features of HTLV-1 infection. This is a retrospective analysis of individuals enrolled in a cohort study from an HTLV-1 clinic who were evaluated for past or latent tuberculosis (LTB) and classified clinically as HTLV-1 carriers, probable HAM/TSP and definite HAM/TSP. Spontaneous cytokine production (interferon-gamma [IFN-γ], tumor necrosis factor [TNF], and interleukin[IL]-10), serum chemokines (CXCL9 and CXCL10) and HTLV-1 proviral load were evaluated. Of 172 participants, 64 did not have histories of TB (TB- group), 81 had LTB and 27 had TB in the past (TB+ group). In the TB+ group, there was a higher frequency of HAM/TSP patients (35%) than in HTLV-1 carriers (10%) (OR = 3.8, p = .0001). HAM/TSP patients with histories of TB had higher IFN-γ/IL-10 and TNF/IL-10 ratios when compared with HAM/TSP patients without histories of TB. There were no differences in serum chemokine production and proviral load across TB groups stratified on HTLV-1 clinical status. In conclusion, TB may influence the development of HAM/TSP, and patients with these two diseases have an impairment in the modulation of immune response.
Collapse
Affiliation(s)
- Anselmo Souza
- Immunology Service, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
- National Institute of Science and Technology of Tropical Diseases (CNPq/MCT), Salvador, Bahia, Brazil
| | - Natália Carvalho
- Immunology Service, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
- National Institute of Science and Technology of Tropical Diseases (CNPq/MCT), Salvador, Bahia, Brazil
| | - Yuri Neves
- Immunology Service, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Silvane Braga Santos
- Immunology Service, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
- National Institute of Science and Technology of Tropical Diseases (CNPq/MCT), Salvador, Bahia, Brazil
- Biological Science Department, State University of Feira de Santana, Feira de Santana, Bahia, Brazil
| | - Maria de Lourdes Bastos
- Immunology Service, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Sérgio Arruda
- Centro de Pesquisa Gonçalo Moniz (CPqGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
| | - Eduardo Martins Netto
- University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Marshall J. Glesby
- Center for Global Health, Weill Cornell Medical College, New York, New York
| | - Edgar Carvalho
- Immunology Service, University Hospital Prof. Edgard Santos, Federal University of Bahia, Salvador, Bahia, Brazil
- National Institute of Science and Technology of Tropical Diseases (CNPq/MCT), Salvador, Bahia, Brazil
- Centro de Pesquisa Gonçalo Moniz (CPqGM), Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Bahia, Brazil
| |
Collapse
|
48
|
Frutos MC, Gastaldello R, Balangero M, Remondegui C, Blanco S, Otsuki K, Paulo Vicente AC, Elías D, Mangeaud A, Nates S, Gallego S. Silent dissemination of HTLV-1 in an endemic area of Argentina. Epidemiological and molecular evidence of intrafamilial transmission. PLoS One 2017; 12:e0174920. [PMID: 28384180 PMCID: PMC5383099 DOI: 10.1371/journal.pone.0174920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/17/2017] [Indexed: 11/25/2022] Open
Abstract
Background Molecular and epidemiological studies of transmission routes and risk factors for infection by HTLV-1 are extremely important in order to implement control measures, especially because of the high prevalence of HTLV-1 in several regions of the world. San Salvador de Jujuy, Northwest Argentina, is a highly endemic area for HTLV-1 and foci of tropical spastic paraparesis/HTLV-1-associated myelopathy. Objective To gain further insight into the role of intrafamilial transmission of HTLV-1 in a highly endemic region in Argentina. Method Cross-sectional study in Northwest Argentina. Epidemiological data and blood samples were collected from 28 HTLV-1 infected subjects (index cases) and 92 close relatives/cohabitants. HTLV-1 infection was diagnosed by detection of antibodies and proviral DNA. The LTR region was sequenced and analyzed for genetic distances (VESPA software), in addition to determination and identification of polymorphisms to define HTLV-1 family signatures. Results Fifty seven of the 120 subjects enrolled had antibodies against HTLV-1 and were typified as HTLV-1 by PCR. The prevalence rate of HTLV-1 infection in family members of infected index cases was 31.52% (29/92). The infection was significantly associated with gender, age and prolonged lactation. Identity of LTR sequences and presence of polymorphisms revealed high prevalence of mother-to-child and interspousal transmission of HTLV-1 among these families. Conclusion There is an ongoing and silent transmission of HTLV-1 through vertical and sexual routes within family clusters in Northwest Argentina. This evidence highlights that HTLV-1 infection should be considered as a matter of public health in Argentina, in order to introduce preventive measures as prenatal screening and breastfeeding control.
Collapse
Affiliation(s)
- María C. Frutos
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas–Universidad Nacional de Córdoba, Córdoba, Argentina
- * E-mail:
| | - Rene Gastaldello
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas–Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Marcos Balangero
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas–Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Carlos Remondegui
- Departamento de Enfermedades Infecciones, Hospital San Roque, San Salvador de Jujuy, Argentina
| | - Sebastián Blanco
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas–Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Koko Otsuki
- Laboratorio de Genética Molecular de Microorganismos, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - David Elías
- Departamento de Matemática. Facultad de Ciencias Exactas, Físicas y Naturales- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Arnaldo Mangeaud
- Departamento de Matemática. Facultad de Ciencias Exactas, Físicas y Naturales- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Silvia Nates
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas–Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Sandra Gallego
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas–Universidad Nacional de Córdoba, Córdoba, Argentina
| |
Collapse
|
49
|
Santos RFS, Conceição GC, Martins MS, Kraychete A, Penalva MAC, Carvalho EM, Lopes AA, Rocha PN. Prevalence and risk factors for Human T-Lymphotropic Virus Type 1 (HTLV-1) among maintenance hemodialysis patients. BMC Nephrol 2017; 18:64. [PMID: 28202003 PMCID: PMC5312583 DOI: 10.1186/s12882-017-0484-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/09/2017] [Indexed: 11/11/2022] Open
Abstract
Background Infection with the human T-cell lymphotropic virus type 1 (HTLV-1), although asymptomatic in most cases, can lead to potentially grave consequences, such as adult T-cell leukemia-lymphoma and HTLV-1-associated myelopathy / tropical spastic paraparesis. Its prevalence varies widely across different populations and geographic regions. A population-based study in the city of Salvador, located in the Northeast region of Brazil, showed an overall prevalence of HTLV-1 seropositivity of 1.7%. Blood borne virus infections are recognized as important hazards for patients and staff in maintenance hemodialysis (MHD) units but most studies focus on hepatitis B, hepatitis C and human immunodeficiency viruses. There are scarce data about HTLV-1 infection in the MHD population. We aimed to determine the prevalence and risk factors for HTLV-1 infection among MHD patients in the city of Salvador-Bahia, Brazil. Methods We conducted a multi-center, cross-sectional study nested in a prospective cohort of MHD patients enrolled from four outpatient clinics. HTLV-1 screening was performed with ELISA and positive cases were confirmed by Western Blot. Factors associated with HTLV-1 seropositivity were identified by multivariable logistic regression. Results 605 patients were included in the study. The overall prevalence of HTLV-1 infection was 2.48% (15/605), which was similar to that of hepatitis B [1.98% (12/605)] and C [3.14% (19/605)] viruses in our sample. HTLV-1 seropositivity was positively associated with age [prevalence odds ratio (POR) 1.04; 95% confidence interval (CI) 1.01–1.08], unmarried status (POR 3.65; 95% CI 1.13–11.65), and history of blood transfusion (POR 3.35; 95% CI 1.01–11.13). Conclusions The overall prevalence of HTLV-1 infection in a sample of MHD patients was similar to that of other viral infections, such as hepatitis B and C. Our data revealed that MHD patients who are older, unmarried or who have received blood transfusions are at higher risk for HTLV-1 infection.
Collapse
Affiliation(s)
- Rilma F S Santos
- Division of Nephrology, Hospital Geral Roberto Santos, Salvador, Brazil. .,Postgraduate Program in Health Sciences, Federal University of Bahia, Salvador, Brazil.
| | | | - Márcia S Martins
- Unit of Clinical Epidemiology and Evidence Based Medicine of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil
| | - Angiolina Kraychete
- Unit of Clinical Epidemiology and Evidence Based Medicine of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil
| | | | - Edgar M Carvalho
- Centro de Pesquisas Gonçalo Moniz (Fiocruz-Ba), Salvador, Brazil.,Department of Internal Medicine and Diagnostic Support, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Antonio Alberto Lopes
- Unit of Clinical Epidemiology and Evidence Based Medicine of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil.,Department of Internal Medicine and Diagnostic Support, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| | - Paulo Novis Rocha
- Postgraduate Program in Health Sciences, Federal University of Bahia, Salvador, Brazil.,Department of Internal Medicine and Diagnostic Support, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil
| |
Collapse
|
50
|
Nunes D, Boa-Sorte N, Grassi MFR, Taylor GP, Teixeira MG, Barreto ML, Dourado I, Galvão-Castro B. HTLV-1 is predominantly sexually transmitted in Salvador, the city with the highest HTLV-1 prevalence in Brazil. PLoS One 2017; 12:e0171303. [PMID: 28158226 PMCID: PMC5291389 DOI: 10.1371/journal.pone.0171303] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 01/18/2017] [Indexed: 11/18/2022] Open
Abstract
Background Salvador is the city with the highest number of HTLV-1 infected individuals in Brazil, yet the main route of HTLV-1 transmission is unknown. Objective To investigate the association of syphilis infection as a proxy for sexual transmission of HTLV-1 infection in the general population of this city. Methods A cross sectional population-based study was conducted with 3,451 serum samples obtained by a representative simple random sampling. Data on gender, age, income, and years of education were collected by questionnaire and the presence of HTLV, HIV and Treponema pallidum infection was determined by serology. Logistic regression analysis was used to evaluate the independent effect of the potential explanatory variables to HTLV-1 infection and Odds Ratios (OR) and 95% CI were calculated. Results The majority of studied individuals were female (56.4%), had less than 7 years of education (55.3%) and earned two or less minimum wages (52.0%). The overall prevalence of HTLV-1 was 1.48% (51/3,451; 95% CI: 1.10%– 1.94%), which increased with age. Only three persons younger than 17 (3/958; 0.31%; CI 95% 0.06–0.91) years were infected by HTLV-1. Among the 45 syphilis positives, 12 (26.7%) were HTLV positive, while among 21 HIV positives, only one (4.8%) was HTLV positive. HTLV-1 infection was found to be associated with syphilis infection (ORADJUSTED 36.77; 95% CI 14.96–90.41). Conclusion The data presented herein indicate that horizontal transmission between adults is the main route of HTLV-1 infection in the general population of Salvador and that this is likely to occur through sexual contact.
Collapse
Affiliation(s)
- David Nunes
- Centro Integrativo e Interdisciplinar de HTLV, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Ney Boa-Sorte
- Centro Integrativo e Interdisciplinar de HTLV, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Centro Integrativo e Interdisciplinar de HTLV, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz/Bahia, Salvador, Bahia, Brazil
| | - Graham P. Taylor
- Imperial College Healthcare NHS Trust, National Centre for Human Retrovirology, St. Mary’s Hospital, London, United Kingdom
| | | | - Mauricio L. Barreto
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz/Bahia, Salvador, Bahia, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Inês Dourado
- Imperial College Healthcare NHS Trust, National Centre for Human Retrovirology, St. Mary’s Hospital, London, United Kingdom
| | - Bernardo Galvão-Castro
- Centro Integrativo e Interdisciplinar de HTLV, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz/Bahia, Salvador, Bahia, Brazil
- * E-mail:
| |
Collapse
|