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Marcusso RMDN, Assone T, Haziot ME, Smid J, Folgosi VA, Rosadas C, Casseb J, de Oliveira ACP. HTLV-1-Associated Myelopathy (HAM) Incidence in Asymptomatic Carriers and Intermediate Syndrome (IS) Patients. Pathogens 2024; 13:403. [PMID: 38787255 PMCID: PMC11124065 DOI: 10.3390/pathogens13050403] [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: 03/29/2024] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
Several studies suggest that HTLV-1 infection may be associated with a wider spectrum of neurological and clinical manifestations that do not meet diagnostic criteria for HAM. These conditions may later progress to HAM or constitute an intermediate clinical form: intermediate syndrome (IS), a mid-point between asymptomatic HTLV-1 carriers and those with full myelopathy. Thus, we determined the incidence of HAM cases in the HTLV-1-asymptomatic and IS patients, and the clinical/laboratory associated markers. A total of 204 HTLV-1-positive patients were included in this study, divided into two groups: Group 1, including 145 asymptomatic HTLV-1 subjects (ASY), and Group 2, including 59 patients with inflammatory clinical symptoms in more than three systems and a high proviral load (PVL). During a 60-month follow-up time, with the age ranging from 47 to 79 years, ten patients of the fifty-nine initially diagnosed as IS developed HAM (iHAM), and two patients of the initial 145 ASY developed HAM directly. Women were more prevalent in all groups. For the iHAM patients, the age ranged from 20 to 72 years, with a mean of 53 (±15 SD). Older age was associated with the development of HAM, higher PVL and IS; however, there was no any specific symptom or clinical sign, that was associated with risk for iHAM. In conclusion, IS cases could be an early phase of development of HAM. These findings show the presence of higher incidence probabilities in our cohort than previously reported.
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Affiliation(s)
| | - Tatiane Assone
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
- Departamento de Dermatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
| | - Michel E. Haziot
- Instituto de Infectologia Emílio Ribas, São Paulo 01246-000, Brazil; (R.M.d.N.M.); (M.E.H.); (J.S.); (A.C.P.d.O.)
| | - Jerusa Smid
- Instituto de Infectologia Emílio Ribas, São Paulo 01246-000, Brazil; (R.M.d.N.M.); (M.E.H.); (J.S.); (A.C.P.d.O.)
| | - Victor A. Folgosi
- Departamento de Dermatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London SW7 2BX, UK;
| | - Jorge Casseb
- Departamento de Dermatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-000, Brazil;
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Prates G, Paiva A, Haziot ME, Fonseca LAM, Smid J, Marcusso RMDN, Assone T, de Oliveira ACP, Casseb J. Could Cesarean Delivery Help Prevent Mother-to-Child Transmission of Human T-Lymphotropic Virus Type 1? J Infect Dis 2023; 228:1766-1775. [PMID: 37386934 DOI: 10.1093/infdis/jiad219] [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: 10/17/2022] [Revised: 06/09/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Mother-to-child transmission (MTCT) of human T-lymphotropic virus type 1 (HTLV-1) is an important route of transmission that can cause lifelong infection. There is high morbidity and mortality due to adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy (HAM), and other inflammatory disorders. These conditions develop in nearly 10% of people with HTLV-1 infection, with a higher risk if infection occurs early in life. Identification of risk factors can inform targeted measures to reduce HTLV-1 MTCT. This study aimed to investigate the potential of cesarean delivery to prevent HTLV-1 MTCT. METHODS We performed a review of the cases of women and their offspring under regular follow-up at the HTLV-1 outpatient clinic at the Institute of Infectious Diseases Emilio Ribas. RESULTS A total of 177 HTLV-1-infected women and 369 adult offspring were investigated. Overall, 15% of the children were positive for HTLV-1 and 85% were negative. Regarding vertical transmission, we found that a breastfeeding duration of >6 months was associated with MTCT. Moreover, maternal proviral load was not associated with transmission, but high educational level and cesarean delivery were identified as protective factors. CONCLUSIONS HTLV-1 MTCT was associated with mother's age at delivery of >25 years, low educational level, prolonged breastfeeding, and vaginal delivery.
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Affiliation(s)
- Gabriela Prates
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Arthur Paiva
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Universitary Hospital of the Federal University of Alagoas, Maceió, Brazil
| | - Michel E Haziot
- Institute of Infectious Diseases "Emilio Ribas" (IIER) of Sao Paulo, Sao Paulo, Brazil
| | - Luiz Augusto M Fonseca
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Jerusa Smid
- Institute of Infectious Diseases "Emilio Ribas" (IIER) of Sao Paulo, Sao Paulo, Brazil
| | | | - Tatiane Assone
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | | | - Jorge Casseb
- Departamento de Dermatologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
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Assone T, Menezes SM, de Toledo Gonçalves F, Folgosi VA, da Silva Prates G, Dierckx T, Braz M, Smid J, Haziot ME, Marcusso RMN, Dahy FE, Vanderlinden E, Claes S, Schols D, Bruhn R, Murphy EL, Penalva de Oliveira AC, Daelemans D, Vercauteren J, Casseb J, Van Weyenbergh J. Systemic cytokines and GlycA discriminate disease status and predict corticosteroid response in HTLV-1-associated neuroinflammation. J Neuroinflammation 2022; 19:293. [PMID: 36482436 PMCID: PMC9733207 DOI: 10.1186/s12974-022-02658-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 11/28/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) is an incapacitating neuroinflammatory disorder for which no disease-modifying therapy is available, but corticosteroids provide some clinical benefit. Although HAM/TSP pathogenesis is not fully elucidated, older age, female sex and higher proviral load are established risk factors. We investigated systemic cytokines and a novel chronic inflammatory marker, GlycA, as possible biomarkers of immunopathogenesis and therapeutic response in HAM/TSP, and examined their interaction with established risk factors. PATIENTS AND METHODS We recruited 110 People living with HTLV-1 (PLHTLV-1, 67 asymptomatic individuals and 43 HAM/TSP patients) with a total of 946 person-years of clinical follow-up. Plasma cytokine levels (IL-2, IL-4, IL-6, IL-10, IL-17A, IFN-γ, TNF) and GlycA were quantified by Cytometric Bead Array and 1NMR, respectively. Cytokine signaling and prednisolone response were validated in an independent cohort by nCounter digital transcriptomics. We used multivariable regression, machine learning algorithms and Bayesian network learning for biomarker identification. RESULTS We found that systemic IL-6 was positively correlated with both age (r = 0.50, p < 0.001) and GlycA (r = 0.45, p = 0.00049) in asymptomatics, revealing an 'inflammaging" signature which was absent in HAM/TSP. GlycA levels were higher in women (p = 0.0069), but cytokine levels did not differ between the sexes. IFN-γ (p = 0.007) and IL-17A (p = 0.0001) levels were increased in untreated HAM/TSP Multivariable logistic regression identified IL-17A and proviral load as independent determinants of clinical status, resulting in modest accuracy of predicting HAM/TSP status (64.1%), while a machine learning-derived decision tree classified HAM/TSP patients with 90.7% accuracy. Pre-treatment GlycA and TNF levels significantly predicted clinical worsening (measured by Osame Motor Disability Scale), independent of proviral load. In addition, a poor prednisolone response was significantly correlated with higher post-treatment IFN-γ levels. Likewise, a transcriptomic IFN signaling score, significantly correlated with previously proposed HAM/TSP biomarkers (CASP5/CXCL10/FCGR1A/STAT1), was efficiently blunted by in vitro prednisolone treatment of PBMC from PLHTLV-1 and incident HAM/TSP. CONCLUSIONS An age-related increase in systemic IL-6/GlycA levels reveals inflammaging in PLHTLV-1, in the absence of neurological disease. IFN-γ and IL-17A are biomarkers of untreated HAM/TSP, while pre-treatment GlycA and TNF predict therapeutic response to prednisolone pulse therapy, paving the way for a precision medicine approach in HAM/TSP.
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Affiliation(s)
- Tatiane Assone
- Laboratory of Medical Investigation LIM 56, Division of Dermatology and Institute of Tropical Medicine of Sao Paulo, Medical School, University of São Paulo, São Paulo, SP, Brazil
- Laboratory of Immunohematology and Forensic Hematology-LIM40, Department of Forensic Medicine, Medical Ethics, Social Medicine and Work, University of São Paulo Medical School, São Paulo, Brazil
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Soraya Maria Menezes
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Fernanda de Toledo Gonçalves
- Laboratory of Medical Investigation LIM 56, Division of Dermatology and Institute of Tropical Medicine of Sao Paulo, Medical School, University of São Paulo, São Paulo, SP, Brazil
- Laboratory of Immunohematology and Forensic Hematology-LIM40, Department of Forensic Medicine, Medical Ethics, Social Medicine and Work, University of São Paulo Medical School, São Paulo, Brazil
| | - Victor Angelo Folgosi
- Laboratory of Medical Investigation LIM 56, Division of Dermatology and Institute of Tropical Medicine of Sao Paulo, Medical School, University of São Paulo, São Paulo, SP, Brazil
- Laboratory of Immunohematology and Forensic Hematology-LIM40, Department of Forensic Medicine, Medical Ethics, Social Medicine and Work, University of São Paulo Medical School, São Paulo, Brazil
| | - Gabriela da Silva Prates
- Laboratory of Medical Investigation LIM 56, Division of Dermatology and Institute of Tropical Medicine of Sao Paulo, Medical School, University of São Paulo, São Paulo, SP, Brazil
- Laboratory of Immunohematology and Forensic Hematology-LIM40, Department of Forensic Medicine, Medical Ethics, Social Medicine and Work, University of São Paulo Medical School, São Paulo, Brazil
| | - Tim Dierckx
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Marcos Braz
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Jerusa Smid
- Institute of Infectious Diseases "Emilio Ribas" (IIER) de São Paulo, São Paulo, SP, Brazil
| | - Michel E Haziot
- Institute of Infectious Diseases "Emilio Ribas" (IIER) de São Paulo, São Paulo, SP, Brazil
| | - Rosa M N Marcusso
- Institute of Infectious Diseases "Emilio Ribas" (IIER) de São Paulo, São Paulo, SP, Brazil
| | - Flávia E Dahy
- Institute of Infectious Diseases "Emilio Ribas" (IIER) de São Paulo, São Paulo, SP, Brazil
| | - Evelien Vanderlinden
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Sandra Claes
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Dominique Schols
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Roberta Bruhn
- Vitalant Research Institute, San Francisco, CA, USA
- University of California San Francisco, San Francisco, CA, USA
| | - Edward L Murphy
- Vitalant Research Institute, San Francisco, CA, USA
- University of California San Francisco, San Francisco, CA, USA
| | | | - Dirk Daelemans
- Laboratory of Virology and Chemotherapy, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Jurgen Vercauteren
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Jorge Casseb
- Laboratory of Medical Investigation LIM 56, Division of Dermatology and Institute of Tropical Medicine of Sao Paulo, Medical School, University of São Paulo, São Paulo, SP, Brazil
- Laboratory of Immunohematology and Forensic Hematology-LIM40, Department of Forensic Medicine, Medical Ethics, Social Medicine and Work, University of São Paulo Medical School, São Paulo, Brazil
| | - Johan Van Weyenbergh
- Laboratory of Clinical and Epidemiological Virology, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
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Rocamonde B, Futsch N, Orii N, Allatif O, Penalva de Oliveira AC, Mahieux R, Casseb J, Dutartre H. Immunoprofiling of fresh HAM/TSP blood samples shows altered innate cell responsiveness. PLoS Negl Trop Dis 2021; 15:e0009940. [PMID: 34767551 PMCID: PMC8631667 DOI: 10.1371/journal.pntd.0009940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/30/2021] [Accepted: 10/21/2021] [Indexed: 11/28/2022] Open
Abstract
The Human T-cell Leukemia Virus-1 (HTLV-1)-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) is a devastating neurodegenerative disease with no effective treatment, which affects an increasing number of people in Brazil. Immune cells from the adaptive compartment are involved in disease manifestation but whether innate cell functions participate in disease occurrence has not been evaluated. In this study, we analyzed innate cell responses at steady state and after blood cell stimulation using an agonist of the toll-like receptor (TLR)7/8-signaling pathway in blood samples from HTLV-1-infected volunteers, including asymptomatic carriers and HAM/TSP patients. We observed a lower response of IFNα+ DCs and monocytes in HAM/TSP compared to asymptomatic carriers, as a potential consequence of corticosteroid treatments. In contrast, a higher frequency of monocytes producing MIP-1α and pDC producing IL-12 was detected in HAM/TSP blood samples, together with higher IFNγ responsiveness of NK cells, suggesting an increased sensitivity to inflammatory response in HAM/TSP patients compared to asymptomatic carriers. This sustained inflammatory responsiveness could be linked or be at the origin of the neuroinflammatory status in HAM/TSP patients. Therefore, the mechanism underlying this dysregulations could shed light onto the origins of HAM/TSP disease. The infection by the Human T-cell Leukemia Virus-1 (HTLV-1) is quite frequent in Brazil. Between 1–5% of infected individuals develop a devastating neurodegenerative disease (HAM/TSP) as a result of a sustained inflammation in the central nervous system, with no effective treatment. So far, inflammation has been linked to the deregulated activation of T-cells, but the role of innate cells has not been investigated yet. In this work, we aimed to characterize the responsiveness of innate cells, as this immune population is cornerstone of efficient immune response, but also might participate in disease exacerbation found in chronic infection. Our findings suggest an impaired antiviral response and increased inflammatory responsiveness by dendritic cells and monocytes in HAM/TSP patients compared to asymptomatic carriers. This sustained inflammatory responsiveness upon innate cell activation could participate in the establishment of the HAM/TSP disease.
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Affiliation(s)
- Brenda Rocamonde
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111—Université Claude Bernard Lyon 1, CNRS, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France, Equipe labelisée par la Fondation pour la Recherche Médicale, Labex Ecofect
| | - Nicolas Futsch
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111—Université Claude Bernard Lyon 1, CNRS, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France, Equipe labelisée par la Fondation pour la Recherche Médicale, Labex Ecofect
| | - Noemia Orii
- Faculdade de Medicina/Instituto de Medicina Tropical de São Paulo/Universidade da São Paulo, São Paulo, SP, Brazil
| | - Omran Allatif
- International Center for Research in Infectiology, service BIBS, INSERM U1111—Université Claude Bernard Lyon 1, CNRS, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France
| | | | - Renaud Mahieux
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111—Université Claude Bernard Lyon 1, CNRS, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France, Equipe labelisée par la Fondation pour la Recherche Médicale, Labex Ecofect
| | - Jorge Casseb
- Faculdade de Medicina/Instituto de Medicina Tropical de São Paulo/Universidade da São Paulo, São Paulo, SP, Brazil
| | - Hélène Dutartre
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111—Université Claude Bernard Lyon 1, CNRS, Ecole Normale Supérieure de Lyon, Université Lyon, Lyon, France, Equipe labelisée par la Fondation pour la Recherche Médicale, Labex Ecofect
- * E-mail:
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Rosadas C, Brites C, Arakaki-Sanchez D, Casseb J, Ishak R. Brazilian Protocol for Sexually Transmitted Infections 2020: human T-cell lymphotropic virus (HTLV) infection. Rev Soc Bras Med Trop 2021; 54:e2020605. [PMID: 34008723 PMCID: PMC8210483 DOI: 10.1590/0037-8682-605-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 12/26/2022] Open
Abstract
This article addresses the Human T-lymphotropic virus (HTLV). This subject comprises the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. HTLV-1/2 infection is a public health problem globally, and Brazil has the largest number of individuals living with the virus. HTLV-1 causes several clinical manifestations of neoplasm (adult T-cell leukemia/lymphoma) and inflammatory nature, such as HTLV-1-associated myelopathy and other manifestations such as uveitis, arthritis, and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health authorities professionals regarding viral transmission, diagnosis, treatment, and monitoring of individuals living with HTLV-1 and 2 in Brazil. HTLV-1/2 transmission can occur through blood transfusion and derivatives, injectable drug use, organ transplantation, unprotected sexual intercourse, and vertical transmission.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, London, United Kingdom
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Rosadas C, Brites C, Arakaki-Sánchez D, Casseb J, Ishak R. [Brazilian Protocol for Sexually Transmitted Infections 2020: human T cell lymphotropic virus (HTLV) infection]. ACTA ACUST UNITED AC 2021; 30:e2020605. [PMID: 33729406 DOI: 10.1590/s1679-497420200006000015.esp1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/07/2020] [Indexed: 11/22/2022]
Abstract
This manuscript is related to the chapter about human T-cell lymphotropic virus (HTLV) that is part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Health Ministry. HTLV-1/2 infection is a worldwide public health problem and Brazil has the largest number of individuals living with the virus. HTLV-1 causes a variety of clinical manifestations of a neoplastic nature, such as adult leukemia/T-cell lymphoma, and also of an inflammatory nature, such as HTLV-1-associated myelopathy, as well as other manifestations such as uveitis, arthritis and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health service managers and workers regarding virus transmission modes, diagnosis, treatment and monitoring of individuals living with HTLV-1 and 2 in Brazil.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, Londres, Reino Unido
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Becherer L, Hess JF, Frischmann S, Bakheit M, Nitschko H, Stinco S, Zitz F, Hofer H, Porro G, Hausladen F, Stock K, Drossart D, Wurm H, Kuhn H, Huber D, Hutzenlaub T, Paust N, Keller M, Strohmeier O, Wadle S, Borst N, Zengerle R, von Stetten F. Point-of-Care System for HTLV-1 Proviral Load Quantification by Digital Mediator Displacement LAMP. MICROMACHINES 2021; 12:mi12020159. [PMID: 33562822 PMCID: PMC7915047 DOI: 10.3390/mi12020159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 01/09/2023]
Abstract
This paper presents a universal point-of-care system for fully automated quantification of human T-cell lymphotropic virus type 1 (HTLV-1) proviral load, including genomic RNA, based on digital reverse RNA transcription and c-DNA amplification by MD LAMP (mediator displacement loop-mediated isothermal amplification). A disposable microfluidic LabDisk with pre-stored reagents performs automated nucleic acid extraction, reaction setup, emulsification, reverse transcription, digital DNA amplification, and quantitative fluorogenic endpoint detection with universal reporter molecules. Automated nucleic acid extraction from a suspension of HTLV-1-infected CD4+ T-lymphocytes (MT-2 cells) yielded 8 ± 7 viral nucleic acid copies per MT-2 cell, very similar to the manual reference extraction (7 ± 2 nucleic acid copies). Fully automated sample processing from whole blood spiked with MT-2 cells showed a comparable result of 7 ± 3 copies per MT-2 cell after a run time of two hours and 10 min.
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Affiliation(s)
- Lisa Becherer
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Jacob Friedrich Hess
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | | | | | - Hans Nitschko
- Department of Virology, Pettenkoferstraße 9a, Max von Pettenkofer-Institute, 80336 Munich, Germany
| | - Silvina Stinco
- Department of Virology, Pettenkoferstraße 9a, Max von Pettenkofer-Institute, 80336 Munich, Germany
| | - Friedrich Zitz
- E.L.T. Kunststofftechnik & Werkzeugbau GmbH, Weidenweg 339, 8240 Friedberg, Austria
| | - Hannes Hofer
- E.L.T. Kunststofftechnik & Werkzeugbau GmbH, Weidenweg 339, 8240 Friedberg, Austria
| | - Giampiero Porro
- Datamed srl, Via Achille Grandi 4/6, 20068 Peschiera Borromeo MI, Italy
| | - Florian Hausladen
- Institut für Lasertechnologien in der Medizin und Meßtechnik, University of Ulm, Helmholtzstraße 12, 89081 Ulm, Germany
| | - Karl Stock
- Institut für Lasertechnologien in der Medizin und Meßtechnik, University of Ulm, Helmholtzstraße 12, 89081 Ulm, Germany
| | - Dominik Drossart
- Institut für Lasertechnologien in der Medizin und Meßtechnik, University of Ulm, Helmholtzstraße 12, 89081 Ulm, Germany
| | - Holger Wurm
- Institut für Lasertechnologien in der Medizin und Meßtechnik, University of Ulm, Helmholtzstraße 12, 89081 Ulm, Germany
| | - Hanna Kuhn
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- NB Technologies GmbH, Ludwig-Erhard-Allee 2, 53175 Bonn, Germany
| | - Dominik Huber
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Tobias Hutzenlaub
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Nils Paust
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Mark Keller
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Spindiag GmbH, Engesserstraße 4a, 79108 Freiburg, Germany
| | - Oliver Strohmeier
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Spindiag GmbH, Engesserstraße 4a, 79108 Freiburg, Germany
| | - Simon Wadle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Volpi AG, Wiesenstrasse 33, 8952 Schlieren, Switzerland
| | - Nadine Borst
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Roland Zengerle
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
| | - Felix von Stetten
- Hahn-Schickard, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
- Laboratory for MEMS Applications, IMTEK-Department of Microsystems Engineering, University of Freiburg, Georges-Koehler-Allee 103, 79110 Freiburg, Germany
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Gomes Y, Caterino-de-Araujo A, Campos K, Gonçalves MG, Leite AC, Lima MA, Araújo A, Silva MT, Espíndola O. Loop-Mediated Isothermal Amplification (LAMP) Assay for Rapid and Accurate Confirmatory Diagnosis of HTLV-1/2 Infection. Viruses 2020; 12:v12090981. [PMID: 32899621 PMCID: PMC7552020 DOI: 10.3390/v12090981] [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: 07/29/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 12/23/2022] Open
Abstract
Laboratory diagnosis of human T-lymphotropic viruses (HTLV) 1 and 2 infection is performed by serological screening and further confirmation with serological or molecular assays. Thus, we developed a loop-mediated isothermal nucleic acid amplification (LAMP) assay for the detection of HTLV-1/2 in blood samples. The sensitivity and accuracy of HTLV-1/2 LAMP were defined with DNA samples from individuals infected with HTLV-1 (n = 125), HTLV-2 (n = 19), and coinfected with HIV (n = 82), and compared with real-time polymerase chain reaction (qPCR) and PCR-restriction fragment length polymorphism (RFLP). The overall accuracy of HTLV-1/2 LAMP (95% CI 74.8-85.5%) was slightly superior to qPCR (95% CI 69.5-81.1%) and similar to PCR-RFLP (95% CI 79.5-89.3%). The sensitivity of LAMP was greater for HTLV-1 (95% CI 83.2-93.4%) than for HTLV-2 (95% CI 43.2-70.8%). This was also observed in qPCR and PCR-RFLP, which was associated with the commonly lower HTLV-2 proviral load. All molecular assays tested showed better results with samples from HTLV-1/2 mono-infected individuals compared with HIV-coinfected patients, who present lower CD4 T-cell counts. In conclusion, HTLV-1/2 LAMP had similar to superior performance than PCR-based assays, and therefore may represent an attractive alternative for HTLV-1/2 diagnosis due to reduced working time and costs, and the simple infrastructure needed.
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Affiliation(s)
- Yago Gomes
- Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (A.C.L.); (M.A.L.); (A.A.)
- Correspondence: (Y.G.); (M.T.S.); (O.E.)
| | - Adele Caterino-de-Araujo
- Laboratory of HTLV Research, Immunology Center, Adolfo Lutz Institute, São Paulo 01246-000, Brazil; (A.C.-d.-A.); (K.C.); (M.G.G.)
| | - Karoline Campos
- Laboratory of HTLV Research, Immunology Center, Adolfo Lutz Institute, São Paulo 01246-000, Brazil; (A.C.-d.-A.); (K.C.); (M.G.G.)
| | - Maria Gisele Gonçalves
- Laboratory of HTLV Research, Immunology Center, Adolfo Lutz Institute, São Paulo 01246-000, Brazil; (A.C.-d.-A.); (K.C.); (M.G.G.)
| | - Ana Claudia Leite
- Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (A.C.L.); (M.A.L.); (A.A.)
| | - Marco Antonio Lima
- Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (A.C.L.); (M.A.L.); (A.A.)
| | - Abelardo Araújo
- Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (A.C.L.); (M.A.L.); (A.A.)
| | - Marcus Tulius Silva
- Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (A.C.L.); (M.A.L.); (A.A.)
- Correspondence: (Y.G.); (M.T.S.); (O.E.)
| | - Otávio Espíndola
- Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro 21040-900, Brazil; (A.C.L.); (M.A.L.); (A.A.)
- Correspondence: (Y.G.); (M.T.S.); (O.E.)
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Benencio P, Fraile Gonzalez SA, Ducasa N, Page K, Berini CA, Biglione MM. HLA-B*35 as a new marker for susceptibility to human T-cell lymphotropic virus type 1 (HTLV-1) Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) in patients living in Argentina. Retrovirology 2020; 17:29. [PMID: 32883310 PMCID: PMC7469403 DOI: 10.1186/s12977-020-00536-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiological agent of HTLV associated myelopathy/ Tropical Spastic Paraparesis (HAM/TSP) and Adult T cell leukemia/lymphoma (ATLL), in around 2–5% of the infected individuals. Host genetic background might play a role in disease progression. Several previous studies across many countries report HLA haplotype to be one such factor. Here, we sequenced HLA-A, -B and -C of 66 individuals by Sequence-Based Typing (SBT), and compared the frequency of different alleles among ATLL patients, HAM/TSP patients, asymptomatic carriers and non-infected individuals living in Argentina. Results The frequency of HLA-A, -B and -C alleles largely matched that of the general population in Argentina. We identified HLA-A*02, HLA-B*35 and HLA-C*07 as associated to protection from ATLL (p = 0.031), susceptibility to HAM/TSP (p < 0.001) and susceptibility to ATLL (p = 0.017), respectively. We also found a strong correlation between high proviral load (PVL) and disease (p = 0.008), but were unable to identify any particular allele associated with high or low PVL. Conclusions We have found HLA-A*02, HLA-B*35 and HLA-C*07 to be associated to protection from ATLL (HLA-A*02) and susceptibility to HAM/TSP (HLA-B*35) or to ATLL (HLA-C*07), respectively. Whereas HLA-A*02 protection from ATLL has already been extensively described in other regions of the world, this is the first report that links HLA-B*35 and an increased susceptibility to HAM/TSP. As for HLA-C*07 it has previously been associated to susceptibility to HAM/TSP in other countries but in our population it has been linked to ATLL.
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Affiliation(s)
- Paula Benencio
- CONICET- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Paraguay 2155, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina
| | - Sindy A Fraile Gonzalez
- CONICET- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Paraguay 2155, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nicolás Ducasa
- CONICET- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Paraguay 2155, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina
| | - Kimberly Page
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.,The University of New Mexico, Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Carolina A Berini
- CONICET- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Paraguay 2155, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Mirna M Biglione
- CONICET- Universidad de Buenos Aires, Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Paraguay 2155, C1121ABG, Ciudad Autónoma de Buenos Aires, Argentina
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10
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Prates G, Assone T, Corral M, Baldassin MPM, Mitiko T, Silva Sales FC, Haziot ME, Smid J, Fonseca LAM, de Toledo Gonçalves F, Penalva de Oliveira AC, Casseb J. Prognosis Markers for Monitoring HTLV-1 Neurologic Disease. Neurol Clin Pract 2020; 11:134-140. [PMID: 33842066 DOI: 10.1212/cpj.0000000000000866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/20/2020] [Indexed: 12/24/2022]
Abstract
Background Human T-cell lymphotropic virus type 1 (HTLV-1) infection is associated not only with some severe manifestations, such as HTLV-1-associated myelopathy (HAM) and ATLL, but also with other, less severe conditions. Some studies have reported neurologic manifestations that did not meet all the criteria for the diagnosis of HAM in individuals infected with HTLV-1; these conditions may later progress to HAM or constitute an intermediate clinical form, between asymptomatic HTLV-1 carriers and those with full myelopathy. This study evaluated the prognostic value and looked for a possible association of those parameters with the intermediate syndrome (IS) status and HAM status. Methods Proviral load (PVL), spontaneous lymphoproliferation, interferon (IFN)-γ spontaneous production was quantified in samples of asymptomatic and HAM patients, as well as patients with IS. Results The critical age range was 50-60 years for IS outcome and more of 60 years for HAM outcome, with an increased risk of 2.5-fold for IS and 6.8-fold for HAM. IFN-γ was increased in patients with IS compared with asymptomatic carriers (ACs) (p = 0.007) and in patients with HAM compared with ACs (p = 0.03). Lymphoproliferation was increased in patients with HAM vs ACs (p = 0.0001) and patients with IS (p = 0.0001). PVL was similar between groups. Conclusion IFN-γ has high specificity of prediction of subject remain asymptomatic compared with PVL and lymphoproliferation assay tests. IFN-γ has been shown to be a biomarker of progression to intermediate stage and to HAM. The association of other markers with manifestations associated with HTLV-1 infection that does not meet the HAM criteria should be verified.
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Affiliation(s)
- Gabriela Prates
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Tatiane Assone
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Marcelo Corral
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Maíra P M Baldassin
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Tatiane Mitiko
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Flávia C Silva Sales
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Michel E Haziot
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Jerusa Smid
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Luiz A M Fonseca
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Fernanda de Toledo Gonçalves
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Augusto C Penalva de Oliveira
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
| | - Jorge Casseb
- Faculty of Medicine-University of São Paulo (GP, TA, MC, MPMB, TM, FCSS, LAMF, JC); Institute of Infectious Diseases "Emilio Ribas" (MEH, JS, ACPdO); and Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina FMUSP (FdTG), University of São Paulo, Brazil
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Delimitation of the upstream region of NFKBIA gene associated with HTLV-1-associated myelopathy/tropical spastic paraparesis using candidate Tag-SNPs in Peruvian HTLV-1 infected individuals. INFECTION GENETICS AND EVOLUTION 2019; 75:103929. [PMID: 31226330 DOI: 10.1016/j.meegid.2019.103929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/29/2019] [Accepted: 06/18/2019] [Indexed: 11/20/2022]
Abstract
In Peru, it is estimated that about 150 000-400 000 people carry the Human T-lymphotropic virus 1 (HTLV-1). Only 10% of HTLV-1 carries develop complications related to HTLV-1. HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic disabling inflammatory disease affecting the spinal cord. HAM/TSP produces principally weakness in the lower limbs and bladder disturbances, among other complications. In a previous study, our group identified three SNPs (rs3138053, rs2233406, and rs3138045) located in the promoter region of the NFKBIA gene associated with HAM/TSP. This study aimed to analyze the association between four Tag-SNPs (rs10148482, rs17103274, rs17103282, and rs762009) located in the upstream region of the NFKBIA gene and HAM/TSP, and to delimit the linkage disequilibrium zone in the upstream region of the NFBKIA gene associated with HAM/TSP. The tetra-primers ARMS-PCR technique was used to genotype 4 Tag-SNPs on 140 HAM/TSP patients and 258 asymptomatic carriers. The SNP rs17103282 showed a deviation from Hardy-Weinberg equilibrium (p < .0001). Neither of three Tag-SNPs showed an association with HAM/TSP (P > .05). No linkage disequilibrium between four Tag-SNPs evaluated in this study and previous ones was observed. Here we show the region located in the upstream region of the NFKBIA gene highly associated with HAM/TSP disease in patients infected with HTLV-1 from Lima, Peru.
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Balanda M, Fernández J, Vergara N, Campano C, Arata L, Martín HS, Ramírez E. Genetic variability of human papillomavirus type 66 L1 gene among women presenting for cervical cancer screening in Chile. Med Microbiol Immunol 2019; 208:757-771. [PMID: 31165237 DOI: 10.1007/s00430-019-00621-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 05/23/2019] [Indexed: 12/31/2022]
Abstract
The high-risk human papillomaviruses (HR-HPVs) are involved in the development of cervical cancer. Nevertheless, there are differences in the oncogenic potential among them. HPV-16 and HPV-18 are associated with approximately 70% of cancer worldwide, and both types are the most extensively studied HR-HPV. Great variations in the prevalence of HR-HPV have been described in different countries. The impact of these variations on the epidemiology of lesions and cervical cancer is currently unknown. A high prevalence of HPV-66 has been detected in Chile. Here, we have analyzed the genetic variability of the L1 gene from HPV-66-infected Chilean women. Higher order interactions between identified mutations were analyzed by co-variation and cluster analyses. Antigenic-index alterations following L1 mutations and B-cell epitopes were predicted by BcePred algorithm. HPV-66 L1 sequences clustered phylogenetically into two main clades. The genetic variability in the HPV-66 L1 gene involved thirty nucleotide changes. Four of these were for the first time identified in this study. Some of these variants are embedded in the B-cell epitope regions. Amino acid homology in the immunodominant epitopes of HPV-66 L1 protein (DE, FG and H1 loops) was 42.9-59.1% and 28.6-68.9% compared with HPV-16 and HPV-18, respectively. The results of this research suggest that the neutralizing epitopes of HPV-66 are antigenically different compared to HPV-16 and HPV-18. Our findings show the need to perform new structural and immunological studies on HPV-66 L1 protein to evaluate the cross-protection conferred by current HPV vaccines.
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Affiliation(s)
- Monserrat Balanda
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Jorge Fernández
- Subdepto. de Genética Molecular, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Nicolás Vergara
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile.,Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile
| | - Constanza Campano
- Subdepto. de Genética Molecular, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Loredana Arata
- Subdepto. de Genética Molecular, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Héctor San Martín
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Eugenio Ramírez
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile.
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Haziot ME, Gascon MR, Assone T, Fonseca LAM, Luiz ODC, Smid J, Paiva AM, Marcusso RMDN, de Oliveira ACP, Casseb J. Detection of clinical and neurological signs in apparently asymptomatic HTLV-1 infected carriers: Association with high proviral load. PLoS Negl Trop Dis 2019; 13:e0006967. [PMID: 31042700 PMCID: PMC6513103 DOI: 10.1371/journal.pntd.0006967] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/13/2019] [Accepted: 04/08/2019] [Indexed: 01/11/2023] Open
Abstract
Several studies suggest that HTLV-1 infection may be associated with a wider spectrum of neurologic manifestations that do not meet diagnostic criteria for HAM/TSP. These conditions may later progress to HAM/TSP or constitute an intermediate clinical form, between asymptomatic HTLV-1 carriers and those with full myelopathy. Our aim was to determine the prevalence of HTLV-1-associated disease in subjects without HAM/TSP, and the relationship between these findings with HTLV-1 proviral load (PVL). Methods: 175 HTLV-1-infected subjects were submitted to a careful neurological evaluation, during their regular follow up at the HTLV outpatient clinic of the Institute of Infectious Diseases “Emilio Ribas”, São Paulo city, Brazil. Clinical evaluation and blinded standardized neurological screening were performed for all the subjects by the same neurologist (MH). Results: After the neurological evaluation, 133 patients were classified as asymptomatic and 42 fulfilled the criteria for intermediate syndrome (IS). The mean age of the enrolled subjects was 46.3 years and 130 (74.3%) were females. Clinical classification shows that neurological symptoms (p<0.001), visual disorders (p = 0.001), oral conditions (p = 0.001), skin lesions (p<0.001), bladder disorders (p<0.001), and rheumatological symptoms (p = 0.001), were strongly associated to IS, except for disautonomy (p = 0.21). A multivariate analysis revealed that HTLV-1 proviral load, oral conditions, bladder disorders and rheumatological symptoms were independently associated with the IS. Conclusions: We found some early alterations in 42 patients (24%), particularly the presence of previously not acknowledged clinical and neurological symptoms, among subjects previously classified as "asymptomatic", who we reclassified as having an intermediate syndrome. At least 5–10 million people live with the Human T-Cell Lymphotropic Virus type 1 (HTLV-1) worldwide, and around 0.25–5% of them may develop HTLV-1-associated myelopathy/Tropical spastic paraparesis (HAM/TSP), which is associated with chronic inflammation. In this study, involving 175 HTLV-1-infected subjects originally classified as asymptomatic, we found that 42 of them in reality presented some early clinical conditions, including alterations related not only to the neurological system, but also to the eyes and the skin. We called such conditions intermediate syndrome. Thus, it seems reasonable to suggest that all HTLV-1-infected subjects should be monitored for symptoms that may arise earlier in the course of their infection.
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Affiliation(s)
- Michel E. Haziot
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo, SP, Brazil
| | - M. Rita Gascon
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo, SP, Brazil
| | - Tatiane Assone
- Laboratory of Dermatology and Immunodeficiencies, Department of Dermatology, University of São Paulo Medical School, Brazil
- Institute of Tropical Medicine of São Paulo, São Paulo, SP, Brazil
| | | | - Olinda do Carmo Luiz
- Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | - Jerusa Smid
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo, SP, Brazil
| | - Arthur M. Paiva
- Laboratory of Dermatology and Immunodeficiencies, Department of Dermatology, University of São Paulo Medical School, Brazil
- Institute of Tropical Medicine of São Paulo, São Paulo, SP, Brazil
| | | | | | - Jorge Casseb
- Laboratory of Dermatology and Immunodeficiencies, Department of Dermatology, University of São Paulo Medical School, Brazil
- Institute of Tropical Medicine of São Paulo, São Paulo, SP, Brazil
- * E-mail:
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Spinal cord hypometabolism associated with infection by human T-cell lymphotropic virus type 1(HTLV-1). PLoS Negl Trop Dis 2018; 12:e0006720. [PMID: 30148843 PMCID: PMC6128630 DOI: 10.1371/journal.pntd.0006720] [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: 02/10/2018] [Revised: 09/07/2018] [Accepted: 07/25/2018] [Indexed: 12/14/2022] Open
Abstract
Background HTLV-1 infection is endemic in Brazil. About 1 to 2% of the Brazilian population is estimated to be infected, but most infected HTLV-1 individuals do not know about their own infection, which favors the continuity of sexual and vertical virus transmission. In addition, HTLV-1 associated central nervous system diseases and their pathophysiologic mechanisms are not fully understood. This study aimed to evaluate the correlation of spinal cord metabolism, viral and inflammatory profiles with features of neurological presentation in HTLV-1 infected individuals. Methodology This is a cross-sectional study of a cohort including 48 HTLV-1 infected individuals clinically classified as asymptomatic-AG (N = 21), symptomatic-SG (N = 11) and HAM/TSP-HG (N = 16) and a nested case-control study with HTLV-1 infected individuals-HIG (N = 48) and HTLV-1 non infected controls-CG (N = 30) that had their spinal cord analysed by Positron Emission Tomography with 18F-Fluordeoxyglucose (18F-FDG PET/CT). HTLV-1 infected individuals had 18F-FDG PET/CT results analyzed with clinical and demographic data, proviral load, cytokines and chemokines in the blood and cerebrospinal fluid (CSF). Principal Findings 18F-FDG PET/CT showed hypometabolism in the thoracic spinal cord in HTLV-1 infected individuals. The method had an accuracy of 94.4% to identify HAM/TSP. A greater involvement of the thoracic spinal cord was observed, although hypometabolism was also observed in the cervical spinal cord segment in HTLV-1 infected individuals. Individuals with HAM/TSP showed a pro-inflammatory profile in comparison to asymptomatic and symptomatic groups, with a higher level of Interferon-inducible T-cell alpha chemoattractant (ITAC/CXCL11), IL-6, IL-12p70 in the plasma; and ITAC, IL-4, IL-5, IL-8 (CXCL8) and TNF-alpha in the CSF. Using regression, thoracic spinal cord SUV (standardized uptake value) and CSF ITAC level were identified as the HAM/TSP predictors in the multivariate model. Conclusions 18F-FDG PET/CT imaging showed spinal cord hypometabolism in most HTLV-1 infected individuals, even in the asymptomatic HTLV-1 group. Thoracic spinal cord hypometabolism and CSF-ITAC levels were identified predictors of HAM/TSP. Significance Our findings suggested that in most HTLV-1 infected individuals there was compromise of central nervous system (CNS) structures despite of the lack of clinical symptoms. To explain the found hypometabolism, the role of microcirculatory and metabolic factors in the pathogenesis of neurological diseases associated with HTLV-1 infection must be further investigated. It is paramount to evaluate the central nervous function and to compare the performance among HTLV-1 infected individuals considered asymptomatic to the uninfected controls. For the past 30 years, human T-cell lymphotropic virus type-1 (HTLV-1) has been isolated and associated with neoplastic, inflammatory, and infectious diseases. It is known that the neurological disorder associated with HTLV-1 comprises HTLV-1-associated myelopathy (HAM/TSP) or any other isolated signals and symptoms. Despite all the knowledge accumulated so far, the association of neurological diseases to HTLV-1 infection remains difficult and neglected. We designed this study in order to assess the degree of neurological impairment associated with HTLV-1 infection through a metabolic evaluation with 18F-FDG PET/CT. Our results evidenced a more pronounced hypometabolism in the spinal cord of individuals with neurological impairment, but also evidenced hypometabolism in asymptomatic HTLV-1 infected individuals. We believe that areas of the CNS with lower circulatory and perfusional balance are more vulnerable to HTLV-1 infection. Mechanisms of cellular entry of the virus may be associated with loss of microcirculatory homeostasis and predisposition to a breakdown of the blood-brain barrier in these areas. Further studies are still necessary to shed light on the mechanisms associated with brain and spinal hypometabolism.
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Paiva AM, Assone T, Haziot MEJ, Smid J, Fonseca LAM, Luiz ODC, de Oliveira ACP, Casseb J. Risk factors associated with HTLV-1 vertical transmission in Brazil: longer breastfeeding, higher maternal proviral load and previous HTLV-1-infected offspring. Sci Rep 2018; 8:7742. [PMID: 29773807 PMCID: PMC5958084 DOI: 10.1038/s41598-018-25939-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/26/2018] [Indexed: 01/09/2023] Open
Abstract
HTLV-1 is transmitted primarily either through sexual intercourse or from mother to child. The mother/child pairs were classified as seroconcordant or serodiscordant. We analyzed mother to child transmission (MTCT) according to sociodemographic, clinical and epidemiological characteristics of the mother, child's gender and duration of breastfeeding. Between June 2006 and August 2016 we followed 192 mothers with HTLV-1 infection (mean age 41 years old), resulting in 499 exposed offspring, 288 (57.7%) of whom were tested for HTLV-1, making up the final sample for the study, along with their 134 respective mothers. Among the tested mother/child pairs, 41 (14.2%) were HTLV-1 positive, highlighted that seven of 134 family clusters concentrated 48.8% of positive cases. Variables associated with a positive child: breastfeeding duration ≥12 months, maternal PVL ≥100 copies/104 PBMC, mother's age at delivery >26 years old, and HTLV-1 in more than one child of the same mother. In a multiple logistic regression, breastfeeding ≥12 months, higher maternal PVL and ≥2 previous HTLV-1-infected children remained independently associated with the outcome. Thus, high maternal PVL and breastfeeding beyond 12 months were independently associated with MTCT of the HTLV-1 infection. Our results reinforce the need for both prenatal HTLV screening in endemic areas and for advising mothers on breastfeeding.
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Affiliation(s)
- Arthur M Paiva
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Lab. de Imunologia e Dermatologia, LIM-56, SP, Brazil.
- Hospital Universitário "Prof. Alberto Antunes", Universidade Federal de Alagoas, Alagoas, Brazil.
| | - Tatiane Assone
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Lab. de Imunologia e Dermatologia, LIM-56, SP, Brazil
| | - Michel E J Haziot
- Instituto de Infectologia "Emilio Ribas", Secretaria da Saúde do Estado de São Paulo, São Paulo, SP, Brazil
| | - Jerusa Smid
- Instituto de Infectologia "Emilio Ribas", Secretaria da Saúde do Estado de São Paulo, São Paulo, SP, Brazil
| | - Luiz Augusto M Fonseca
- Faculdade de Medicina FMUSP, Serviço de Alergia e Imunologia, Universidade de São Paulo, SP, Brazil
| | - Olinda do Carmo Luiz
- Department of Preventive Medicine, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Jorge Casseb
- Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, Lab. de Imunologia e Dermatologia, LIM-56, SP, Brazil.
- Faculdade de Medicina FMUSP, Departamento de Medicina Preventiva, Universidade de São Paulo, SP, Brazil.
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Assone T, Kanashiro TM, Baldassin MPM, Paiva A, Haziot ME, Smid J, Oliveira APD, Fonseca LAM, Norris PJ, Casseb J. In vitro basal T-cell proliferation among asymptomatic Human T cell Leukemia Virus type 1 patients co-infected with hepatitis C and/or Human Immunodeficiency Virus type 1. Braz J Infect Dis 2018; 22:106-112. [PMID: 29499169 PMCID: PMC9428222 DOI: 10.1016/j.bjid.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/28/2018] [Accepted: 02/02/2018] [Indexed: 11/30/2022] Open
Abstract
Background Infection with Human T cell Leukemia Virus type 1 can be associated with myelopathy/tropical spastic paraparesis (HAM/TSP) and other inflammatory diseases. Lymphocytes from about half of Human T cell Leukemia Virus type 1-infected subjects spontaneously proliferate in vitro, and how this phenomenon relates to symptomatic disease and viral burden is poorly understood. Objective To evaluate T-cell proliferation in vitro among patients co-infected with Human T cell Leukemia Virus type 1/Hepatitis C Virus/Human Immunodeficiency Virus type 1. Material and methods From 610 Human T cell Leukemia Virus-infected patients of the Human T cell Leukemia Virus outpatient clinic from Institute of Infectious Diseases “Emilio Ribas” in São Paulo, 273 agreed to participate: 72 had HAM/TSP (excluded from this analysis) and 201 were asymptomatic, a classification performed during a regular neurological appointment. We selected the subgroup made up only by the 201 asymptomatic subjects to avoid bias by the clinical status as a confounder effect, who had laboratory results of Human T cell Leukemia Virus type 1 proviral load and T-cell proliferation assay in our database. They were further grouped according to their serological status in four categories: 121 Human T cell Leukemia Virus type 1 asymptomatic mono-infected carriers; 32 Human T cell Leukemia Virus type 1/Hepatitis C Virus, 29 Human T cell Leukemia Virus type 1/Human Immunodeficiency Virus type 1, and 19 Human T cell Leukemia Virus type 1/Human Immunodeficiency Virus type 1/Hepatitis C Virus co-infected patients. Clinical data were obtained from medical records and interviews. DNA Human T cell Leukemia Virus type 1 proviral load (PVL) and T-cell proliferation (LPA) assay were performed for all samples. Results From a total of 273 subjects with Human T cell Leukemia Virus type 1, 80 presented co-infections: 29 had Human Immunodeficiency Virus type 1, 32 had Hepatitis C Virus, and 19 had Human Immunodeficiency Virus type 1 and Hepatitis C Virus. Comparing the groups based on their serological status, independently of being asymptomatic carriers, we observed a significant increase of PVL (p < 0.001) and LPA (p = 0.001). However, when groups were stratified according to their clinical and serological status, there was no significant increase in Human T cell Leukemia Virus type 1 PVL and LPA. Conclusion No significant increase of basal T-cell proliferation among Human T cell Leukemia Virus type 1 co-infected was observed. This interaction may be implicated in liver damage, worsening the prognosis of co-infected patients or, on the contrary, inducing a higher spontaneous clearance of Hepatitis C Virus infection in Human T cell Leukemia Virus type 1 co-infected patients.
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Affiliation(s)
- Tatiane Assone
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Dermatologia, Laboratório de Investigação em Dermatologia e Imunodeficiências, São Paulo, SP, Brazil; Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brazil
| | - Tatiana M Kanashiro
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Dermatologia, Laboratório de Investigação em Dermatologia e Imunodeficiências, São Paulo, SP, Brazil
| | - Maira P M Baldassin
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Dermatologia, Laboratório de Investigação em Dermatologia e Imunodeficiências, São Paulo, SP, Brazil
| | - Arthur Paiva
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Dermatologia, Laboratório de Investigação em Dermatologia e Imunodeficiências, São Paulo, SP, Brazil; Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brazil
| | - Michel E Haziot
- Instituto de Doenças Infecciosas "Emilio Ribas" (IIER), São Paulo, SP, Brazil
| | - Jerusa Smid
- Instituto de Doenças Infecciosas "Emilio Ribas" (IIER), São Paulo, SP, Brazil
| | | | - Luiz Augusto M Fonseca
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Preventiva, São Paulo, SP, Brazil
| | - Philip J Norris
- Blood Systems Research Institute, San Francisco, California, USA; University of California, San Francisco, California, USA
| | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Dermatologia, Laboratório de Investigação em Dermatologia e Imunodeficiências, São Paulo, SP, Brazil; Instituto de Medicina Tropical de São Paulo, São Paulo, SP, Brazil.
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17
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Polymorphisms in HLA-C and KIR alleles are not associated with HAM/TSP risk in HTLV-1-infected subjects. Virus Res 2018; 244:71-74. [DOI: 10.1016/j.virusres.2017.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 11/18/2022]
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Detection and genotyping of HPV in urine samples from Chilean women attending primary health care centers. Med Microbiol Immunol 2017; 207:95-103. [PMID: 29238853 DOI: 10.1007/s00430-017-0530-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/09/2017] [Indexed: 12/22/2022]
Abstract
Cervical cancer is the second most common malignant neoplasm in women worldwide representing approximately 10% of all types of cancers. Triage of women through cervical cytology has been an important strategy for the surveillance and control of new cases of cervical cancer. However, in many regions around the world cervical cytology has a low coverage compared to developed countries. The molecular detection of HPV is the most effective method to increase the screening sensitivity of women at risk of developing cervical cancer. There are very few studies about the efficacy of urine testing for detection of HPV in women followed up in primary health care centers. Consequently, the efficacy of using urine HPV screening in these populations has not been addressed yet. Here, we compared the detection of HPV in simultaneous urine and cervical samples of women followed up in primary health care centers. Urine and cervical samples were analyzed in 543 women attending at primary health care centers. HPV was detected by real time PCR, and HPV typing performed by PCR-RLB. A general HPV concordance of 86.2% (κ = 0.72) was determined between urine and cervical samples. The concordance for HPV-16 and 18 was almost perfect (κ = 0.82) and strong (κ = 0.77), respectively. The sensitivity and specificity for all HPV genotypes in urine using cervical samples as reference were 82.1 and 93.7%, respectively. The results showed that urine is a good alternative as clinical sample for HPV screening in women attending primary health care centers. Therefore, urine should be used as an alternative sample for increasing triage coverage either in refractory women participating in Pap surveillance programs or when cervical samples are not available.
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Vergara N, Espinoza G, Balanda M, Quiero A, Hidalgo W, San Martín H, Ramírez A, Ramírez E. Prevalence of Human Papillomavirus infection among Chilean women from 2012 to 2016. J Med Virol 2017; 89:1646-1653. [PMID: 28294358 DOI: 10.1002/jmv.24805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 01/24/2017] [Indexed: 02/02/2023]
Abstract
Here, we evaluated the prevalence of Human Papillomavirus (HPV) in two groups of Chilean women. The first group consisted of 3235 women aged 18-64 years attended in six primary care centers of Santiago. The second group consisted of 456 women 18-85 aged who consulted the Gynaecology Department of the Reference Hospital of Santiago. Samples were collected from October 2012 to February 2016. Cervical swabs were analyzed both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. Results showed a prevalence of 12.0% HPV positive, 10.3% high-risk (HR) HPV types positive, 3.9% low-risk (LR) HPV types positive, and 1.0% Pap positive in group 1. The most frequent types were 16, 66, and 59, with a prevalence of 3.0%, 1.6%, and 1.5%, respectively. The prevalence were 71.9% HPV positive, 67.3% HR-HPV types positive, 13.6% LR-HPV types positive, and 62.5% Pap positive in group 2. The most frequent types were 16, 31, and 58, with prevalence of 33.6%, 10.5%, and 7.0%, respectively. Among infected women with HPV: 7.6% were infected with HPV16 or HPV18, 3.0% with HPV31, HPV33 or HPV45, and 6.7% with any other HR-HPV. These findings show great difference in HPV prevalence and types between primary care and reference center, and provide useful epidemiological information to assess the impact of HPV vaccination in the future.
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Affiliation(s)
- Nicolás Vergara
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Gloria Espinoza
- Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile
| | - Monserrat Balanda
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Andrea Quiero
- Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile
| | - Wilma Hidalgo
- Dirección de Salud, Municipalidad de Huechuraba, Santiago, Chile
| | - Héctor San Martín
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile
| | | | - Eugenio Ramírez
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Santiago, Chile.,Programa de Virología, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Paiva A, Smid J, Haziot MEJ, Assone T, Pinheiro S, Fonseca LAM, de Oliveira ACP, Casseb J. High risk of heterosexual transmission of human T-cell lymphotropic virus type 1 infection in Brazil. J Med Virol 2016; 89:1287-1294. [PMID: 27935065 DOI: 10.1002/jmv.24745] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 12/28/2022]
Abstract
Human T-cell lymphotropic virus type 1 is transmitted primarily either through sexual intercourse or from mother to child. The current study investigated sexual transmission and compared the HTLV-1 proviral load between seroconcordant and serodiscordant couples by examining both men and women among the index partners without using subjective criteria to establish the direction of sexual transmission. Between January 2013 and May 2015, 178 HTLV-1-positive patients had spouses, 107 of which had tested partners, thus increasing the initial sample size (46 men and 61 women). Individuals co-infected with HTLV-2 or human immunodeficiency virus were not included in the analysis. From among the included participants, 26 men and 26 women were paired with each other, resulting in 26 seroconcordant couples; 12 seroconcordant couples were formed from another four men and eight women. Forty-three serodiscordant couples were formed from 16 men and 27 women. The rate of seroconcordance was 46.9%. The HTLV-1 proviral load was compared between 19 and 37 seroconcordant and serodiscondant couples, respectively, and the concordant couples showed higher proviral loads (P = 0.03). There were no differences between the groups according to age, relationship length, having a mother or sibling with HTLV-1, race, ethnicity, nationality, education, history of blood transfusion, HAM/TSP, ALT, or hepatitis C virus status. In multivariate analysis, relationship time was shown associated with ocurrence of seroconcordance status. The apparent association between high circulating levels of provirus and seroconcordance rate among couples suggests that proviral loads contribute markedly to the risk of sexual transmission, regardless of gender index.
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Affiliation(s)
- Arthur Paiva
- Institute of Tropical Medicine of São Paulo, São Paulo, São Paulo, Brazil.,Department of Dermatology, Laboratory of Dermatology and Immunodeficiencies, University of São Paulo Medical School, Butantã, São Paulo, Brazil
| | - Jerusa Smid
- Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, São Paulo, Brazil
| | - Michel E J Haziot
- Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, São Paulo, Brazil
| | - Tatiane Assone
- Institute of Tropical Medicine of São Paulo, São Paulo, São Paulo, Brazil.,Department of Dermatology, Laboratory of Dermatology and Immunodeficiencies, University of São Paulo Medical School, Butantã, São Paulo, Brazil
| | - Samara Pinheiro
- Department of Dermatology, Laboratory of Dermatology and Immunodeficiencies, University of São Paulo Medical School, Butantã, São Paulo, Brazil
| | - Luiz A M Fonseca
- Department of Preventive Medicine, University of São Paulo Medical School, Butantã, São Paulo, Brazil
| | | | - Jorge Casseb
- Institute of Tropical Medicine of São Paulo, São Paulo, São Paulo, Brazil.,Department of Dermatology, Laboratory of Dermatology and Immunodeficiencies, University of São Paulo Medical School, Butantã, São Paulo, Brazil
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Prevalence of human papillomavirus infection among women presenting for cervical cancer screening in Chile, 2014-2015. Med Microbiol Immunol 2016; 205:585-594. [PMID: 27539577 DOI: 10.1007/s00430-016-0473-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/18/2016] [Indexed: 12/18/2022]
Abstract
Cervical cancer is the fourth most common malignancy in women worldwide. In Chile, cervical cancer is the second leading cause of death among women of reproductive age, causing more than 600 deaths annually. This study was carried out to determine the burden and confirm the predominant human papillomavirus (HPV) genotypes among women presenting for cervical cancer screening in public health services in Chile. Women aged 18-64 years residing in the north and central areas covered by six primary care centers of Santiago, Chile, were invited to participate from March 2014 to August 2015. Cervical swabs were examined both HPV genotyping by PCR and Reverse Line Blot, and cervical cytology by Pap testing. A total of 1738 women were included in this study: 11.1 % were HPV positive, 9.7 % were high-risk types positive, 3.2 % were low-risk types positive, 1.4 % were Pap positive and 0.9 % were positive by both tests. The four most predominant genotypes were 16, 66, 51 and 59, with prevalence of 2.8, 1.4, 1.2 and 1.2 %, respectively. Multiple HPV infections were detected among 3.8 % participants. Age-specific prevalence of HPV showed a peak in HPV infection at younger ages (≤30 years), declining to a plateau in middle age. Among women with normal cytology, the 9.4 % were HPV positive, while 58.3 % of women with abnormal cytology were HPV positive. These findings show new epidemiological data confirming HPV 16 and 66 as the most predominant genotypes in Chile. These data are important for design successful strategies for prevention of cervical cancer in Chile.
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22
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Assone T, de Souza FV, Gaester KO, Fonseca LAM, Luiz ODC, Malta F, Pinho JRR, Gonçalves FDT, Duarte AJDS, de Oliveira ACP, Casseb J. IL28B gene polymorphism SNP rs8099917 genotype GG is associated with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in HTLV-1 carriers. PLoS Negl Trop Dis 2014; 8:e3199. [PMID: 25233462 PMCID: PMC4169378 DOI: 10.1371/journal.pntd.0003199] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 08/18/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The polymorphisms of IL28B have been described as important in the pathogenesis of infections caused by some viruses. The aim of this research was to evaluate whether IL28B gene polymorphisms (SNP rs8099917 and SNP rs12979860) are associated with HAM/TSP. METHODS The study included 229 subjects, classified according to their neurological status in two groups: Group I (136 asymptomatic HTLV-1 carriers) and Group II (93 HAM/TSP patients). The proviral loads were quantified, and the rs8099917 and rs12979860 SNPs in the region of IL28B-gene were analyzed by StepOnePlus Real-time PCR System. RESULTS A multivariate model analysis, including gender, age, and HTLV-1 DNA proviral load, showed that IL28B polymorphisms were independently associated with HAM/TSP outcome in rs12979860 genotype CT (OR = 2.03; IC95% = 0.96-4.27) and in rs8099917 genotype GG (OR = 7.61; IC95% = 1.82-31.72). CONCLUSION Subjects with SNP rs8099917 genotype GG and rs12979618 genotype CT may present a distinct immune response against HTLV-1 infection. So, it seems reasonable to suggest that a search for IL28B polymorphisms should be performed for all HTLV-1-infected subjects in order to monitor their risk for disease development; however, since this is the first description of such finding in the literature, we should first replicate this study with more HTLV-1-infected persons to strengthen the evidence already provided by our results.
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Affiliation(s)
- Tatiane Assone
- Laboratório de Dermatologia e Imunodeficiências, Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | - Fernando Vieira de Souza
- Instituto de Doenças Infecciosas “Emilio Ribas” (IIER) de São Paulo, São Paulo, São Paulo, Brazil
| | - Karen Oliveira Gaester
- Laboratório de Dermatologia e Imunodeficiências, Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Olinda do Carmo Luiz
- Departamento de Medicina Preventiva, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Fernanda Malta
- Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Fernanda de Toledo Gonçalves
- Laboratório de Imuno-hematologia e Hematologia Forense – LIM40, Departamento de Medicina Legal, Ética Médica, Medicina Social e do Trabalho, Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, São Paulo, Brazil
| | - Alberto Jose da Silva Duarte
- Laboratório de Dermatologia e Imunodeficiências, Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Jorge Casseb
- Laboratório de Dermatologia e Imunodeficiências, Departamento de Dermatologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Instituto de Medicina Tropical de São Paulo, São Paulo, São Paulo, Brazil
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HTLV-1 infects human mesenchymal stromal cell in vitro and modifies their phenotypic characteristics. Virology 2014; 449:190-9. [DOI: 10.1016/j.virol.2013.11.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 09/13/2013] [Accepted: 11/13/2013] [Indexed: 11/22/2022]
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Okajima R, Oliveira ACP, Smid J, Casseb J, Sanches JA. High prevalence of skin disorders among HTLV-1 infected individuals independent of clinical status. PLoS Negl Trop Dis 2013; 7:e2546. [PMID: 24244779 PMCID: PMC3820737 DOI: 10.1371/journal.pntd.0002546] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 10/04/2013] [Indexed: 02/03/2023] Open
Abstract
Background Human T-cell lymphotropic virus type 1 (HTLV-1) infection can increase the risk of developing skin disorders. This study evaluated the correlation between HTLV-1 proviral load and CD4+ and CD8+ T cells count among HTLV-1 infected individuals, with or without skin disorders (SD) associated with HTLV-1 infection [SD-HTLV-1: xerosis/ichthyosis, seborrheic dermatitis or infective dermatitis associated to HTLV-1 (IDH)]. Methods A total of 193 HTLV-1-infected subjects underwent an interview, dermatological examination, initial HTLV-1 proviral load assay, CD4+ and CD8+ T cells count, and lymphproliferation assay (LPA). Results A total of 147 patients had an abnormal skin condition; 116 (79%) of them also had SD-HTLV-1 and 21% had other dermatological diagnoses. The most prevalent SD-HTLV-1 was xerosis/acquired ichthyosis (48%), followed by seborrheic dermatitis (28%). Patients with SD-HTLV-1 were older (51 vs. 47 years), had a higher prevalence of myelopathy/tropical spastic paraparesis (HAM/TSP) (75%), and had an increased first HTLV-1 proviral load and basal LPA compared with patients without SD-HTLV-1. When excluding HAM/TSP patients, the first HTLV-1 proviral load of SD-HTLV-1 individuals remains higher than no SD-HTLV-1 patients. Conclusions There was a high prevalence of skin disorders (76%) among HTLV-1-infected individuals, regardless of clinical status, and 60% of these diseases are considered skin disease associated with HTLV-1 infection. HTLV-1 infection may increase the risk of developing skin disorders. A total of 193 HTLV-1 infected subjects were studied, including asymptomatic carriers and HAM/TSP patients. Of the subjects, 76% had an abnormal skin condition, with a high prevalence both among HTLV-1 asymptomatic carriers and HAM/TSP patients. The most prevalent SD-HTLV-1 was xerosis/acquired ichthyosis (48%), followed by seborrheic dermatitis (28%). Patients with SD-HTLV-1 were older (51 vs. 47 years), had a higher prevalence of myelopathy/tropical spastic paraparesis (HAM/TSP) (75%) and an increased first HTLV-1 proviral load compared with patients without SD-HTLV-1. When excluding HAM/TSP patients, the first HTLV-1 proviral load of SD-HTLV-1 individuals remains higher than no SD-HTLV-1 patients. Thus, skin diseases are highly prevalent among HTLV-1-infected individuals.
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Affiliation(s)
- Renata Okajima
- HTLV-Outpatient Clinic, Institute of Infectious Diseases “Emilio Ribas,” São Paulo, Brazil
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Augusto C. P. Oliveira
- HTLV-Outpatient Clinic, Institute of Infectious Diseases “Emilio Ribas,” São Paulo, Brazil
| | - Jerusa Smid
- HTLV-Outpatient Clinic, Institute of Infectious Diseases “Emilio Ribas,” São Paulo, Brazil
| | - Jorge Casseb
- HTLV-Outpatient Clinic, Institute of Infectious Diseases “Emilio Ribas,” São Paulo, Brazil
- Institute of Tropical Medicine of São Paulo, Laboratory of Medical Investigation 56 (LIM56), University of São Paulo Medical School, São Paulo, Brazil
- * E-mail:
| | - Jose Antonio Sanches
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
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Human T-cell leukemia/lymphoma virus type 1 p30, but not p12/p8, counteracts toll-like receptor 3 (TLR3) and TLR4 signaling in human monocytes and dendritic cells. J Virol 2013; 88:393-402. [PMID: 24155397 DOI: 10.1128/jvi.01788-13] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The human T-cell leukemia/lymphoma virus type 1 (HTLV-1) p30 protein, essential for virus infectivity in vivo, is required for efficient infection of human dendritic cells (DCs) but not B and T cells in vitro. We used a human monocytic cell line, THP-1, and dendritic cells to study the mechanism of p30 and p12/p8 requirements in these cell types. p30 inhibited the expression of interferon (IFN)-responsive genes (ISG) following stimulation by lipopolysaccharide (LPS) of Toll-like receptor 4 (TLR4) and by poly(I·C) of TLR3 but not of TLR7/8 with imiquimod. Results with THP-1 mirrored those for ex vivo human primary monocytes and monocyte-derived dendritic cells (Mo-mDC). The effect of p30 on TLR signaling was also demonstrated by ablating its expression within a molecular clone of HTLV-1. HTLV-1 infection of monocytes inhibited TLR3- and TLR4-induced ISG expression by 50 to 90% depending on the genes, whereas the isogenic clone p30 knockout virus was less effective at inhibiting TLR3 and TRL4 signaling and displayed lower infectivity. Viral expression and inhibition of ISG transcription was, however, rescued by restoration of p30 expression. A chromatin immunoprecipitation assay demonstrated that p30 inhibits initiation and elongation of PU.1-dependent transcription of IFN-α1, IFN-β, and TLR4 genes upon TLR stimulation. In contrast, experiments conducted with p12/p8 did not demonstrate an effect on ISG expression. These results provide a mechanistic explanation of the requirement of p30 for HTLV-1 infectivity in vivo, suggest that dampening interferon responses in monocytes and DCs is specific for p30, and represent an essential early step for permissive HTLV-1 infection and persistence.
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Grassi MFR, Olavarria VN, Kruschewsky RDA, Yamano Y, Jacobson S, Taylor GP, Martin F, Galvão-Castro B. Utility of HTLV proviral load quantification in diagnosis of HTLV-1-associated myelopathy requires international standardization. J Clin Virol 2013; 58:584-6. [PMID: 24095029 DOI: 10.1016/j.jcv.2013.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 08/29/2013] [Accepted: 09/03/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Maria Fernanda Rios Grassi
- Advanced Laboratory of Public Health, Gonçalo Moniz Center, Fundação Oswaldo Cruz, Salvador, Bahia, Brazil; Bahiana School of Medicine and Public Health (EBMSP), Salvador, Bahia, Brazil.
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27
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Okajima R, Casseb J, Sanches JA. Co-presentation of human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis and adult-onset infective dermatitis associated with HTLV-1 infection. Int J Dermatol 2013; 52:63-8. [PMID: 23278610 DOI: 10.1111/j.1365-4632.2012.05606.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human T-cell lymphotropic virus type 1 (HTLV-1) is the etiologic agent of adult T-cell leukemia/lymphoma (ATLL), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), infective dermatitis associated with HTLV-1 (IDH), and various other clinical conditions. Several of these diseases can occur in association. OBJECTIVE Report an association of diseases related to HTLV-1 infection, occurring in an unusual age group. METHODS Dermatological and laboratory exams were consecutively performed in HTLV-1-infected individuals from January 2008 to July 2010 in the HTLV Outpatient Clinic at the Institute of Infectious Diseases "Emilio Ribas" in São Paulo, Brazil. RESULTS A total of 193 individuals (73 HAM/TSP and 120 asymptomatic carriers) were evaluated, three of which were associated with adult-onset IDH and HAM/TSP. In all three cases, the patients were affected by IDH after the development and progression of HAM/TSP-associated symptoms. LIMITATIONS Small number of cases because of the rarity of these diseases. CONCLUSION We draw attention to the possibility of co-presentation of adult-onset IDH in patients with a previous diagnosis of HAM/TSP, although IDH is a disease classically described in children. Thus, dermatologists should be aware of these diagnoses in areas endemic for HTLV-1 infection.
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Affiliation(s)
- Renata Okajima
- HTLV Outpatient Clinic, Institute of Infectious Diseases Emilio Ribas, São Paulo, Brazil
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28
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Jones RB, Leal FE, Hasenkrug AM, Segurado AC, Nixon DF, Ostrowski MA, Kallas EG. Human endogenous retrovirus K(HML-2) Gag and Env specific T-cell responses are not detected in HTLV-I-infected subjects using standard peptide screening methods. J Negat Results Biomed 2013; 12:3. [PMID: 23305161 PMCID: PMC3560086 DOI: 10.1186/1477-5751-12-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 12/23/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An estimated 10-20 million individuals are infected with the retrovirus human T-cell leukemia virus type 1 (HTLV-1). While the majority of these individuals remain asymptomatic, 0.3-4% develop a neurodegenerative inflammatory disease, termed HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HAM/TSP results in the progressive demyelination of the central nervous system and is a differential diagnosis of multiple sclerosis (MS). The etiology of HAM/TSP is unclear, but evidence points to a role for CNS-inflitrating T-cells in pathogenesis. Recently, the HTLV-1-Tax protein has been shown to induce transcription of the human endogenous retrovirus (HERV) families W, H and K. Intriguingly, numerous studies have implicated these same HERV families in MS, though this association remains controversial. RESULTS Here, we explore the hypothesis that HTLV-1-infection results in the induction of HERV antigen expression and the elicitation of HERV-specific T-cells responses which, in turn, may be reactive against neurons and other tissues. PBMC from 15 HTLV-1-infected subjects, 5 of whom presented with HAM/TSP, were comprehensively screened for T-cell responses to overlapping peptides spanning HERV-K(HML-2) Gag and Env. In addition, we screened for responses to peptides derived from diverse HERV families, selected based on predicted binding to predicted optimal epitopes. We observed a lack of responses to each of these peptide sets. CONCLUSIONS Thus, although the limited scope of our screening prevents us from conclusively disproving our hypothesis, the current study does not provide data supporting a role for HERV-specific T-cell responses in HTLV-1 associated immunopathology.
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Affiliation(s)
- R Brad Jones
- Department of Immunology, University of Toronto, 1 King's College Circle, Rm 6352, Toronto, ON M5S 1A8, Canada.
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29
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Levin MC, Lee S, Gardner LA, Shin Y, Douglas JN, Groover CJ. Pathogenic mechanisms of neurodegeneration based on the phenotypic expression of progressive forms of immune-mediated neurologic disease. Degener Neurol Neuromuscul Dis 2012; 2:175-187. [PMID: 30890887 PMCID: PMC6065584 DOI: 10.2147/dnnd.s38353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Considering there are no treatments for progressive forms of multiple sclerosis (MS), a comprehensive understanding of the role of neurodegeneration in the pathogenesis of MS should lead to novel therapeutic strategies to treat it. Many studies have implicated viral triggers as a cause of MS, yet no single virus has been exclusively shown to cause MS. Given this, human and animal viral models of MS are used to study its pathogenesis. One example is human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Importantly, HAM/TSP is similar clinically, pathologically, and immunologically to progressive MS. Interestingly, both MS and HAM/TSP patients were found to make antibodies to heterogeneous nuclear ribonucleoprotein (hnRNP) A1, an RNA-binding protein overexpressed in neurons. Anti-hnRNP A1 antibodies reduced neuronal firing and caused neurodegeneration in neuronal cell lines, suggesting the autoantibodies are pathogenic. Further, microarray analyses of neurons exposed to anti-hnRNP A1 antibodies revealed novel pathways of neurodegeneration related to alterations of RNA levels of the spinal paraplegia genes (SPGs). Mutations in SPGs cause hereditary spastic paraparesis, genetic disorders clinically indistinguishable from progressive MS and HAM/TSP. Thus, there is a strong association between involvement of SPGs in neurodegeneration and the clinical phenotype of progressive MS and HAM/TSP patients, who commonly develop spastic paraparesis. Taken together, these data begin to clarify mechanisms of neurodegeneration related to the clinical presentation of patients with chronic immune-mediated neurological disease of the central nervous system, which will give insights into the design of novel therapies to treat these neurological diseases.
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Affiliation(s)
- Michael C Levin
- Veterans Administration Medical Center, Memphis, TN, USA,
- Departments of Neurology,
- Neuroscience, University of Tennessee Health Science Center, Memphis, TN, USA,
| | - Sangmin Lee
- Veterans Administration Medical Center, Memphis, TN, USA,
- Departments of Neurology,
| | - Lidia A Gardner
- Veterans Administration Medical Center, Memphis, TN, USA,
- Departments of Neurology,
| | - Yoojin Shin
- Veterans Administration Medical Center, Memphis, TN, USA,
- Departments of Neurology,
| | - Joshua N Douglas
- Veterans Administration Medical Center, Memphis, TN, USA,
- Neuroscience, University of Tennessee Health Science Center, Memphis, TN, USA,
| | - Chassidy J Groover
- Veterans Administration Medical Center, Memphis, TN, USA,
- Departments of Neurology,
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Talledo M, López G, Huyghe JR, Verdonck K, González E, Clark D, Vanham G, Gotuzzo E, Van Camp G, Van Laer L. Possible implication of NFKB1A and NKG2D genes in susceptibility to HTLV-1-associated myelopathy/tropical spastic paraparesis in Peruvian patients infected with HTLV-1. J Med Virol 2012; 84:319-26. [PMID: 22170554 DOI: 10.1002/jmv.22255] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The human T-cell lymphotropic virus type 1 (HTLV-1) is the etiological agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a progressive disease causing paraparesis of the lower limbs. Only a minority of persons infected with HTLV-1 develop HAM/TSP. Universal susceptibility factors for HAM/TSP are not known. The viral genotype is similar in asymptomatic carriers and HAM/TSP patients. High proviral load has been associated consistently with HAM/TSP, but this factor does not explain fully the presence of disease in HTLV-1-infected subjects. Most likely, host genetic factors will play an important role in HAM/TSP development. A two-stage case-control study was carried out to evaluate the association between HAM/TSP and candidate single nucleotide polymorphisms (SNPs) from 45 genes in addition to six human leukocyte antigen (HLA) alleles. Ancestry-informative markers were used to correct for population stratification. Several SNPs belonging to NFKB1A and NKG2D showed a trend of association in both stages. The fact that the direction of the association observed in the first stage was the same in the second stage suggests that NFKB1A and NKG2D may be implicated in the development of HAM/TSP. Further replication studies in independent HTLV-1 patient groups should validate further these associations.
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Affiliation(s)
- Michael Talledo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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31
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Detection of human T-cell lymphotropic virus type 1 in plasma samples. Virus Res 2012; 163:87-90. [DOI: 10.1016/j.virusres.2011.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 08/19/2011] [Accepted: 08/22/2011] [Indexed: 11/23/2022]
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Costa EAS, Magri MC, Caterino-de-Araujo A. The best algorithm to confirm the diagnosis of HTLV-1 and HTLV-2 in at-risk individuals from São Paulo, Brazil. J Virol Methods 2011; 173:280-6. [PMID: 21349293 DOI: 10.1016/j.jviromet.2011.02.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 02/07/2011] [Accepted: 02/15/2011] [Indexed: 10/18/2022]
Abstract
The ability to confirm the diagnosis of human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) in at-risk individuals in São Paulo, Brazil by Western blotting (WB), conventional polymerase chain reaction (tax and pol PCR) and real-time PCR (pol) is compared. Seventy-three blood samples that were reactive in HTLV-1/2 serological screening enzyme immunoassays (EIAs) were evaluated. HTLV-1/2 was confirmed in 53 blood samples: 48 were positive by WB, 41 were positive by PCR and 42 scored positive by real-time PCR assays (37 of 48 WB-positive samples plus five WB-indeterminate samples that were further confirmed by sequencing). Although WB was able to detect more cases of HTLV-1/2 infection, the real-time PCR assay was able to discriminate between these two viruses and confirm an individual HTLV-1/HTLV-2 diagnosis in two HTLV WB-untyped samples and five WB-indeterminate samples. Because of the large number of WB-indeterminate samples and the cost of the WB assay in Brazil, it is proposed an algorithm that employs two EIAs for screening and then real-time PCR to confirm the infection, followed by testing any PCR-negative samples with the WB assay. This strategy reduces costs and improves the accuracy of the diagnosis of HTLV-1/2.
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Affiliation(s)
- Emanuela A S Costa
- Immunology Department, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças da Secretaria de Estado da Saúde de São Paulo, Av. Dr. Arnaldo, 355, 11° andar, 01246-902, São Paulo, SP, Brazil
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33
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Olah I, Fukumori LMI, Smid J, de Oliveira ACP, Duarte AJS, Casseb J. Neither molecular diversity of the envelope, immunosuppression status, nor proviral load causes indeterminate HTLV western blot profiles in samples from human T-cell lymphotropic virus type 2 (HTLV-2)-infected individuals. J Med Virol 2010; 82:837-42. [PMID: 20336719 DOI: 10.1002/jmv.21718] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Although human T-cell lymphotropic virus type 2 (HTLV-2) is considered of low pathogenicity, serological diagnosis is important for counseling and monitoring. The confirmatory tests most used are Western blot (WB) and PCR. However, in high-risk populations, about 50% of the indeterminate WB were HTLV-2 positives by PCR. The insensitivity of the WB might be due to the use of recombinant proteins of strains that do not circulate in our country. Another possibility may be a high level of immunosuppression, which could lead to low production of virus, resulting in low stimulation of antibody. We found one mutation, proline to serine in the envelope region in the position 184, presented at least 1/3 of the samples, independent the indeterminate WB profile. In conclusion, we found no correlation of immune state, HTLV-2 proviral load, or env diversity in the K55 region and WB indeterminate results. We believe that the only WB kit available in the market is probably more accurate to detect HTLV-1 antibodies, and some improvement for HTLV-2 detection should be done in the future, especially among high-risk population.
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Affiliation(s)
- Ingrid Olah
- Laboratory of Dermatology and Immunology, São Paulo University Medical School, Sao Paulo, SP, Brazil
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34
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Campdelacreu J, Capurro S, Pumarola T. Varón de 52 años con inestabilidad de la marcha. Med Clin (Barc) 2010; 134:260-7. [DOI: 10.1016/j.medcli.2009.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2009] [Accepted: 05/15/2009] [Indexed: 10/20/2022]
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35
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Montanheiro PA, Penalva de Oliveira AC, Smid J, Fukumori LMI, Olah I, da S Duarte AJ, Casseb J. The elevated interferon gamma production is an important immunological marker in HAM/TSP pathogenesis. Scand J Immunol 2009; 70:403-7. [PMID: 19751276 DOI: 10.1111/j.1365-3083.2009.02291.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is the agent of the HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), which may occur in >5% of patients during their lifetime. HTLV-1-infection causes disturbances in the immune system, and the viral load may also play an important role in the pathogenesis of HAM/TSP. Some cytokines are involved in the pathogenesis of this disorder. We have determined IL-2, IL-4, IL-10, IL-12 p70, IFN-gamma and TNF-alpha production among HTLV-1-infected subjects from our HTLV-out Clinic in Institute of Infectious 'Emílio Ribas' in Sao Paulo city, Brazil. PBMC obtained from healthy controls (n = 32), asymptomatic HTLV-1 carriers (n = 68) and HAM/TSP patients (n = 44) were grown in the absence and in the presence of phytohaemagglutinin (PHA), and the supernatants' fluids were measured for cytokines production. IL-2 levels were increased in the asymptomatic HTLV-1 carriers, and IFN-gamma was increased in both groups of patients (asymptomatic HTLV-1 carriers and more significantly among HAM/TSP patients). IL-4, IL-10, TNF-alpha and IL-12 p70 levels were not significantly increased on both groups of patients, as compared with controls. The major finding of this study is that IFN-gamma was an important cytokine for the HAM/TSP pathogenesis. Therefore, immune modulation of IFN-gamma may be critical to treat of HAM/TSP patients.
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Affiliation(s)
- P A Montanheiro
- Laboratório de Dermatologia e Imunodedeficiências, LIM-56, Departamento de Dermatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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36
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Development and validation of a multiplex real-time PCR assay for simultaneous genotyping and human T-lymphotropic virus type 1, 2, and 3 proviral load determination. J Clin Microbiol 2009; 47:3682-91. [PMID: 19741085 DOI: 10.1128/jcm.00781-09] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The human T-lymphotropic virus (HTLV) proviral load remains the best surrogate marker for disease progression. Real-time PCR techniques have been developed for detection and quantification of cosmopolitan HTLV type 1a (HTLV-1a) and HTLV-2. Since a growing level of diversity in subtypes and genotypes is observed, we developed a multiplex quantitative PCR for simultaneous detection, genotyping, and quantification of proviral loads of HTLV-1, 2, and 3. Our assay uses tax type-specific primers and dually labeled probes and has a dynamic range of 10(5) to 10 HTLV copies. One hundred sixty-three samples were analyzed, among which all of the different subtypes within each HTLV genotype could be detected. The performance of proviral load determination of our multiplex assay was compared with that of a previously published HTLV-1 singleplex quantitative PCR based on SYBR green detection, developed at a different institute. Linear regression analysis showed a statistically significant (P < 0.0001) and strong (r(2) = 0.87) correlation between proviral load values measured with the two distinct real-time PCR assays. In conclusion, our novel assay offers an accurate molecular diagnosis and genotyping, together with the determination of the proviral load of HTLV-infected individuals, in a single amplification reaction. Moreover, our molecular assay could offer an alternative when current available serological assays are insufficient.
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37
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Ferraz-Chaoui AK, Atta AM, Atta MLS, Galvão-Castro B, Santiago MB. Study of autoantibodies in patients with keratoconjunctivitis sicca infected by the human T cell lymphotropic virus type 1. Rheumatol Int 2009; 30:775-8. [DOI: 10.1007/s00296-009-1066-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Accepted: 07/12/2009] [Indexed: 10/20/2022]
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38
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Maragno L, Casseb J, Fukumori LMI, Sotto MN, Duarte AJDS, Festa-Neto C, Sanches JA. Human T-cell lymphotropic virus type 1 infective dermatitis emerging in adulthood. Int J Dermatol 2009; 48:723-30. [DOI: 10.1111/j.1365-4632.2009.04008.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Croda MG, de Oliveira ACP, Vergara MPP, Bonasser F, Smid J, Duarte AJDS, Casseb J. Corticosteroid therapy in TSP/HAM patients: The results from a 10 years open cohort. J Neurol Sci 2008; 269:133-7. [DOI: 10.1016/j.jns.2008.01.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 01/06/2008] [Accepted: 01/10/2008] [Indexed: 11/29/2022]
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40
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Montanheiro P, Olah I, Fukumori LMI, Smid J, Oliveira ACPD, Kanzaki LIB, Fonseca LAM, Duarte AJS, Casseb J. Low DNA HTLV-2 proviral load among women in São Paulo City. Virus Res 2008; 135:22-5. [PMID: 18343520 DOI: 10.1016/j.virusres.2008.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 01/28/2008] [Accepted: 01/30/2008] [Indexed: 12/01/2022]
Abstract
BACKGROUND HTLV-2 infections are almost always asymptomatic, and diseases associated with the infection are rarely reported. Little information is available on the relationship between HTLV-2 proviral load and gender or expression of disease, especially among patients with HIV-1 co-infection. METHODS We studied 77 HTLV-2-infected subjects followed in our clinic for the last 9 years; 53 (69%) of them were co-infected with HIV-1. HTLV-2 DNA proviral load (PVL) was measured by real time PCR, a test with a sensitivity of 10 in 10(4) PBMCs. RESULTS Six of 53HTLV-2/HIV-1 cases had a myelopathy (all of them had undetectable PVL of HTLV-2). Only 3 of 35 women (2 out of 3 co-infected with HIV) had a detectable PVL, whereas 10 of 42 men had a detectable PVL. Regardless of their HIV status women had significantly lower PVL than men (10 vs. 43 copies/10(4) PBMCs, p<0.05). CONCLUSIONS We noticed the occurrence of myelopathy in HTLV-2/HIV-1 co-infected patients, with undetectable HTLV-2 viral load. There was a sex difference in viral load for HTLV-2, what may be the result in mode of transmission or acquisition of the virus.
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Affiliation(s)
- Patrícia Montanheiro
- Laboratory of Dermatology and Immunology, São Paulo University Medical School, Sao Paulo, Brazil
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41
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Jacob F, Santos-Fortuna E, Azevedo RS, Caterino-de-Araujo A. Serological patterns and temporal trends of HTLV-1/2 infection in high-risk populations attending Public Health Units in São Paulo, Brazil. J Clin Virol 2008; 42:149-55. [PMID: 18346935 DOI: 10.1016/j.jcv.2008.01.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Revised: 01/17/2008] [Accepted: 01/31/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND HTLV-1/2 diagnosis in high-risk populations from São Paulo, Brazil has been problematic due a high proportion of seroindeterminate results. OBJECTIVES To confirm and extend previous findings regarding HTLV-1/2 diagnosis in this geographic area. STUDY DESIGN Sera from 2312 patients were tested for HTLV-1/2 antibodies using enzyme immunoassay (EIA) and Western blot (WB) analysis. Patients were from AIDS Reference Centers (Group I; 1393 patients) and HTLV out-patient clinics (Group II; 919 patients). Results were analyzed according to patients' age, gender, and clinic type. RESULTS HTLV-1 and HTLV-2 were detected in both groups. Among seropositive females, HTLV-2 was slightly more common in Group I (54.5%), while HTLV-1 prevailed in Group II (73.9%). Males from Group II had a higher percentage of HTLV-seroindeterminate results. No correlation between HTLV serological results and age was detected. Temporal analyses disclosed a high number of HTLV-seroindeterminate samples, and a large spectrum of indeterminate WB profiles. GD21 and/or rgp46-II bands were detected in 34.6% of sera from Group I, and a p24 or p19 band was detected in 35.3% of sera from Group II. CONCLUSIONS High rates of HTLV-indeterminate serological patterns during temporal analyses were confirmed in high-risk populations from São Paulo, Brazil.
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Affiliation(s)
- Fabrício Jacob
- Immunology Department, Instituto Adolfo Lutz, Av. Dr. Arnaldo 355, 11 andar, 01246-902 São Paulo, SP, Brazil
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Casseb J, de Oliveira ACP, Vergara MPP, Montanheiro P, Bonasser F, Meilman Ferreira C, Smid J, Duarte AJDS. Presence of tropical spastic paraparesis/human T-cell lymphotropic virus type 1-associated myelopathy (TSP/HAM)-like among HIV-1-infected patients. J Med Virol 2008; 80:392-8. [DOI: 10.1002/jmv.21111] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Tamegão-Lopes BP, Rezende PR, Maradei-Pereira LMC, de Lemos JAR. [HTLV-1 and HTLV-2 proviral load: a simple method using quantitative real-time PCR]. Rev Soc Bras Med Trop 2007; 39:548-52. [PMID: 17308700 DOI: 10.1590/s0037-86822006000600007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2005] [Accepted: 12/04/2006] [Indexed: 11/22/2022] Open
Abstract
When the human T cell lymphotropic virus (HTLV) is integrated with the host cell genome (provirus), its proviral DNA is a replication marker. Proviral load appears to be an important factor in the development of diseases related to these retroviruses. In this study, a methodology for absolute quantification of the HTLV-1 and HTLV-2 proviral load using real-time PCR was developed. Fifty-three blood donor samples with positive ELISA test result were subjected to this methodology, which utilized the TaqMan system for three target sequences: HTLV-1, HTLV-2 and albumin. The absolute proviral load was quantified using the relative ratio between the HTLV genome and the host cell genome, taking into consideration the white blood cell count. The method presented is sensitive (215 copies/ml), practical and simple for proviral quantification, and is efficient and appropriate for confirming and discriminating infections according to viral type.
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Olah I, Fukumori LMI, Montanheiro P, Vergara MP, Smid J, Duarte AJS, Penalva de Oliveira AC, Casseb J. Patterns of In vitro Lymphoproliferative Responses Among HTLV-1-infected Subjects: Upregulation by HTLV-1 During HIV-1 Co-infection. Scand J Immunol 2007; 65:577-80. [PMID: 17523951 DOI: 10.1111/j.1365-3083.2007.01941.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The present study evaluated the in vitro response to different mitogens and a candidin antigen (CMA) in Human T-cell lymphotropic virus type 1 (HTLV-1) and co-infected HIV-1/HTLV-1 patients, to identify if this co-infection may modify the spontaneous lymph proliferative response. Peripheral blood mononuclear cells from 72 healthy seronegative controls, 75 asymptomatic HTLV-1-infected carriers, 42 HAM/TSP cases, 33 solely HIV-1-infected subjects and 24 HIV-1/HTLV-1 patients were assayed in the presence and absence of mitogens (PHA, PWM and OKT3) and CMA. The HAM/TSP group had the highest proliferation rate at 3 and 6 days after culture. HAM/TSP cases showed decreased response to PHA, compared with asymptomatic HTLV-1 subjects, and most important, the co-infected HIV-1/HTLV-1 cases presented a similar response to HTLV-1-infected subjects after 3 days of culture. The singles HIV-1-infected group had decreased in vitro response. It appears that during co-infection, the HTLV-1 regulatory proteins overwhelm the action of HIV-1 regulatory proteins.
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Affiliation(s)
- I Olah
- Laboratory of Allergy and Clinical Immunology - FMUSP, Institute of Infectious Diseases Emilio Ribas, São Paulo, Brazil
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45
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Verdonck K, González E, Van Dooren S, Vandamme AM, Vanham G, Gotuzzo E. Human T-lymphotropic virus 1: recent knowledge about an ancient infection. THE LANCET. INFECTIOUS DISEASES 2007; 7:266-81. [PMID: 17376384 DOI: 10.1016/s1473-3099(07)70081-6] [Citation(s) in RCA: 433] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Human T-lymphotropic virus 1 (HTLV-1) has infected human beings for thousands of years, but knowledge about the infection and its pathogenesis is only recently emerging. The virus can be transmitted from mother to child, through sexual contact, and through contaminated blood products. There are areas in Japan, sub-Saharan Africa, the Caribbean, and South America where more than 1% of the general population is infected. Although the majority of HTLV-1 carriers remain asymptomatic, the virus is associated with severe diseases that can be subdivided into three categories: neoplastic diseases (adult T-cell leukaemia/lymphoma), inflammatory syndromes (HTLV-1-associated myelopathy/tropical spastic paraparesis and uveitis among others), and opportunistic infections (including Strongyloides stercoralis hyperinfection and others). The understanding of the interaction between virus and host response has improved markedly, but there are still no clear surrogate markers for prognosis and there are few treatment options.
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Affiliation(s)
- Kristien Verdonck
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Adaui V, Verdonck K, Best I, González E, Tipismana M, Arévalo J, Vanham G, Campos M, Zimic M, Gotuzzo E. SYBR Green-based quantitation of human T-lymphotropic virus type 1 proviral load in Peruvian patients with neurological disease and asymptomatic carriers: influence of clinical status, sex, and familial relatedness. J Neurovirol 2007; 12:456-65. [PMID: 17162661 DOI: 10.1080/13550280601039634] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
To evaluate the human T-lymphotropic virus type 1 (HTLV-1) proviral DNA load in patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and asymptomatic HTLV-1 carriers, a SYBR Green-based real-time quantitative polymerase chain reaction (qPCR) assay was developed. HTLV-1 proviral DNA in peripheral blood mononuclear cells (PBMCs) was quantified using primers targeting the pX region and the HTLV-1 copy number normalized to the amount of ERV-3 (Endogenous Retrovirus 3) cellular DNA. Thirty-three asymptomatic HTLV-1 carriers (ACs) and 39 patients with HAM/TSP were enrolled. Some participants were relatives of HAM/TSP cases (16 ACs and 7 patients with HAM/TSP). On multiple linear regression analysis, the authors found a significant association between clinical status and HTLV-1 proviral load (P < .01), but only among women. ACs showed a median proviral load of 561 copies per 104 PBMCs (interquartile range: 251-1623). In HAM/TSP patients, the median proviral load was 1783 (1385-2914). ACs related to HAM/TSP patients presented a relatively high proviral load (median 1152); however, the association between relatedness to a HAM/TSP patient and proviral load was not significant (P = .1). In HAM/TSP patients, no association was found between proviral load and disease duration, progression or severity. The fact that the effect of HAM/TSP upon the HTLV-1 proviral load differed between sexes and the finding of a high proviral load among asymptomatic relatives of HAM/TSP patients suggest that not yet identified genetic or environmental factors influence the pathogenesis of HTLV-1 infection.
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Affiliation(s)
- Vanessa Adaui
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Abstract
The employment of polymerase chain reaction (PCR) techniques for virus detection and quantification offers the advantages of high sensitivity and reproducibility, combined with an extremely broad dynamic range. A number of qualitative and quantitative PCR virus assays have been described, but commercial PCR kits are available for quantitative analysis of a limited number of clinically important viruses only. In addition to permitting the assessment of viral load at a given time point, quantitative PCR tests offer the possibility of determining the dynamics of virus proliferation, monitoring of the response to treatment and, in viruses displaying persistence in defined cell types, distinction between latent and active infection. Moreover, from a technical point of view, the employment of sequential quantitative PCR assays in virus monitoring helps identifying false positive results caused by inadvertent contamination of samples with traces of viral nucleic acids or PCR products. In this review, we provide a survey of the current state-of-the-art in the application of the real-time PCR technology to virus analysis. Advantages and limitations of the RQ-PCR methodology, and quality control issues related to standardization and validation of diagnostic assays are discussed.
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Affiliation(s)
| | | | - T. Lion
- Corresponding author. Tel.: +43 1 40470 489; fax: +43 1 40470 437.
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