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Silva IC, Pinheiro BT, Nobre AFS, Coelho JL, Pereira CCC, Ferreira LDSC, Almeida CPSD, Viana MDNDSDA, Almeida DSD, Falcão JR, Santos YCVD, Araújo MWLD, Borges MDS, Nascimento LD, Valentim LS, Casseb JSDR, Costa CAD, Sousa MSD. Moderate endemicity of the human T-lymphotropic virus infection in the metropolitan region of Belém, Pará, Brazil. Rev Bras Epidemiol 2018; 21:e180018. [PMID: 30328937 DOI: 10.1590/1980-549720180018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 08/14/2017] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The spread of the HTLV infection in families living in the metropolitan area of Belém, Pará, Brazil, and the lack of studies in the general population requires studies to better understand its prevalence in the region. METHODS An anti-HTLV-1/HTLV-2 antibodies test was carried out on random adults in public places in Belém between November 2014 and November 2015. A proviral DNA test detected if the person was infected, and then a clinical evaluation and an intrafamilial investigation were carried out. RESULTS Of the 1059 individuals being investigated, 21 (2.0%) had seroreagent samples, 15 (1.4%) had HTLV-1, 5 (0.5%) had HTLV-2, and proviral DNA was undetectable in one case. The mean age of the infected people (57.2) was higher than that of those that were uninfected (46.2) (p = 0.0010). The prevalence of infection increased with age, especially in individuals with a family income equal to or less than a minimum wage. Intrafamilial transmission seems to have occurred in all of the families being studied. Among the patients with HTLV-1, 30% (3/10) already had some symptom related to the infection. DISCUSSION The increase in prevalence rates according to age may be due to late seroconversion of a previously acquired infection, or the cumulative risk of new infections, especially in women. CONCLUSION There was a moderate prevalence of the HTLV infection among adult individuals from the metropolitan area of Belém, with a predominance of HTLV-1. This infection was associated with low income and increasingly older women. It also presented intrafamily spread and negligence in the diagnosis of associated diseases.
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Affiliation(s)
- Ingrid Christiane Silva
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Bruna Teles Pinheiro
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Akim Felipe Santos Nobre
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Jaciana Lima Coelho
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Cássia Cristine Costa Pereira
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Louise de Souza Canto Ferreira
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Camila Pâmela Santos de Almeida
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | | | - Danilo Souza de Almeida
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Jairo Ribeiro Falcão
- Mestrado Profissionalizante em Análises Clínicas, Instituto de Ciências Biológicas, Universidade Federal do Pará - Belém (PA), Brasil
| | | | | | - Mariza da Silva Borges
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Lisandra Duarte Nascimento
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | - Lorena Saldanha Valentim
- Faculdade de Farmácia, Instituto de Ciências da Saúde, Universidade Federal do Pará - Belém (PA), Brasil
| | | | - Carlos Araújo da Costa
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
| | - Maísa Silva de Sousa
- Programa de Pós-Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará - Belém (PA), Brasil
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Socorro de Almeida Viana MDND, Santos Nobre AF, Costa Jr E, Silva IC, Pinheiro BT, Pereira CCC, de Souza Canto Ferreira L, de Almeida DS, de Araújo MWL, da Silva Borges M, da Costa CA, Ishikawa EAY, Ferrari SF, Silva de Sousa M. Stability of the HTLV-1 glycoprotein 46 (gp46) gene in an endemic region of the Brazilian Amazon and the presence of a significant mutation (N93D) in symptomatic patients. Virol J 2018; 15:80. [PMID: 29716616 PMCID: PMC5930498 DOI: 10.1186/s12985-018-0984-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 04/12/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The human T-lymphotropic virus type 1 (HTLV-1) affects 2-5 million people worldwide, and is associated with a number of degenerative and infectious diseases. The Envelope glycoproteins (gp) are highly conserved among the different HTLV-1 isolates, although nucleotide substitutions in the region that codifies these proteins may influence both the infectivity and the replication of the virus. The gp46 gene has functional domains which have been associated with the inhibition of the formation of the syncytium, cell-cell transmission, and the production of antibodies. The present study investigated the genetic stability of the gp46 gene of HTLV-1 in an endemic region of Brazilian Amazonia. METHODS Index case (IC - a sample of a given family group) carriers of HTLV-1 were investigated in the metropolitan region of Belém (Pará, Brazil) between January 2010 (registered retrospectively) and December 2015. The sequences that codify the gp46 were amplified by PCR, purified and sequenced (MF084788-MF084825). The gene was characterized using bioinformatics and Bayesian Inference. RESULTS The 40 patients analyzed had a mean age of 45.2 years and 70% presented some type of symptom, with a predominance of pain and sensitivity, dysautonomia, and motor disorders. All patients presented the aA (Transcontinental Cosmopolitan) genotype, with an extremely low mutation rate, which is characteristic of the codifying region (aA - 1.83 × 10-4 mutations per site per year). The gp46 gene had a nucleotide diversity of between 0.00% and 2.0%. Amino acid mutations were present in 66.6% of the samples of individuals with signs/symptoms or diseases associated with HTLV-1 (p = 0.0091). Of the three most frequent mutations, the previously undescribed N93D mutant was invariably associated with symptomatic cases. CONCLUSIONS The aA HTLV-1 subtype is predominant in the metropolitan region of Belém and presented a high degree of genetic stability in the codifying region. The rare N93D amino acid mutation may be associated with the clinical manifestations of this viral infection. IMPORTANCE Little is known of the phylogeny of HTLV-1 in the endemic region of Brazilian Amazonia, and few complete gene sequences are available for the gp46 glycoprotein from the local population. The nucleotide sequences of the viral gp46 gene recorded in the present study confirmed the genetic stability of the region, and pointed to a homogeneous viral group, with local geographic characteristics. Further research will be necessary to more fully understand the molecular diversity of this protein, given the potential of this codifying region as a model for an effective HTLV-1 vaccine. The identification of a rare mutation (N93D), present only in symptomatic patients, should also be investigated further as a potential clinical marker. TRIAL REGISTRATION ISRCTN 12345678, registered 28 September 2014.
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Affiliation(s)
| | - Akim Felipe Santos Nobre
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Edivaldo Costa Jr
- Virology Section, Instituto Evandro Chagas, Health Surveillance Secretariat, Brazilian Ministry of Health, Ananindeua, Pará Brazil
| | - Ingrid Christiane Silva
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Bruna Teles Pinheiro
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Cássia Cristine Costa Pereira
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Louise de Souza Canto Ferreira
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Danilo Souza de Almeida
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | | | | | - Carlos Araujo da Costa
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | - Edna Aoba Yassui Ishikawa
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
| | | | - Maísa Silva de Sousa
- Postgraduate Program in Tropical Diseases, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará Brazil
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Barbosa SFDC, Costa CAD, Ferreira LDSC, Almeida DDS, Azevedo TCDB, Lemos JARD, Sousa MSD. Aspectos epidemiológicos dos casos de leucemia e linfomas em jovens e adultos atendidos em hospital de referência para câncer em Belém, Estado do Pará, Amazônia, Brasil. ACTA ACUST UNITED AC 2015. [DOI: 10.5123/s2176-62232015000300006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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da Costa CA, Furtado KCYO, Ferreira LDSC, Almeida DDS, Linhares ADC, Ishak R, Vallinoto ACR, de Lemos JAR, Martins LC, Ishikawa EAY, de Sousa RCM, de Sousa MS. Familial transmission of human T-cell lymphotrophic virus: silent dissemination of an emerging but neglected infection. PLoS Negl Trop Dis 2013; 7:e2272. [PMID: 23785534 PMCID: PMC3681619 DOI: 10.1371/journal.pntd.0002272] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 04/29/2013] [Indexed: 11/23/2022] Open
Abstract
Background HTLV-1 is a retrovirus that causes lymphoproliferative disorders and inflammatory and degenerative diseases of the central nervous system in humans. The prevalence of this infection is high in parts of Brazil and there is a general lack of public health care programs. As a consequence, official data on the transmission routes of this virus are scarce. Objective To demonstrate familial aggregation of HTLV infections in the metropolitan region of Belém, Pará, Brazil. Method A cross-sectional study involving 85 HTLV carriers treated at an outpatient clinic and other family members. The subjects were tested by ELISA and molecular methods between February 2007 and December 2010. Results The prevalence of HTLV was 43.5% (37/85) for families and 25.6% (58/227) for the family members tested (95% CI: 1.33 to 3.79, P = 0.0033). Sexual and vertical transmission was likely in 38.3% (23/60) and 20.4% (29/142) of pairs, respectively (95% CI: 1.25 to 4.69, P = 0.0130). Positivity was 51.3% (20/39) and 14.3% (3/21) in wives and husbands, respectively (95% CI: 0.04 to 0.63, P = 0.0057). By age group, seropositivity was 8.0% (7/88) in subjects <30 years of age and 36.7% (51/139) in those of over 30 years (95% CI: 0.06 to 0.34, P<0.0001). Positivity was 24.1% (7/29) in the children of patients infected with HTLV-2, as against only 5.8% (4/69) of those infected with HTLV-1 (95% CI: 0.05 to 0.72, P = 0.0143). Conclusion The results of this study indicate the existence of familial aggregations of HTLV characterized by a higher prevalence of infection among wives and subjects older than 30 years. Horizontal transmission between spouses was more frequent than vertical transmission. The higher rate of infection in children of HTLV-2 carriers suggests an increase in the prevalence of this virus type in the metropolitan region of Belém. Human T-cell lymphotropic virus (HTLV) has a slow replication rate and infection is characterized by low morbidity and mortality, as well as silent transmission within the population. While rare, HTLV-associated diseases are usually debilitating and life-threatening. The virus is endemic in the state of Pará (Brazil), although there have been no studies of the distribution of the virus within the local population. The results of the present study confirm the existence of familial aggregations of HTLV infection in the metropolitan region of the state capital, Belém. Considerably higher rates of sexual transmission of HTLV from men to women were also demonstrated. Rates of infection were similar for the two virus types, although HTLV-2 appears to be increasing in the population. The frequency of positivity among family members increased in direct proportion to age and was associated with a relatively large proportion of asymptomatic carriers. In addition, widespread ignorance of the virus increases the risk of transmission. The available evidence indicates that significant human suffering is caused by this virus in patients suffering complications, and this is little justification for the lack of intervention on the part of public health authorities, which might impede the ongoing proliferation of this infection in the population.
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Affiliation(s)
| | | | | | | | | | - Ricardo Ishak
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | | | | | | | | | - Rita Catarina Medeiros de Sousa
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
- Section of Virology, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil
| | - Maísa Silva de Sousa
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
- Section of Virology, Instituto Evandro Chagas, Ministério da Saúde, Ananindeua, Pará, Brazil
- * E-mail:
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Furtado KCYO, Costa CAD, Ferreira LDSC, Martins LC, Linhares ADC, Ishikawa EAY, Batista EDJO, Sousa MSD. Occurrence of strongyloidiasis among patients with HTLV-1/2 seen at the outpatient clinic of the Núcleo de Medicina Tropical, Belém, State of Pará, Brazil. Rev Soc Bras Med Trop 2013; 46:241-3. [DOI: 10.1590/0037-8682-981-2013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 01/12/2012] [Indexed: 11/22/2022] Open
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