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de Aquino Firmino A, Filho PRTG, Martins ALL, Araújo TH, Gois LL, da Silva Batista E, Araújo JPL, Galvão-Castro B, Grassi MFR. HTLV-1 Proviral Load in Vaginal Fluid Correlates with Levels in Peripheral Blood Mononuclear Cells. Pathogens 2023; 12:pathogens12050682. [PMID: 37242352 DOI: 10.3390/pathogens12050682] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The prevalence of human T-lymphotropic virus type-1 (HTLV-1) infection is higher in women, and sexual intercourse has been described as an important route of male-to-female transmission. The present study aimed to quantify HTLV-1 proviral load (PVL) in vaginal fluid, and to investigate correlations with PVL in peripheral blood mononuclear cells (PBMCs). In addition, cytopathological alterations and vaginal microbiota were evaluated. METHODS HTLV-1-infected women were consecutively recruited at a multidisciplinary center for HTLV patients in Salvador, Brazil. All women underwent gynecological examinations to obtain cervicovaginal fluid and venipuncture for blood collection. PVL, as measured by real-time quantitative polymerase chain reaction (RT-qPCR), was expressed as the number of copies of HTLV-1/106 cells in blood and vaginal fluid samples. Light microscopy was used to assess cervicovaginal cytopathology and vaginal microbiota. RESULTS In the 56 included women (43 asymptomatic carriers and 13 diagnosed with HTLV-1-associated myelopathy/tropical spastic paraparesis-HAM/TSP), mean age was 35.9 (SD ± 7.2) years. PVL was higher in PBMCs (median: 23,264 copies/106 cells; IQR: 6776-60,036) than in vaginal fluid (451.9 copies/106 cells; IQR: 0-2490) (p < 0.0001). PVL in PBMCs was observed to correlate directly with PVL in vaginal fluid (R = 0.37, p = 0.006). PVL was detected in the vaginal fluid of 24 of 43 (55.8%) asymptomatic women compared to 12 of 13 (92.3%) HAM/TSP patients, p = 0.02. Cytopathologic analyses revealed no differences between women with detectable or undetectable PVL. CONCLUSION HTLV-1 proviral load is detectable in vaginal fluid and correlates directly with proviral load in peripheral blood. This finding suggests that sexual transmission of HTLV-1 from females to males may occur, as well as vertical transmission, particularly in the context of vaginal delivery.
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Affiliation(s)
- Alisson de Aquino Firmino
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Paulo Roberto Tavares Gomes Filho
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Adenilda Lima Lopes Martins
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Department of Health (DSAU), State University of Feira de Santana (UEFS), Feira de Santana 44036-900, Bahia, Brazil
| | - Thessika Hialla Araújo
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Luana Leandro Gois
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Department of Biointeraction Sciences, Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador 40110-902, Bahia, Brazil
| | - Everton da Silva Batista
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Jean Paulo Lacerda Araújo
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
| | - Bernardo Galvão-Castro
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Advanced Laboratory of Public Health (LASP), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador 40296-710, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil
- Advanced Laboratory of Public Health (LASP), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador 40296-710, Bahia, Brazil
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Rosadas C, Menezes MLB, Galvão-Castro B, Assone T, Miranda AE, Aragón MG, Caterino-de-Araujo A, Taylor GP, Ishak R. Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies. PLoS Negl Trop Dis 2021; 15:e0009717. [PMID: 34555019 PMCID: PMC8460035 DOI: 10.1371/journal.pntd.0009717] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human T-cell lymphotropic viruses 1 and 2 (HTLV-1/2) are relatively common in Brazil but remain silent and neglected infections. HTLV-1 is associated with a range of diseases with high morbidity and mortality. There is no curative treatment for this lifelong infection, so measures to prevent transmission are essential. This narrative review discusses HTLV-1/2 transmission routes and measures to prevent its continuous dissemination. The public health policies that are currently implemented in Brazil to avoid HTLV-1/2 transmission are addressed, and further strategies are proposed.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Maria Luiza B. Menezes
- Departamento Materno-Infantil, Faculdade de Ciências Médicas, Universidade de Pernambuco, Pernambuco, Brazil
| | - Bernardo Galvão-Castro
- Centro Integrativo e Muldisciplinar de Atendimento ao Portador de HTLV (CHTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Tatiane Assone
- Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | - Angélica E. Miranda
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | - Mayra G. Aragón
- Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
| | | | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Pará, Brazil
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