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Ramesh N, Cockbain B, Taylor GP, Rosadas C. How do socioeconomic determinants of health affect the likelihood of living with HTLV-1 globally? A systematic review with meta-analysis. Front Public Health 2024; 12:1298308. [PMID: 38327581 PMCID: PMC10848500 DOI: 10.3389/fpubh.2024.1298308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Human T Lymphotropic Virus type 1 (HTLV-1) is a neglected retrovirus associated with many clinical disorders, most notably Adult T-cell Leukemia/Lymphoma and HTLV-1-Associated Myelopathy (HAM). Found in endemic clusters across the world, high prevalence has been reported in minoritized groups who suffer from health inequities. This study investigates the association between HTLV-1 prevalence and the following socioeconomic determinants of health: education, income, and employment, which are markers of health inequity. Methods A systematic review was conducted by searching the following databases: Ovid/Medline, Embase, Global Health Database, Web of Science, LILACS and SciELO. Primary studies in English, Spanish and Portuguese mentioning HTLV-1 and one of education, income and/or employment were included. A random-effects meta-analysis was performed, and odds ratios (OR) were calculated to determine the association between these socioeconomic determinants of health and HTLV-1 prevalence. Results 42 studies were included. The likelihood of having HTLV-1 was higher in individuals with less than completed primary education compared to those who completed primary education (OR 1.86 [95% CI 1.34-2.57]; p < 0.01). This may be because individuals with low education have reduced access to and understanding of health information, thus increasing the prevalence of risk factors associated with HTLV-1 infection. No other determinants were found to be statistically significant. Conclusion Fewer years of schooling are associated with increased likelihood of contracting HTLV-1. Therefore, health promotion materials and public health policies regarding HTLV-1 must consider those with lower educational levels to effectively reduce disease transmission. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=335004, identifier (CRD42022335004).
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Affiliation(s)
- Nydile Ramesh
- School of Public Health, Imperial College London, London, United Kingdom
| | - Beatrice Cockbain
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
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Cockbain B, Rosadas C, Taylor GP. HTLV-1 as a contributing factor towards scabies and its systemic sequelae. J Glob Health 2023; 13:03057. [PMID: 37921043 PMCID: PMC10623376 DOI: 10.7189/jogh.13.03057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Affiliation(s)
- Beatrice Cockbain
- Department of Infectious Disease, Imperial College London, London, England, UK
- Chelsea and Westminster NHS Foundation Trust, London, England, UK
| | - Carolina Rosadas
- Department of Infectious Disease, Imperial College London, London, England, UK
| | - Graham P Taylor
- Department of Infectious Disease, Imperial College London, London, England, UK
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, England, UK
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Abreu IN, Lima CNC, Sacuena ERP, Lopes FT, da Silva Torres MK, dos Santos BC, de Oliveira Freitas V, de Figueiredo LGCP, Pereira KAS, de Lima ACR, Brito WRDS, Botelho BJS, Gonçalves JSS, Lima SS, Vallinoto IMVC, Guerreiro JF, Ishak R, Vallinoto ACR. HTLV-1/2 in Indigenous Peoples of the Brazilian Amazon: Seroprevalence, Molecular Characterization and Sociobehavioral Factors Related to Risk of Infection. Viruses 2022; 15:22. [PMID: 36680063 PMCID: PMC9861695 DOI: 10.3390/v15010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
HTLV-1/2 infection is endemic in Indigenous peoples of the Americas. Its origin is attributed to the migratory flow of Amerindian ancestral peoples. The present study aimed to investigate the seroprevalence of HTLV-1/2 infection in Indigenous peoples of the Brazilian Amazon. A total of 3350 Indigenous people belonging to 15 communities were investigated. The investigation was performed using serological (ELISA), molecular (qPCR) and confirmatory (Western blot and/or Inno-Lia) tests to detect and differentiate the infection. The seroprevalence was 8.3% for HTLV-1/2 infection, with 0.1% of individuals seropositive for HTLV-1 and 8.1% for HTLV-2. The prevalence of infection was statistically higher in women (10.1%) than in men (6.5%) (p = 0.0002). This female predominance was observed in all age groups; in females the prevalence was significant from 41 years old (p < 0.0001) and in males from 51 years old (p < 0.0001). Here, we present a prevalence of HTLV-1/2 among Indigenous peoples of the Brazilian Amazon. The endemic infection in these groups must reflect the different epidemiological profiles observed in these peoples, such as sexual transmission through rejection of condom use, breastfeeding, especially in cases of cross-breastfeeding, and the high rate of pregnancy in the villages.
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Affiliation(s)
- Isabella Nogueira Abreu
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Carlos Neandro Cordeiro Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | | | - Felipe Teixeira Lopes
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Maria Karoliny da Silva Torres
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | | | | | | | - Keise Adrielle Santos Pereira
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Aline Cecy Rocha de Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Wandrey Roberto dos Santos Brito
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | | | - Janete Silvana Souza Gonçalves
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Sandra Souza Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Izaura Maria Vieira Cayres Vallinoto
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - João Farias Guerreiro
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Ricardo Ishak
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075-110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil
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Clinical and Public Health Implications of Human T-Lymphotropic Virus Type 1 Infection. Clin Microbiol Rev 2022; 35:e0007821. [PMID: 35195446 PMCID: PMC8941934 DOI: 10.1128/cmr.00078-21] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is estimated to affect 5 to 10 million people globally and can cause severe and potentially fatal disease, including adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The burden of HTLV-1 infection appears to be geographically concentrated, with high prevalence in discrete regions and populations. While most high-income countries have introduced HTLV-1 screening of blood donations, few other public health measures have been implemented to prevent infection or its consequences. Recent advocacy from concerned researchers, clinicians, and community members has emphasized the potential for improved prevention and management of HTLV-1 infection. Despite all that has been learned in the 4 decades following the discovery of HTLV-1, gaps in knowledge across clinical and public health aspects persist, impeding optimal control and prevention, as well as the development of policies and guidelines. Awareness of HTLV-1 among health care providers, communities, and affected individuals remains limited, even in countries of endemicity. This review provides a comprehensive overview on HTLV-1 epidemiology and on clinical and public health and highlights key areas for further research and collaboration to advance the health of people with and at risk of HTLV-1 infection.
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Miranda C, Utsch-Gonçalves D, Piassi FCC, Loureiro P, Gomes I, Ribeiro MA, de Almeida-Neto C, Blatyta P, Amorim L, Garcia Mateos SO, Murphy EL, Custer B, Carneiro-Proietti ABF, Sabino EC. Prevalence and Risk Factors for Human T-Cell Lymphotropic Virus (HTLV) in Blood Donors in Brazil-A 10-Year Study (2007-2016). Front Med (Lausanne) 2022; 9:844265. [PMID: 35355612 PMCID: PMC8959844 DOI: 10.3389/fmed.2022.844265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/10/2022] [Indexed: 12/12/2022] Open
Abstract
It is unknown whether HTLV-1/2 prevalence has been stable or changing with time in Brazil. We present a 10-year (2007–2016) analysis of HTLV-1/2 infection in first-time blood donors from four blood banks in Brazil. The Brazilian blood centers participating in this multicenter Recipient Epidemiology and Donor Evaluation Study (REDS) are located in Recife in the Northeast and in São Paulo, Rio de Janeiro and Belo Horizonte located in the Southeast of the country. A previous REDS study using the same database from 2007 to 2009 showed that the prevalence per 100,000 donors was 222 in Recife, 83 in Belo Horizonte and 101 in São Paulo. From 2007 to 2016, HTLV-1/2 prevalence was calculated by year, blood center and birth cohort. Covariates included age, gender, schooling, self-reported skin color and type of donation. From 1,092,174 first-blood donations, in the general analysis, HTLV-1/2 infection predominated in females, donors over 50 years of age, black skin color and less educated. The average prevalence was 228 per 100,000 donors in Recife, 222 in Rio de Janeiro, 104 in Belo Horizonte and 103 in São Paulo. In the 10-year analysis, HTLV-1/2 prevalence was stable, but a trend was observed toward an increase in HTLV-1/2 infection among younger people (p < 0.001), males (p = 0.049), those with white skin color (p < 0.001), and higher education (p = 0.014). Therefore, this 10-year surveillance of the infection showed stable HTLV-1/2 prevalence overall but a trend toward increased prevalence among the younger and more educated donors despite Brazilian policies to control sexually transmitted infections being in place for more than 10 years.
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Affiliation(s)
- Carolina Miranda
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise Utsch-Gonçalves
- Programa de Pós-Graduação em Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabiana Chagas Camargos Piassi
- Departamento de Propedêutica Complementar, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Paula Loureiro
- Fundação Hemope, Recife, Brazil.,Department of Clinical Medicine, Universidade de Pernambuco, Recife, Brazil
| | - Isabel Gomes
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Paula Blatyta
- Fundação Pró-Sangue, Hemocentro de São Paulo, São Paulo, Brazil
| | - Luiz Amorim
- Fundação Hemorio, Hemocentro do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Edward L Murphy
- Department of Laboratory Medicine, Vitalant Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Brian Custer
- Department of Laboratory Medicine, Vitalant Research Institute, San Francisco, CA, United States.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | | | - Ester C Sabino
- Faculdade de Medicina da Universidade de São Paulo, Instituto de Medicina Tropical, São Paulo, Brazil
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Martel M, Gotuzzo E. HTLV-1 Is Also a Sexually Transmitted Infection. Front Public Health 2022; 10:840295. [PMID: 35433594 PMCID: PMC9008201 DOI: 10.3389/fpubh.2022.840295] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
HTLV-1 is a retrovirus which causes diverse diseases in 10% of its infected population, significantly worsening their quality of life and mortality rate. Even though it is globally distributed and is endemic in many countries (including Peru), it is still highly neglected. It spreads through vertical, sexual and parenteral transmission. As no effective treatment against this virus exist, prevention is required to contain it. The World Health Organization published a technical report on the matter in 2021, with the collaboration of international HTLV-1 experts. However, neither the impact of sexual transmission (cause of the majority of adult cases and infection in non-endemic areas) nor its prevention were considered. Evidence is presented, which shows the magnitude of sexual transmission, its risk factors and preventive measures; hoping it will encourage health workers to help eradicate this infection.
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Affiliation(s)
- Mariana Martel
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Alexander von Humboldt Institute of Tropical Medicine, Cayetano Heredia National Hospital, Lima, Peru
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James IC, Mejía-Mertel J, Gil Artunduaga MA, Rojas-Hernández JP. Case Series: Pediatric Human T-Lymphotropic Virus Type 1 and Its Clinical Expression. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.824067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PurposeHuman T-lymphotropic Virus type 1 (HTLV-1) was the first retrovirus to be identified and associated with oncogenic activity. It is estimated that approximately 10–20 million people in the world are infected with it. The clinical manifestations most commonly associated with HTLV-1 infection include T-cell leukemia/lymphoma and myelopathy associated to HTLV-1 infection. The purpose of this study is to describe clinical and demographic characteristics in pediatric patients with HTLV-1 infection.Methodology and PatientsAmbispective case series analysis, with collection of medical records and subsequent description of demographic data (sex, origin, age) and clinical characteristics in 16 patients with HTLV-1 infection were collected. Twelve of these patients were part of an initially reported cohort and four were recruited later in the study. The patients were collected between January 2017 and July 2021 in a pediatric institution in Cali, in a reference hospital in the southwest region of Colombia.ResultsThirteen of a total of sixteen patients came from the Colombian Pacific coast, where nine were with significant nutritional deficiencies. Seven showed dermatological compromise. Eight patients presented images compatible with inflammation and chronic lung injury, and six of the eight patients were with opportunistic infections. Coinfection with other microorganisms was also observed where one case presented with meningeal tuberculosis, another patient presented with simultaneous infections, namely, malaria, leptospirosis and toxoplasmosis, and a third patient presented intestinal parasitosis and soft tissue infection by Streptococcus pyogenes. Three patients had concomitant autoimmune diseases and a fourth patient was highly suspicious of having polymyositis.ConclusionsThe different clinical findings with simultaneous HTLV-1 infection broaden the panorama to suspect infection by this virus. More studies are required to achieve a direct association between structural lung disease, autoimmune diseases, immunodeficiency and HTLV-1 infection. This study aims to raise interest and awareness of an ancient but neglected disease.
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Rosadas C, Taylor GP. HTLV-1 and Co-infections. Front Med (Lausanne) 2022; 9:812016. [PMID: 35187000 PMCID: PMC8850362 DOI: 10.3389/fmed.2022.812016] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023] Open
Abstract
Human T lymphotropic virus type 1 (HTLV-1) is a retrovirus that causes lifelong T-cell infection in humans, impacting the host immune response. This virus causes a range of clinical manifestations, from inflammatory conditions, including neuronal damage (HTLV-1 associated myelopathy, HAM) to life-threatening leukemia (adult T-cell leukemia, ATL). Human T lymphotropic virus type 1 is also associated with increased risk of all-cause mortality, but the mechanisms remain unclear. As a blood-borne and sexually transmitted infection (STI), HTLV-1 shares transmission routes to many other pathogens and although it has worldwide distribution, it affects mainly those in low- and middle-income tropical areas, where the prevalence of other infectious agents is high. These factors contribute to a high incidence of co-infections in people living with HTLV-1 (PLHTLV). This comprehensive review addresses the impact of HTLV-1 on several co-infections and vice-versa. There is evidence of higher rates of HTLV-1 infection in association with other blood borne (HCV, HBV) and sexually transmitted (Syphilis, Chlamydia, HPV, HSV) infections but whether this represents increased susceptibility or opportunity is unclear. Higher frequency of Mycobacterium tuberculosis (MTb) and Mycobacterium leprae (M. leprae) is observed in PLHTLV. Reports of opportunistic infections and high frequency of crusted scabies in patients with HTLV-1 points to immune impairment in those individuals. Human T lymphotropic virus type 1 may influence the persistence of pathogens, exemplified by the higher rates of Schistosoma mansoni and Strongyloides stercoralis (St. stercoralis) treatment failure observed in PLHTLV. This retrovirus is also associated with increased tuberculosis (TB) severity with some evidence pointing to a deleterious impact on leprosy outcome as well. These findings are supported by immune alterations observed in those co-infected individuals. Although the role of HTLV-1 in HCV outcome is debatable, most data indicate that HTLV may negatively impact the clinical course of hepatitis C. Co-infections may also influence the risk of developing HTLV-1 associated disease, but data are still limited. The impact of HTLV-1 on the response to more common infections, might contribute to the increased mortality rate of HTLV-1. Large scale prospective controlled studies on the prevalence and impact of HTLV-1 in co-infections and vice-versa are needed. Human T lymphotropic virus type 1 impact in public health is broad. Measures to increase awareness and to prevent new infections are needed.
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Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
- National Centre for Human Retrovirology, Division of Medicine and Integrated Care, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- *Correspondence: Graham P. Taylor
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Einsiedel L, Pham H, Talukder MR, Taylor K, Wilson K, Kaldor J, Gessain A, Woodman R. Very high prevalence of infection with the human T cell leukaemia virus type 1c in remote Australian Aboriginal communities: Results of a large cross-sectional community survey. PLoS Negl Trop Dis 2021; 15:e0009915. [PMID: 34879069 PMCID: PMC8654171 DOI: 10.1371/journal.pntd.0009915] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
Infection with the human T cell leukaemia virus type 1 (HTLV-1) subtype C is endemic among Aboriginal people in central Australia. To provide insights into the risk factors for transmission, we conducted the first large-scale, community-based prevalence study in seven remote Aboriginal communities. Residents >2 years old were invited to participate in the study between August 2014 and June 2018. HTLV-1 infection was defined as a positive western blot (WB) test or a positive HTLV-1 PCR. 720 community residents participated in the study (children <15 years, 142; adults, 578). Prevalences for children and adults were 3.5% (5/142) and 36.8% (213/578), respectively, reaching 49.3% (106/215) for those older than 45 years. A wide range of proviral loads were measured for both asymptomatic and symptomatic participants with no difference within groups according to age or gender; however, median PVL was 1.34 log10 higher for symptomatic participants. The adult prevalence of HTLV-1 infection in central Australia is the highest reported worldwide. Sexual contact is likely to be the predominant mode of transmission.
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Affiliation(s)
- Lloyd Einsiedel
- Baker Heart and Diabetes Institute, Alice Springs, Northern Territory, Australia
- * E-mail:
| | - Hai Pham
- Baker Heart and Diabetes Institute, Alice Springs, Northern Territory, Australia
| | | | - Kerry Taylor
- Poche Centre for Indigenous Health and Wellbeing, Alice Springs, Northern Territory, Australia
| | - Kim Wilson
- National Serology Reference Laboratory, Melbourne, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
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Screening for Human T-Cell Lymphotropic Virus (HTLV) in Pregnant Women in the Peruvian Amazon and Systematic Review with Meta-Analysis of HTLV Infection in Peru. Pathogens 2021; 10:pathogens10030260. [PMID: 33668710 PMCID: PMC7996293 DOI: 10.3390/pathogens10030260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/19/2021] [Indexed: 01/13/2023] Open
Abstract
Background. Human T-cell lymphotropic virus type 1 (HTLV-1) is responsible for tropical spastic paraparesis and HTLV-1-associated leukemia/lymphoma. The infection is endemic in some areas of Peru, but its prevalence in the Peruvian Amazon is not well established. We aimed to assess the seroprevalence of HTLV-1 infection in pregnant women in the Peruvian Amazon. Moreover, we performed a systematic literature review and meta-analysis of the seroprevalence of HTLV infection in Peru. (2) Methods. This is a prospective cross-sectional study involving pregnant women attending health centers in the city of Iquitos, Peru, in May and June 2019. The presence of antibodies against HTLV-1 was assessed using ELISA (HTLV I + II ELISA recombinant v.4.0, Wiener lab, Rosario, Argentina). Positive cases were confirmed by Western Blot and HTLV-1 proviral load. (3) Results. The study included 300 pregnant women with a mean age of 26 years (standard deviation [SD] 6.4). Five patients were diagnosed with HTLV-1 infection (prevalence 1.7%, 95% confidence interval (CI) 0.7% to 3.8%). Pregnant women with HTLV-1 infection were discretely younger (mean age 22.6 [SD 22.6] vs 26.8 [SD 6.3]; p = 0.128). None of the five women had been transfused, and all were asymptomatic. Two (40%) also had a positive serology for Strongyloides, but larvae were not detected in any of the parasitological stool studies. The systematic review component identified 40 studies, which showed that the prevalence of HTLV infection in the general population was 2.9% (95% CI 1.2% to 5.3%) and in women of childbearing age, 2.5% (95% CI 1.2% to 4.0%). (4) Conclusion. The prevalence of HTLV-1 in the Peruvian Amazon basin is about 1.7%, indicating an endemic presence. Screening for HTLV-1 in prenatal care is warranted.
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Mejía-Mertel J, Gómez-Banoy N, Rojas-Hernández JP, Gotuzzo-Herencia E. Clinical profile of human T-lymphotropic virus type I: a forgotten infection in pediatrics. INFECTIO 2020. [DOI: 10.22354/in.v25i1.905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis. Pathogens 2020; 9:pathogens9060450. [PMID: 32517313 PMCID: PMC7350296 DOI: 10.3390/pathogens9060450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of patients with early-onset HAM/TSP, defined as disease onset before 20 years of age. Methods: This is a retrospective study from an HTLV-1 clinical cohort between 1989 and 2019. We searched for medical records of patients with (1) diagnosis of HTLV-1 infection using two ELISA and/or one Western blot, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) HAM/TSP symptom-onset before 20 years of age. Results: A total of 38 cases were identified in the cohort; 25 were female (66%). The median age of onset was 14 years old. 31 (82%) cases had HTLV-1 testing done among family members; 22 out of 25 tested mothers (88%) were HTLV-1 positive. Most patients (27/34) were breastfed for more than one year. Disease progression measured through EDSS and IPEC-1 showed an upward trend towards worsening spasticity with 18 patients (47%) eventually requiring mobility aids. Conclusions: Cases of early-onset HAM/TSP are not of rare occurrence, which translates into many more years of dependency, the use of mobility aids, and increased overall morbidity.
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Eusebio-Ponce E, Candel FJ, Anguita E. Human T-Cell Lymphotropic Virus Type 1 and associated diseases in Latin America. Trop Med Int Health 2019; 24:934-953. [PMID: 31183938 DOI: 10.1111/tmi.13278] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This narrative review, which is based on a systematic literature search following the PRISMA guidelines, provides a general overview of Human T-cell Lymphotropic Virus type 1 (HTLV-1) and associated diseases: Adult T-cell Leukaemia-Lymphoma (ATLL) and HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) in Latin America, focusing on epidemiology and prevention. Using the published information on HTLV-1, ATLL and HAM/TSP prevalence, we present comprehensive and accurate maps and tables, and developed an algorithm to assist in the prevention of HTLV-1 transmission through breastfeeding while considering socio-economic status. Latin America is an interesting scenario to study HTLV-1 because of the diverse origin of its population. Apart from the expected high prevalence in inhabitants of African ancestry, the presence of endemic foci affecting indigenous populations is particularly striking. ATLL prevention is the biggest challenge in this field. Most ATLL cases are transmitted through breastfeeding; thus, prevention methods to avoid ATLL in endemic countries have to be focused on this. In view of the high inequality in most Latin American countries, reduction in breastfeeding duration, freezing/thawing and pasteurisation of breastmilk can be suitable interventions in poor settings, considering that avoiding the risk of malnutrition and infant mortality must be the priority.
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Affiliation(s)
- Emiliana Eusebio-Ponce
- Research Department, Universidad Iberoamericana, Santo Domingo, Dominican Republic.,Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Francisco Javier Candel
- Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Clinical Microbiology and Infectious Diseases Department, Transplant Coordination Unit, IdISSC and IML Institutes, Hospital Clínico San Carlos, Study Group of Infections in Emergency Departments (Infurgsemes, SEMES), Madrid, Spain
| | - Eduardo Anguita
- Department of Medicine, Faculty of Medicine, Universidad Complutense de Madrid (UCM), Madrid, Spain.,Hematology Department, Instituto de Medicina de Laboratorio (IML), Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain
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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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Rosadas C, Taylor GP. Mother-to-Child HTLV-1 Transmission: Unmet Research Needs. Front Microbiol 2019; 10:999. [PMID: 31134031 PMCID: PMC6517543 DOI: 10.3389/fmicb.2019.00999] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/18/2019] [Indexed: 02/04/2023] Open
Abstract
Mother-to-child transmission (MTCT) of Human T-cell lymphotropic virus type 1 (HTLV-1) causes lifelong infection. At least 5–10 million individuals worldwide are currently living with HTLV-1. Studies of regional variation are required to better understand the contribution of MTCT to the global burden of infection. Although most infected individuals remain asymptomatic ∼10% develop high morbidity, high mortality disease. Infection early in life is associated with a higher risk of disease development. Adult T-cell leukemia (ATL), which is caused by HTLV-1 and has a median survival of 8 months is linked to MTCT, indeed evidence of ATL following infection as an adult is sparse. Infective dermatitis also only occurs following neonatal infection. Whilst HTLV-1-associated myelopathy (HAM) follows sexual and iatrogenic infection approximately 30% of patients presenting with HAM/TSP acquired the infection through their mothers. HAM/TSP is a disabling neurodegenerative disease that greatly impact patient’s quality of life. To date there is no cure for HTLV-1 infection other than bone marrow transplantation for ATL nor any measure to prevent HTLV-1 associated diseases in an infected individual. In this context, prevention of MTCT is expected to contribute disproportionately to reducing both the incidence of HTLV-1 and the burden of HTLV-1 associated diseases. In order to successfully avoid HTLV-1 MTCT, it is important to understand all the variables involved in this route of infection. Questions remain regarding frequency and risk factors for in utero peri-partum transmission whilst little is known about the efficacy of pre-labor cesarean section to reduce these infections. Understanding the contribution of peripartum infection to the burden of disease will be important to gauge the risk-benefit of interventions in this area. Few studies have examined the impact of HTLV-1 infection on fertility or pregnancy outcomes nor the susceptibility of the mother to infection during pregnancy and lactation. Whilst breast-feeding is strongly associated with transmission and avoidance of breast-feeding a proven intervention little is known about the mechanism of transmission from the breast milk to the infant and there have been no clinical trials of antiretroviral therapy (ARV) to prevent this route of transmission.
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Affiliation(s)
- Carolina Rosadas
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
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Bandeira LM, Uehara SNO, Puga MAM, Rezende GR, Vicente ACP, Domingos JA, do Lago BV, Niel C, Motta-Castro ARC. HTLV-1 intrafamilial transmission among Japanese immigrants in Brazil. J Med Virol 2017; 90:351-357. [DOI: 10.1002/jmv.24938] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 08/18/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Larissa M. Bandeira
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - Silvia N. O. Uehara
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - Marco A. M. Puga
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - Grazielli R. Rezende
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | | | - João A. Domingos
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
| | - Bárbara V. do Lago
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
- Oswaldo Cruz Institute; Fiocruz; Rio de Janeiro Brazil
- Bio-Manguinhos; Fiocruz; Rio de Janeiro Brazil
| | | | - Ana R. C. Motta-Castro
- Federal University of Mato Grosso do Sul; Campo Grande Mato Grosso do Sul Brazil
- Fiocruz; Mato Grosso do Sul Brazil
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Stewart J, Heitzinger K, Pollett S, Calderón M, Alarcón J, Ton TGN, Zunt JR. The Changing Epidemiology of Human T-Cell Lymphotropic Virus Type 1 Infection in Peruvian Female Sex Workers, 1993-2010. Am J Trop Med Hyg 2016; 96:373-379. [PMID: 27879458 DOI: 10.4269/ajtmh.16-0014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 10/10/2016] [Indexed: 11/07/2022] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus to be reported and is associated with neoplastic, neurological, autoimmune, and infectious complications. HTLV-1 is endemic in Peru, with the highest prevalence reported among commercial sex workers. Seroprevalence data collected from Peruvian female sex workers (FSWs) working in Callao over three study periods between 1993 and 2010 were used to examine the secular trend in HTLV-1 prevalence. Between 1993 and 2010, the prevalence of HTLV-1 decreased significantly from 14.5% to 3.1% (P < 0.01). The prevalence of HTLV-1 seropositivity differed significantly by birth cohort (1922-1959, 1960-1969, 1970-1979, and 1980-1992), and for each of the four birth cohorts, the prevalence did not significantly decrease by screening year (P > 0.07). There were no cases of HTLV-1 detected among FSW born after 1979 (N = 224). Participant characteristics associated with HTLV-1 seropositivity were birth in the Andes Mountains region, age, increased time in sex work, younger age of starting sex work, and human immunodeficiency virus (HIV) seropositivity. The secular trend in declining prevalence persisted after adjustment for age, time in sex work, place of birth, and HIV serostatus, with the odds of HTLV-1 infection decreasing approximately 16% per year (adjusted odds ratio = 0.84, 95% confidence interval = 0.78, 0.90). The increasing use of condoms by later birth cohorts noted in our analysis, as well as the increasing availability of free condoms provided by the Peruvian government-which started in the late 1980s before this study-may have been responsible for declining HTLV seroprevalence.
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Affiliation(s)
- Jenell Stewart
- Department of Internal Medicine, University of Washington, Seattle, Washington.
| | - Kristen Heitzinger
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Simon Pollett
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Martha Calderón
- Clínica de Salud Pública "Alberto Barton" del Callao, Callao, Peru
| | - Jorge Alarcón
- Instituto de Medicina Tropical, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Thanh G N Ton
- Department of Global Health and Neurology, University of Washington, Seattle, Washington
| | - Joseph R Zunt
- Department of Internal Medicine, University of Washington, Seattle, Washington.,Department of Epidemiology, University of Washington, Seattle, Washington.,Department of Global Health and Neurology, University of Washington, Seattle, Washington
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Einsiedel L, Woodman RJ, Flynn M, Wilson K, Cassar O, Gessain A. Human T-Lymphotropic Virus type 1 infection in an Indigenous Australian population: epidemiological insights from a hospital-based cohort study. BMC Public Health 2016; 16:787. [PMID: 27526923 PMCID: PMC4986258 DOI: 10.1186/s12889-016-3366-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 07/23/2016] [Indexed: 11/17/2022] Open
Abstract
Background The Human T Lymphotropic Virus type 1 (HTLV-1) subtype C is endemic to central Australia where each of the major sequelae of HTLV-1 infection has been documented in the socially disadvantaged Indigenous population. Nevertheless, available epidemiological information relating to HTLV-1c infection is very limited, risk factors for transmission are unknown and no coordinated program has been implemented to reduce transmission among Indigenous Australians. Identifying risk factors for HTLV-1 infection is essential to direct strategies that could control HTLV-1 transmission. Methods Risk factors for HTLV-1 infection were retrospectively determined for a cohort of Indigenous Australians who were tested for HTLV-1 at Alice Springs Hospital (ASH), 1st January 2000 to 30th June 2013. Demographic details were obtained from the ASH patient management database and the results of tests for sexually transmitted infections (STI) were obtained from the ASH pathology database. Results Among 1889 Indigenous patients whose HTLV-1 serostatus was known, 635 (33.6 %) were HTLV-1 Western blot positive. Only one of 77 (1.3 %) children tested was HTLV-1 infected. Thereafter, rates progressively increased with age (15–29 years, 17.3 %; 30–49 years, 36.2 %; 50–64 years, 41.7 %) reaching 48.5 % among men aged 50–64 years. In a multivariable model, increasing age (OR, 1.04; 95 % CI, 1.03–1.04), male gender (OR, 1.41; 95 % CI, 1.08–1.85), residence in the south (OR, 10.7; 95 % CI, 7.4–15.6) or west (OR, 4.4; 95 % CI, 3.1–6.3) of central Australia and previous STI (OR, 1.42; 95 % CI, 1.04–1.95) were associated with HTLV-1 infection. Infection was acquired by three of 351 adults who were tested more than once during the study period (seroconversion rate, 0.24 (95 % CI = 0.18–2.48) per 100 person-years). Conclusions This study confirms that HTLV-1 is highly endemic to central Australia. Although childhood infection was documented, HTLV-1 infection in adults was closely associated with increasing age, male gender and STI history. Multiple modes of transmission are therefore likely to contribute to high rates of HTLV-1 infection in the Indigenous Australian population. Future strategies to control HTLV-1 transmission in this population require careful community engagement, cultural understanding and Indigenous leadership.
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Affiliation(s)
- Lloyd Einsiedel
- Flinders University/Northern Territory Rural Clinical School, Alice Springs Hospital, Rubuntja Building, 0870, Northern Territory, Australia. .,Aboriginal Health Unit, BakerIDI,central Australia, Alice Springs Hospital, 0870, Northern Territory, Australia.
| | - Richard J Woodman
- Flinders University/Northern Territory Rural Clinical School, Alice Springs Hospital, Rubuntja Building, 0870, Northern Territory, Australia
| | - Maria Flynn
- Flinders University/Northern Territory Rural Clinical School, Alice Springs Hospital, Rubuntja Building, 0870, Northern Territory, Australia
| | - Kim Wilson
- National Serological Reference Laboratory, Melbourne, Australia
| | - Olivier Cassar
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, F-75015, Paris, France.,CNRS, UMR 3569, 28 Rue du Dr. Roux, F-75015, Paris, France
| | - Antoine Gessain
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, F-75015, Paris, France.,CNRS, UMR 3569, 28 Rue du Dr. Roux, F-75015, Paris, France
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San Martín H, Balanda M, Vergara N, Valenzuela MA, Cartier L, Ayala S, Ramírez E. Human T-Lymphotropic Virus Type 1 and 2 Seroprevalence among first-time blood donors in Chile, 2011-2013. J Med Virol 2015; 88:1067-75. [DOI: 10.1002/jmv.24428] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 01/17/2023]
Affiliation(s)
- Héctor San Martín
- Departamento de Virología; Instituto de Salud Pública de Chile; Santiago Chile
| | - Monserrat Balanda
- Departamento de Virología; Instituto de Salud Pública de Chile; Santiago Chile
| | - Nicolás Vergara
- Departamento de Virología; Instituto de Salud Pública de Chile; Santiago Chile
| | - María Antonieta Valenzuela
- Departamento de Bioquímica y Biología Molecular; Facultad de Ciencias Químicas y Farmacéuticas; Universidad de Chile; Santiago Chile
| | - Luis Cartier
- Departamento de Ciencias Neurológicas; Facultad de Medicina; Universidad de Chile; Santiago Chile
| | - Salvador Ayala
- Subdepartamento de Vigilancia de Laboratorio; Departamento de Asuntos Científicos; Instituto de Salud Pública de Chile Santiago Chile
| | - Eugenio Ramírez
- Departamento de Virología; 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, Casseb J. Origin and prevalence of human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2) among indigenous populations in the Americas. Rev Inst Med Trop Sao Paulo 2015; 57:1-13. [PMID: 25651320 PMCID: PMC4325517 DOI: 10.1590/s0036-46652015000100001] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 09/02/2014] [Indexed: 01/09/2023] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is found in indigenous peoples
of the Pacific Islands and the Americas, whereas type 2 (HTLV-2) is widely
distributed among the indigenous peoples of the Americas, where it appears to be more
prevalent than HTLV-1, and in some tribes of Central Africa. HTLV-2 is considered
ancestral in the Americas and is transmitted to the general population and injection
drug users from the indigenous population. In the Americas, HTLV-1 has more than one
origin, being brought by immigrants in the Paleolithic period through the Bering
Strait, through slave trade during the colonial period, and through Japanese
immigration from the early 20th century, whereas HTLV-2 was only brought
by immigrants through the Bering Strait. The endemicity of HTLV-2 among the
indigenous people of Brazil makes the Brazilian Amazon the largest endemic area in
the world for its occurrence. A review of HTLV-1 in all Brazilian tribes supports the
African origin of HTLV-1 in Brazil. The risk of hyperendemicity in these
epidemiologically closed populations and transmission to other populations reinforces
the importance of public health interventions for HTLV control, including the
recognition of the infection among reportable diseases and events.
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Affiliation(s)
- Arthur Paiva
- Universidade Federal de Alagoas, Hospital Universitário, Maceió, Alagoas, Brazil
| | - Jorge Casseb
- Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, SP, Brazil
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Shoeibi A, Rafatpanah H, Azarpazhooh A, Mokhber N, Hedayati-Moghaddam MR, Amiri A, Hashemi P, Foroghipour M, Hoseini RF, Bazarbachi A, Azarpazhooh MR. Clinical features of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in northeast Iran. Acta Neurol Belg 2013; 113:427-33. [PMID: 23568138 DOI: 10.1007/s13760-013-0194-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 03/21/2013] [Indexed: 12/14/2022]
Abstract
This study aimed to introduce clinical manifestations of patients in northeast Iran with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and describe the epidemiological features, as well as risk factors for HTLV-1 infection. This is a cross-sectional study of HTLV-1 infected cases and HAM/TSP patients referred by outpatient neurology clinics as well as Mashhad Blood Transfusion Center from 2005 to 2010. The study comprises 513 cases, including 358 healthy carriers (HCs) and 145 HAM/TSP patients. The majority of carriers were male (73.5%), whereas 67.6% of HAM/TSP sufferers were female (P < 0.001). The mean age of HAM/TSP patients and HCs was 45.9 ± 13.6 and 39.5 ± 11.58 years, respectively (P < 0.001). The history of transfusion, surgery, hospitalization and cupping was observed in a significant greater number of HAM/TSP patients than the HCs (P < 0.001, P < 0.001, P < 0.001 and P = 0.029, respectively). Gait disturbance was the most common complaint in HAM/TSP patients (72.4%). This research develops an HTLV-1 data registry in an endemic area such as Mashhad which can serve useful purposes, including evaluation of clinical and laboratory characteristics of HAM/TSP patients and epidemiological data of HTLV-1-infected cases.
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Affiliation(s)
- Ali Shoeibi
- Department of Neurology, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Boulevard, Mashhad, Iran
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Ita F, Mayer EF, Verdonck K, Gonzalez E, Clark D, Gotuzzo E. Human T-lymphotropic virus type 1 infection is frequent in rural communities of the southern Andes of Peru. Int J Infect Dis 2013; 19:46-52. [PMID: 24262672 DOI: 10.1016/j.ijid.2013.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 10/03/2013] [Accepted: 10/05/2013] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To evaluate the presence of human T-lymphotropic virus type 1 (HTLV-1) infection in isolated rural communities in the southern Andes of Peru. METHODS We conducted a cross-sectional study in five communities located in three provinces in Ayacucho, Peru. The five communities are located at >3000 meters above sea level and are mainly rural, and more than 85% of the population speaks Quechua. Volunteers aged 12 years and older were included. Clinical and epidemiological data were collected, along with a blood sample for serological testing. RESULTS We included 397 participants; their median age was 41 years (interquartile range 31-57 years) and 69% were women. According to our definitions, 98% were of Quechua origin. HTLV-1 was diagnosed in 11 people: 0/164 in Cangallo, 3/154 (2%) in Vilcashuaman, and 8/79 (10%) in Parinacochas. There were no cases of HTLV-2. All the HTLV-1-positive participants were born in Ayacucho and were of Quechua origin; they ranged in age from 29 to 87 years (median 56 years) and 10/11 were women. Ten were apparently healthy, and one woman was diagnosed with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Three out of 11 had a family member with a lower limb impairment compatible with HAM/TSP. CONCLUSION The fact that HTLV-1 infection was present in two out of three provinces suggests that HTLV-1 could be highly endemic in the southern Andes in the Quechua population.
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Affiliation(s)
- Fanny Ita
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Erick F Mayer
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Kristien Verdonck
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Institute of Tropical Medicine, Antwerp, Belgium
| | - Elsa Gonzalez
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Daniel Clark
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorios de Investigación y Desarrollo (LID), Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Cayetano Heredia, Lima, Peru
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Blas MM, Alva IE, García PJ, Cárcamo C, Montano SM, Mori N, Muñante R, Zunt JR. High prevalence of human T-lymphotropic virus infection in indigenous women from the peruvian Amazon. PLoS One 2013; 8:e73978. [PMID: 24040133 PMCID: PMC3763997 DOI: 10.1371/journal.pone.0073978] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 08/01/2013] [Indexed: 01/05/2023] Open
Abstract
Background In an earlier study, we detected an association between human T-cell lymphotropic virus (HTLV) infection and cervical human papillomavirus (HPV) in indigenous Amazonian Peruvian women of the Shipibo-Konibo ethnic group. As both HTLV and HPV can be transmitted sexually, we now report a population-based study examining the prevalence and risk factors for HTLV-1 and HTLV-2 infection in this population. Methods Between July and December 2010, we conducted a comprehensive screening for HTLV among Shipibo-Konibo women 15 to 39 years of age living in two communities located in Lima and in 17 communities located within four hours by car or boat from the Amazonian city of Pucallpa in Peru. Results We screened 1,253 Shipibo-Konibo women for HTLV infection 74 (5.9%) tested positive for HTLV-1, 47 (3.8%) for HTLV-2 infection, and 4 (0.3%) had indeterminate results. In the multivariate analysis, factors associated with HTLV-1 infection included: older age (Prevalence Ratio (PR): 1.04, 95% CI 1.00–1.08), primary education or less (PR: 2.01, 95% CI: 1.25–3.24), younger or same age most recent sex partner (PR: 1.66, 95% CI: 1.00–2.74), and having a most recent sex partner who worked at a logging camp (PR: 1.73, 95% CI: 1.09–2.75). The only factor associated with HTLV-2 infection was older age (PR: 1.08, 95% CI: 1.03–1.12). Conclusion HTLV infection is endemic among Shipibo-Konibo women. Two characteristics of the sexual partner (younger age and labor history) were associated with infection in women. These results suggest the need for implementation of both HTLV screening during the antenatal healthcare visits of Shipibo-Konibo women, and counseling about the risk of HTLV transmission through prolonged breastfeeding in infected women. We also recommend the implementation of prevention programs to reduce sexual transmission of these viruses.
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Affiliation(s)
- Magaly M. Blas
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- * E-mail:
| | - Isaac E. Alva
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia J. García
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar Cárcamo
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia M. Montano
- United States Naval Medical Research Unit No. 6 (NAMRU-6), Callao, Peru
| | - Nicanor Mori
- United States Naval Medical Research Unit No. 6 (NAMRU-6), Callao, Peru
| | - Ricardo Muñante
- Ucayali Regional Health Directorate, Ministry of Health, Ucayali, Peru
| | - Joseph R. Zunt
- School of Public Health and Community Medicine, Departments of Neurology, Global Health and Medicine, University of Washington, Seattle, Washington, United States of America
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Mayer EF, Ita F, Gonzalez E, Verdonck K, Bravo F, Clark D, Gotuzzo E. Association between onychodystrophy and human T-lymphotropic virus type 1 infection. Int J Infect Dis 2012; 17:e312-6. [PMID: 23245620 DOI: 10.1016/j.ijid.2012.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 11/06/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To assess the association between human T-lymphotropic virus type 1 (HTLV-1) infection and onychodystrophy. METHODS This was a cross-sectional study. At our institute, we provide HTLV-1 testing to relatives of HTLV-1-infected people and patients with suspected HTLV-1-associated diseases. The diagnosis of onychodystrophy was made clinically before testing for HTLV-1; the number and distribution of affected nails was registered. We assessed the association between onychodystrophy and HTLV-1 through bi- and multivariable analyses. Logistic regression was used to adjust for age, sex, and indication for HTLV-1 testing, using six affected nails (90(th) percentile) as the cut-off point. RESULTS Between April 2006 and March 2008, we included 893 subjects; their mean age was 38 years (standard deviation 19 years), and 527 (59%) were women. Onychodystrophy of one or more nails was observed in 323 participants (36%), and 236 subjects (26%) were HTLV-1-positive. The median number of affected nails was higher in HTLV-1-positive than in HTLV-1-negative subjects (Mann-Whitney test, p < 0.001). Thirty-eight of 97 subjects with six or more affected nails (39%) were HTLV-1-infected, compared to 198 of 796 subjects with fewer than six affected nails (25%) (crude OR 1.9, 95% confidence interval (CI) 1.2-3.1; p = 0.003). This association remained significant in the multiple logistic regression model (adjusted OR 2.0, 95% CI 1.2-3.3; p = 0.005). CONCLUSIONS There is an independent association between HTLV-1 infection and onychodystrophy. Patients with an HTLV-1 infection might have a higher risk for onychomycosis given the abnormal nail plate and a decreased T-cell-mediated immunologic response.
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Affiliation(s)
- Erick F Mayer
- Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru.
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Gessain A, Cassar O. Epidemiological Aspects and World Distribution of HTLV-1 Infection. Front Microbiol 2012; 3:388. [PMID: 23162541 PMCID: PMC3498738 DOI: 10.3389/fmicb.2012.00388] [Citation(s) in RCA: 922] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 10/18/2012] [Indexed: 01/12/2023] Open
Abstract
The human T-cell leukemia virus type 1 (HTLV-1), identified as the first human oncogenic retrovirus 30 years ago, is not an ubiquitous virus. HTLV-1 is present throughout the world, with clusters of high endemicity located often nearby areas where the virus is nearly absent. The main HTLV-1 highly endemic regions are the Southwestern part of Japan, sub-Saharan Africa and South America, the Caribbean area, and foci in Middle East and Australo-Melanesia. The origin of this puzzling geographical or rather ethnic repartition is probably linked to a founder effect in some groups with the persistence of a high viral transmission rate. Despite different socio-economic and cultural environments, the HTLV-1 prevalence increases gradually with age, especially among women in all highly endemic areas. The three modes of HTLV-1 transmission are mother to child, sexual transmission, and transmission with contaminated blood products. Twenty years ago, de Thé and Bomford estimated the total number of HTLV-1 carriers to be 10-20 millions people. At that time, large regions had not been investigated, few population-based studies were available and the assays used for HTLV-1 serology were not enough specific. Despite the fact that there is still a lot of data lacking in large areas of the world and that most of the HTLV-1 studies concern only blood donors, pregnant women, or different selected patients or high-risk groups, we shall try based on the most recent data, to revisit the world distribution and the estimates of the number of HTLV-1 infected persons. Our best estimates range from 5-10 millions HTLV-1 infected individuals. However, these results were based on only approximately 1.5 billion of individuals originating from known HTLV-1 endemic areas with reliable available epidemiological data. Correct estimates in other highly populated regions, such as China, India, the Maghreb, and East Africa, is currently not possible, thus, the current number of HTLV-1 carriers is very probably much higher.
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Affiliation(s)
- Antoine Gessain
- Département de Virologie, Unité d'épidémiologie et physiopathologie des virus oncogènes, Institut Pasteur Paris, France ; CNRS, URA3015 Paris, France
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McGill NK, Vyas J, Shimauchi T, Tokura Y, Piguet V. HTLV-1-associated infective dermatitis: updates on the pathogenesis. Exp Dermatol 2012; 21:815-21. [DOI: 10.1111/exd.12007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2012] [Indexed: 12/12/2022]
Affiliation(s)
- Neilia-Kay McGill
- Department of Dermatology and Wound Healing; Institute of Infection and Immunity; Cardiff University; Cardiff, UK
| | - Jui Vyas
- Department of Dermatology and Wound Healing; Institute of Infection and Immunity; Cardiff University; Cardiff, UK
| | - Takatoshi Shimauchi
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu; Japan
| | - Yoshiki Tokura
- Department of Dermatology; Hamamatsu University School of Medicine; Hamamatsu; Japan
| | - Vincent Piguet
- Department of Dermatology and Wound Healing; Institute of Infection and Immunity; Cardiff University; Cardiff, UK
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Alva IE, Orellana ER, Blas MM, Bernabe-Ortiz A, Cotrina A, Chiappe M, Kochel TJ, Carcamo CP, García PJ, Zunt JR, Buffardi AL, Montano SM. HTLV-1 and -2 infections among 10 indigenous groups in the Peruvian Amazon. Am J Trop Med Hyg 2012; 87:954-6. [PMID: 22964719 DOI: 10.4269/ajtmh.2012.12-0289] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Infections with HTLV-1 and -2 were detected in 12 (1.9%) and 6 (0.9%) indigenous individuals living in 27 Amazonian villages in Peru. All infections occurred in Shipibo-Konibo people. HTLV was more common among participants living in villages distant from larger port cities and women with non-monogamous sexual partners.
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Affiliation(s)
- Isaac E Alva
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Diffuse large B-cell lymphoma in human T-lymphotropic virus type 1 carriers. LEUKEMIA RESEARCH AND TREATMENT 2011. [PMID: 23198156 PMCID: PMC3505915 DOI: 10.1155/2012/262363] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We describe the clinical and pathological characteristics of seven patients who were human T-lymphotropic virus type 1 (HTLV-1) carriers and had a pathological diagnosis of de novo diffuse large B-cell lymphoma. Interestingly, three of our cases showed positive expression of Epstein-Barr-virus, (EBV-) encoded RNA within the tumor cells indicating a possible interaction between these two viruses. Furthermore, our three EBV-positive cases presented with similar clinical characteristics such as early clinical stage and low-risk indices. To the best of our knowledge, this is the first case series describing the characteristics of HTLV-1-positive DLBCL patients. The potential relationship between HTLV-1 and EBV should be further explored.
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Rafatpanah H, Hedayati-Moghaddam MR, Fathimoghadam F, Bidkhori HR, Shamsian SK, Ahmadi S, Sohgandi L, Azarpazhooh MR, Rezaee SA, Farid R, Bazarbachi A. High prevalence of HTLV-I infection in Mashhad, Northeast Iran: a population-based seroepidemiology survey. J Clin Virol 2011; 52:172-6. [PMID: 21840754 DOI: 10.1016/j.jcv.2011.07.004] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 07/03/2011] [Accepted: 07/05/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mashhad, in the northeast of Iran has been suggested as an endemic area for human T cell lymphotropic virus type I (HTLV-I) infection since 1996. OBJECTIVES We performed a community-based seroepidemiology study to examine the prevalence and risk factors for HTLV-I infection in the city of Mashhad. STUDY DESIGN Between May and September 2009, overall 1678 subjects from all the 12 geographical area of Mashhad were selected randomly by multistage cluster sampling for HTLV antibody. The study population included 763 males and 915 females, with the mean age of 29.1 ± 18.5 years. 1654 serum samples were assessed for HTLV antibody using ELISA and reactive samples were confirmed by Western blot and PCR. RESULTS The overall prevalence of HTLV-I infection in whole population was 2.12% (95% CI, 1.48-2.93) with no significant difference between males and females (p = 0.093) and the prevalence of HTLV-II seropositivity was 0.12% (95% CI, 0.02-0.44). The HTLV-I Infection was associated with age (p<0.001), marital status (p<0.001), education (p = 0.047), and history of blood transfusion (p = 0.009), surgery (p<0.001), traditional cupping (p = 0.002), and hospitalization (p = 0.004). In logistic regression analysis, age was the only variable that had a significant relation with the infection (p = 0.006, OR = 4.33). CONCLUSIONS Our results demonstrated that Mashhad still remains an endemic area for HTLV-I infection despite routine blood screening. Thus, further strategies are needed for prevention of the virus transmission in whole population.
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Affiliation(s)
- Houshang Rafatpanah
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center for Education, Culture & Research (ACECR), Mashhad Branch, Mashhad, Iran
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Rodríguez SM, Florins A, Gillet N, de Brogniez A, Sánchez-Alcaraz MT, Boxus M, Boulanger F, Gutiérrez G, Trono K, Alvarez I, Vagnoni L, Willems L. Preventive and therapeutic strategies for bovine leukemia virus: lessons for HTLV. Viruses 2011; 3:1210-48. [PMID: 21994777 PMCID: PMC3185795 DOI: 10.3390/v3071210] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 06/28/2011] [Accepted: 06/29/2011] [Indexed: 01/06/2023] Open
Abstract
Bovine leukemia virus (BLV) is a retrovirus closely related to the human T-lymphotropic virus type 1 (HTLV-1). BLV is a major animal health problem worldwide causing important economic losses. A series of attempts were developed to reduce prevalence, chiefly by eradication of infected cattle, segregation of BLV-free animals and vaccination. Although having been instrumental in regions such as the EU, these strategies were unsuccessful elsewhere mainly due to economic costs, management restrictions and lack of an efficient vaccine. This review, which summarizes the different attempts previously developed to decrease seroprevalence of BLV, may be informative for management of HTLV-1 infection. We also propose a new approach based on competitive infection with virus deletants aiming at reducing proviral loads.
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Affiliation(s)
- Sabrina M. Rodríguez
- Molecular and Cellular Epigenetics, Interdisciplinary Cluster for Applied Genoproteomics (GIGA), University of Liège (ULg), 4000, Liège, Belgium; E-Mails: (S.M.R.); (N.G.); (F.B.)
| | - Arnaud Florins
- Molecular and Cellular Biology, Gembloux Agro-Bio Tech, University of Liège (ULg), 5030, Gembloux, Belgium; E-Mails: (A.F.); (A.d.B.); (M.T.S.-A.); (M.B.)
| | - Nicolas Gillet
- Molecular and Cellular Epigenetics, Interdisciplinary Cluster for Applied Genoproteomics (GIGA), University of Liège (ULg), 4000, Liège, Belgium; E-Mails: (S.M.R.); (N.G.); (F.B.)
| | - Alix de Brogniez
- Molecular and Cellular Biology, Gembloux Agro-Bio Tech, University of Liège (ULg), 5030, Gembloux, Belgium; E-Mails: (A.F.); (A.d.B.); (M.T.S.-A.); (M.B.)
| | - María Teresa Sánchez-Alcaraz
- Molecular and Cellular Biology, Gembloux Agro-Bio Tech, University of Liège (ULg), 5030, Gembloux, Belgium; E-Mails: (A.F.); (A.d.B.); (M.T.S.-A.); (M.B.)
| | - Mathieu Boxus
- Molecular and Cellular Biology, Gembloux Agro-Bio Tech, University of Liège (ULg), 5030, Gembloux, Belgium; E-Mails: (A.F.); (A.d.B.); (M.T.S.-A.); (M.B.)
| | - Fanny Boulanger
- Molecular and Cellular Epigenetics, Interdisciplinary Cluster for Applied Genoproteomics (GIGA), University of Liège (ULg), 4000, Liège, Belgium; E-Mails: (S.M.R.); (N.G.); (F.B.)
| | - Gerónimo Gutiérrez
- Instituto de Virología, Centro de Investigaciones en Ciencias Veterinarias y Agronómicas, INTA, C.C. 1712, Castelar, Argentina; E-Mails: (G.G.); (K.T.); (I.A.); (L.V.)
| | - Karina Trono
- Instituto de Virología, Centro de Investigaciones en Ciencias Veterinarias y Agronómicas, INTA, C.C. 1712, Castelar, Argentina; E-Mails: (G.G.); (K.T.); (I.A.); (L.V.)
| | - Irene Alvarez
- Instituto de Virología, Centro de Investigaciones en Ciencias Veterinarias y Agronómicas, INTA, C.C. 1712, Castelar, Argentina; E-Mails: (G.G.); (K.T.); (I.A.); (L.V.)
| | - Lucas Vagnoni
- Instituto de Virología, Centro de Investigaciones en Ciencias Veterinarias y Agronómicas, INTA, C.C. 1712, Castelar, Argentina; E-Mails: (G.G.); (K.T.); (I.A.); (L.V.)
| | - Luc Willems
- Molecular and Cellular Epigenetics, Interdisciplinary Cluster for Applied Genoproteomics (GIGA), University of Liège (ULg), 4000, Liège, Belgium; E-Mails: (S.M.R.); (N.G.); (F.B.)
- Molecular and Cellular Biology, Gembloux Agro-Bio Tech, University of Liège (ULg), 5030, Gembloux, Belgium; E-Mails: (A.F.); (A.d.B.); (M.T.S.-A.); (M.B.)
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Hedayati-Moghaddam MR, Fathimoghadam F, Eftekharzadeh Mashhadi I, Soghandi L, Bidkhori HR. Epidemiology of HTLV-1 in Neyshabour, Northeast of Iran. IRANIAN RED CRESCENT MEDICAL JOURNAL 2011; 13:424-7. [PMID: 22737506 PMCID: PMC3371930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2010] [Accepted: 12/22/2010] [Indexed: 11/06/2022]
Abstract
BACKGROUND HTLV-1 infection is endemic in Mashhad, Northeast of Iran. This study was designed to assess the epidemiology of HTLV-1 and potential risk factors in Neyshabour, Northeastern Iran. METHODS All those who referred to Iranian Academic Center for Education, Culture and Research (ACECR)- Mashhad Laboratory in Neyshabour for evaluation of HTLV-I by ELISA, were tested using WB if the ELISA result was positive. A questionnaire about risk factors of infection was completed for all cases. RESULTS HTLV-1 infection was positive in 7.2% (35/483) of the participants according to the results of enzymelinked immunosorbent assay (ELISA) and western blot (WB) tests. Infection was significantly associated with age, family size, income and blood transfusion. However, gender, education, birthplace, race, marital status, and history of surgery, dentistry, traditional cupping, and hospitalization showed no significant relation. CONCLUSION It seems that HTLV-I infection is highly endemic in Neyshabour and it is seems that more effective treatment strategies are needed.
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Affiliation(s)
- M R Hedayati-Moghaddam
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center, Mashhad Branch, Mashhad, Iran
| | - F Fathimoghadam
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center, Mashhad Branch, Mashhad, Iran,Correspondence: Farhad Fathimoghadam, MD, Research Center for HIV/AIDS, HTLV and Viral Hepatitis, ACECR-Mashhad, University Campus, Azadi Sq, P.O.Box: 91775-1376, Mashhad, Iran. Tel.: +98- 511-8832361, Fax: +98-511-8810177, E-mail:
| | - I Eftekharzadeh Mashhadi
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center, Mashhad Branch, Mashhad, Iran
| | - L Soghandi
- Center of Pathological and Medical Diagnostic Services, Iranian Academic Center for Education, Culture and Research (ACECR), Mashhad Branch, Mashhad, Iran
| | - H R Bidkhori
- Research Center for HIV/AIDS, HTLV and Viral Hepatitis, Iranian Academic Center, Mashhad Branch, Mashhad, Iran
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Beltran B, Quiñones P, Morales D, Cotrina E, Castillo JJ. Different prognostic factors for survival in acute and lymphomatous adult T-cell leukemia/lymphoma. Leuk Res 2010; 35:334-9. [PMID: 20828817 DOI: 10.1016/j.leukres.2010.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 08/12/2010] [Accepted: 08/12/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Adult T-cell leukemia/lymphoma (ATLL) is a clinically aggressive and heterogeneous entity; hence it is likely that different variants of ATLL have different prognostic factors. METHODS 95 patients with ATLL seen at our institution between 1987 and 2008 were included. Clinical data were compared, according to ATLL variant, using the Mann-Whitney and the Chi-square tests for continuous and categorical variables, respectively. Kaplan-Meier estimates compared using the log-rank test and Cox proportional-hazard test were used for the univariate and multivariate analysis, respectively. RESULTS Median age was 61 years with male-to-female ratio of 1.07:1. Patients with acute ATLL were more likely to present with bone marrow, liver and spleen involvement, higher β2-microglobulin and lower albumin levels. Poor performance status, high IPI score, presence of B symptoms, high LDH and low albumin levels were associated with a worse survival in lymphomatous ATLL. High LDH, high β2-microglobulin and high PIT score were associated with worse survival in acute ATLL. In the multivariate analysis, low albumin level and presence of B symptoms were independent factors for worse survival in lymphomatous ATLL, and high β2-microglobulin level was independent factor for worse survival in acute ATLL. CONCLUSIONS Aggressive ATLL variants have a distinct, almost mutually exclusive profile of prognostic factors.
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Affiliation(s)
- Brady Beltran
- Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
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Chandía L, Sotomayor C, Ordenes S, Salas P, Navarrete M, Lopez M, Otth C. Seroprevalence of human T-cell lymphotropic virus type 1 and 2 in blood donors from the regional hospital of Valdivia, Chile. Med Microbiol Immunol 2010; 199:341-4. [PMID: 20706847 DOI: 10.1007/s00430-010-0166-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Indexed: 10/19/2022]
Abstract
It is estimated that 15-20 millions of people are infected with human T-cell lymphotropic virus 1/2 (HTLV-1/2) worldwide, and 20-30% of them are Latin Americans. The seroprevalence rates vary according to geographic area, socio-demographic composition and individual risk behaviors. The impact of HTLV-1-associated diseases on the community, as well as the increasing concerns about blood transfusion safety due to infectious transmitted agents, has required mandatory screening assays of blood donors as an effective preventive strategy in HTLV-1 transmission. The aim of this study was to estimate the seroprevalence of HTLV-1/2 in blood donors from Valdivia, southern Chile during the first year of mandatory screening of HTLV by Chilean government. Blood samples were collected from blood donors between May 2009 and 2010 at the Regional Hospital of Valdivia, Chile. Serum samples were screened for antibodies against HTLV-1/2 by enzyme-linked immunosorbent assay MUREX HTLV I + II Abbott. Among 6,237 samples tested by serological assay, 28 samples were reactive; nevertheless, confirmatory techniques indicate that only 15 samples were positive to HTLV-1. Our study shows HTLV-1 seroprevalence of 0.24%, indicating a similar seroprevalence associated with blood donors than previous reports for our country.
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Affiliation(s)
- Luis Chandía
- Institute of Clinical Microbiology, Faculty of Medicine, University Austral of Chile, Valdivia, Chile
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Talledo M, López G, Huyghe JR, Verdonck K, Adaui V, González E, Best I, Clark D, Vanham G, Gotuzzo E, Van Camp G, Van Laer L. Evaluation of host genetic and viral factors as surrogate markers for HTLV-1-associated myelopathy/tropical spastic paraparesis in Peruvian HTLV-1-infected patients. J Med Virol 2010; 82:460-6. [PMID: 20087941 DOI: 10.1002/jmv.21675] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a complication that affects up to 5% of HTLV-1-infected individuals. Several host genetic and viral factors have been associated with the risk of HAM/TSP. The aim of this study was to evaluate the performance of a prognostic model for HAM/TSP developed in Japan in a Peruvian population of 71 HAM/TSP patients and 94 asymptomatic carriers (ACs). This model included age, proviral load (PVL), the presence of HLA-A*02 and HLA-Cw*08 alleles, SDF-1 +801, and TNF-alpha -863 polymorphisms, and viral subgroup. We describe frequencies for the four host genetic markers and demonstrate the presence of the HTLV-1 tax B subgroup in Peru. Using cross-validation, we show that the predictive ability of the prognostic model, as characterized by the area under the receiver-operating characteristic curve (AUC), does not differ from a model containing PVL only (both AUC = 0.74). We found some suggestive evidence of a protective effect of the HLA-A*02 allele but failed to replicate the associations with the other three genetic markers and with viral subgroup. A logistic model containing PVL, age, gender, and HLA-A*02 provided the best predictive ability in the Peruvian cohort (AUC = 0.79). J. Med. Virol. 82:460-466, 2010. (c) 2010 Wiley-Liss, Inc.
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Affiliation(s)
- Michael Talledo
- Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Collins JA, Hernández AV, Hidalgo JA, Salazar R. HTLV-I infection is not associated with a higher risk of death in Peruvian HIV-infected patients. Rev Inst Med Trop Sao Paulo 2009; 51:197-201. [PMID: 19738999 DOI: 10.1590/s0036-46652009000400004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Accepted: 05/06/2009] [Indexed: 11/22/2022] Open
Abstract
Limited and contradictory information exists regarding the prognosis of HIV/HTLV-I co-infection. Our goal was to estimate the effect of HTLV-I infection on mortality in HIV-infected patients at a HIV reference center in Peru. We studied a retrospective cohort of HIV-infected patients, who were exposed or unexposed to HTLV-I. Exposed patients were Western Blot (WB) positive for both retroviruses. Unexposed patients were WB positive for HIV, and had least one negative EIA for HTLV-I. These were selected among patients who entered our Program immediately before and after each exposed patient, between January 1990 and June 2004. Survival time was considered between the diagnosis of exposure to HTLV-I and death or censoring. Confounding variables were age, gender, baseline HIV clinical stage, baseline CD4+ T cell count, and antiretroviral therapy. We studied 50 exposed, and 100 unexposed patients. Exposed patients had a shorter survival compared to unexposed patients [median survival: 47 months (95% CI: 17-77) vs. 85 months (95% CI: 70-100), unadjusted p = 0.06]. Exposed patients had a higher rate of mortality compared to unexposed patients (HIV/HTLV-I (24/50 [48%]) vs. HIV only (37/100 [37%]), univariable p = 0.2]. HTLV-I exposure was not associated to a higher risk of death in the adjusted analysis: HR: 1.2 (0.4-3.5). AIDS clinical stage and lack of antiretroviral therapy were associated to a higher risk of dying. In conclusions, HTLV-I infection was not associated with a higher risk of death in Peruvian HIV-infected patients. Advanced HIV infection and lack of antiretroviral therapy may explain the excess of mortality in this population.
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Affiliation(s)
- Jaime A Collins
- HIV/AIDS Unit, Department of Internal Medicine, Guillermo Almenara General Hospital, Lima, Peru.
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Quispe NCS, Feria EB, Santos-Fortuna EDL, Caterino-de-Araujo A. Confirming the presence of HTLV-1 infection and the absence of HTLV-2 in blood donors from Arequipa, Peru. Rev Inst Med Trop Sao Paulo 2009; 51:25-9. [PMID: 19229387 DOI: 10.1590/s0036-46652009000100005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 11/27/2008] [Indexed: 11/22/2022] Open
Abstract
Epidemiological studies conducted in Peru disclosed HTLV-1 to be prevalent in different ethnic groups, and found HTLV-2 in some Amazonian Indians and in men who have sex with men. No data concerning HTLV-1/2 infection in blood donors from Arequipa, a highlands region in southern Peru, is available. We searched for the presence of HTLV-1 and HTLV-2 antibodies in 2,732 serum samples obtained from blood donors from this geographic area. HTLV-1/2-specific antibodies were detected using an enzyme-linked immunosorbent assay (ELISA) and were confirmed by Western blot (WB). Reactive sera had their blood bags discarded from donation, and the demographic characteristics of the donors were analyzed. Thirty-five sera (1.2%) were HTLV seroreactive by ELISA, and 25 were confirmed HTLV-1-positive by WB. One serum disclosed HTLV-positivity, and the remaining nine serum samples showed indeterminate results by WB; three of which had an HTLV-1 indeterminate Gag profile. The median age of HTLV-positive individuals was 34.6 years; 27 were male and eight were female. All individuals were from southern Peru: 27 from Arequipa, five from Puno, and three from Cuzco. HTLV co-positivity with hepatitis B (five sera) and syphilis (one serum) were detected. Previous transfusion and tattooing were observed in two and one individuals, respectively. No serum was positive for HTLV/HIV co-infection. This study confirmed, for the first time, HTLV-1 infection and the absence of HTLV-2 infection in blood donors from Arequipa, Peru and suggests vertical transmission as the major route of HTLV-1 transmission and acquisition in this geographic region.
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Verdonck K, González E, Schrooten W, Vanham G, Gotuzzo E. HTLV-1 infection is associated with a history of active tuberculosis among family members of HTLV-1-infected patients in Peru. Epidemiol Infect 2007; 136:1076-83. [PMID: 17892632 PMCID: PMC2870904 DOI: 10.1017/s0950268807009521] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The purpose of this study was to assess the association between human T-lymphotropic virus 1 (HTLV-1) and a lifetime history of active tuberculosis (TB) among relatives of HTLV-1-infected patients. We reviewed clinical charts of all relatives of HTLV-1-infected index cases who attended our institute in Lima from 1990-2004. The data of 1233 relatives was analysed; 394 (32.0%) were HTLV-1 positive. Eighty-one subjects (6.6%) had a history of active TB, including 45/394 (11.4%) HTLV-1-positive and 36/839 (4.3%) HTLV-1-negative relatives (P<0.001). On multivariate analysis, three factors were associated with TB history: HTLV-1 infection (adjusted OR 2.5, 95% CI 1.6-3.9), age (adjusted OR 1.3, 95% CI 1.1-1.5 per 10-year age increase) and relation to the index case (adjusted OR 2.6, 95% CI 1.3-5.1, for siblings vs. spouses of index cases). In conclusion, HTLV-1 infection may increase the susceptibility to active TB. In populations where both infections are frequent, such an association could affect the dynamics of TB.
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Affiliation(s)
- K Verdonck
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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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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39
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Best I, Adaui V, Verdonck K, González E, Tipismana M, Clark D, Gotuzzo E, Vanham G. Proviral load and immune markers associated with human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Peru. Clin Exp Immunol 2006; 146:226-33. [PMID: 17034574 PMCID: PMC1942059 DOI: 10.1111/j.1365-2249.2006.03208.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2006] [Indexed: 11/30/2022] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is the aetiological agent of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The objective of this study is to identify which ex vivo and in vivo markers are associated independently with HAM/TSP in a Peruvian population. Eighty-one subjects (33 men/48 women) were enrolled: 35 presented with HAM/TSP, 33 were asymptomatic HTLV-1 carriers (ACs) and 13 were HTLV-1-seronegative controls (SCs). Ex vivo markers included T cell proliferation and Th1 [interferon (IFN)-gamma], Th2 [interleukin (IL)-4, IL-5], proinflammatory [tumour necrosis factor (TNF)-alpha] and anti-inflammatory (IL-10) cytokine production in non-stimulated peripheral blood mononuclear cell (PBMC) cultures. In vivo CD4(+) T cell count, markers of Th1 [interferon-inducible protein (IP)-10] and Th2 (sCD30) activity in plasma and HTLV-1 proviral load in PBMCs were also evaluated. In univariate analysis, several markers, including T cell proliferation, IFN-gamma, IP-10, sCD30 and proviral load were associated with HAM/TSP, but in a multiple logistic regression analysis only the proviral load remained associated significantly with disease manifestation [adjusted OR 9.10 (1.24-66.91)]. Our findings suggest that HAM/TSP is associated primarily with proviral load, whereas the observed association with some immune markers seems secondary.
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Affiliation(s)
- I Best
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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Alarcón JO, Friedman HB, Montano SM, Zunt JR, Holmes KK, Quinnan GV. High endemicity of human T-cell lymphotropic virus type 1 among pregnant women in peru. J Acquir Immune Defic Syndr 2006; 42:604-9. [PMID: 16773029 PMCID: PMC2683844 DOI: 10.1097/01.qai.0000221680.52563.d5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Human T-cell lymphotropic virus type 1(HTLV-1) is associated with adult T-cell leukemia, tropical spastic paraparesis, and other immune-mediated diseases. There are reports of groups with high prevalences of HTLV-1 infection in Peru, but there is limited knowledge of the epidemiology of infection or which routes of infection are most important. We studied 2,492 women presenting to a large maternity hospital in Lima for prenatal, delivery, or abortion services. HTLV-1 seropositivity was confirmed in 42 women (1.7%; 95% confidence interval, 1.2-2.2). Seroprevalence increased with age but did not vary by region of birth or recency of migration to Lima. Age greater than 30 years and sexual intercourse before 20 years of age were strongly and independently associated with infection. History of abortion and history of transfusion were of borderline significance. Women whose male partner had a characteristic that might be a marker for risk of sexually transmitted infections were also more likely to be infected. HTLV-1 is common among Peruvians throughout the country and is maintained by a low level of neonatally acquired infection that is amplified by sexual transmission. In addition to screening of the blood supply, instituted in 1997, programs designed to reduce neonatal and sexual transmission should be effective.
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Affiliation(s)
- Jorge O. Alarcón
- Facultad de Medicina/Instituto de Medicina Tropical, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Heidi B. Friedman
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Silvia M. Montano
- Facultad de Medicina/Instituto de Medicina Tropical, Universidad Nacional Mayor de San Marcos, Lima, Peru
- US Naval Medical Research Center Detachment, Lima, Peru
| | - Joseph R. Zunt
- Department of Medicine, University of Washington, Seattle, WA
| | - King K. Holmes
- Department of Medicine, University of Washington, Seattle, WA
| | - Gerald V. Quinnan
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD
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Armah HB, Narter-Olaga EG, Adjei AA, Asomaning K, Gyasi RK, Tettey Y. Seroprevalence of human T-cell lymphotropic virus type I among pregnant women in Accra, Ghana. J Med Microbiol 2006; 55:765-770. [PMID: 16687597 DOI: 10.1099/jmm.0.46426-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Infection with human T-cell lymphotropic virus type I (HTLV-I) occurs mainly in Japan, Central and West Africa and the Caribbean Basin. Although antibody to HTLV-I has been reported among pregnant women in several endemic countries, there is no information regarding the seroprevalence in pregnant Ghanaian women. The reported seroprevalence of HTLV-I among healthy Ghanaian blood donors is between 0.5 and 4.2 %. Therefore, this study was conducted to determine the seroprevalence of HTLV-I among pregnant women attending the antenatal clinic at the 37 Military Hospital, Accra, Ghana, between the months of January and December 2003. The presence of antibodies specific for HTLV-I/II was tested using a particle agglutination test (PAT) kit and confirmed by Western blotting (WB). Of the 960 sera tested, HTLV-I/II antibodies were detected in 24 samples using the PAT kit. WB results indicated that, of the 24 positive PAT specimens, 20 specimens (83.3 %) were HTLV-I positive, one (4.2 %) was HTLV-II positive, two (8.3 %) were HTLV positive and one (4.2 %) was indeterminate. Therefore, the overall seroprevalence of HTLV-I was 2.1 %. Seroprevalence increased with age, suggesting sexual contact as the primary mode of transmission among women of childbearing age, rather than breastfeeding during infancy. The seroprevalence of 2.1 % reported here for HTLV-I in pregnant women in Accra is comparable to that of human immunodeficiency virus among the same population. In conclusion, the results indicate that HTLV-I is prevalent among asymptomatic Ghanaian pregnant women and thus there is a need to consider introducing antenatal screening for HTLV-I in Ghana.
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Affiliation(s)
- Henry B Armah
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
- Department of Microbiology, Biochemistry & Immunology, Morehouse School of Medicine, Hugh Gloster Building (BMSB) Room 350, 720 Westview Drive SW, Atlanta, GA 30310-1495, USA
| | - Edwin G Narter-Olaga
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Andrew A Adjei
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Kofi Asomaning
- Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA
| | - Richard K Gyasi
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
| | - Yao Tettey
- Department of Pathology, University of Ghana Medical School, Korle-Bu, Accra, Ghana
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Proietti FA, Carneiro-Proietti ABF, Catalan-Soares BC, Murphy EL. Global epidemiology of HTLV-I infection and associated diseases. Oncogene 2005; 24:6058-68. [PMID: 16155612 DOI: 10.1038/sj.onc.1208968] [Citation(s) in RCA: 642] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Epidemiologic aspects of human T-lymphotropic virus type I (HTLV-I) infection have been thoroughly studied over the course of approximately 25 years since its first description. The geographic distribution of the virus has been defined, with Japan, Africa, Caribbean islands and South America emerging as the areas of highest prevalence. The reasons for HTLV-I clustering, such as the high ubiquity in southwestern Japan but low prevalence in neighboring regions of Korea, China and eastern Russia are still unknown. The major modes of transmission are well understood, although better quantitative data on the incidence of transmission, and on promoting/inhibiting factors, are needed. Epidemiologic proof has been obtained for HTLV-I's causative role in major disease associations: adult T-cell leukemia (ATL), HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), HTLV-associated uveitis and infective dermatitis. However, more and better studies are needed for other apparent disease outcomes such as rheumatologic, psychiatric and infectious diseases. Since curative treatment of ATL and HAM/TSP is lacking and a vaccine is unavailable, the social and financial cost for the individual, his/her family and the health system is immense. For this reason, public health interventions aimed at counseling and educating high-risk individuals and populations are of paramount importance.
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Affiliation(s)
- Fernando A Proietti
- Department of Social and Preventive Medicine, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena, 190, Belo Horizonte, Minas Gerais 30.130-100, Brazil.
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Gotuzzo E, Cabrera J, Deza L, Verdonck K, Vandamme AM, Cairampoma R, Vizcarra D, Cabada M, Narvarte G, De las Casas C. Clinical characteristics of patients in Peru with human T cell lymphotropic virus type 1-associated tropical spastic paraparesis. Clin Infect Dis 2004; 39:939-44. [PMID: 15472843 DOI: 10.1086/423957] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2003] [Accepted: 05/06/2004] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Human T cell lymphotropic virus type 1 (HTLV-1) is associated with tropical spastic paraparesis (TSP). Peru is an area of endemicity for HTLV-1. METHODS All patients with suspected cases of TSP referred to our institute (Institute of Tropical Medicine Alexander von Humboldt, Lima, Peru) from 1989 through 2002 were interviewed and tested for HTLV-1. All patients with positive results were evaluated by an expert physician. Disease progression was defined as "rapid" if the time between TSP onset and inability to walk unaided was <2 years. RESULTS Among 165 patients enrolled, the symptoms and signs most frequently found were spasticity (in 97.5% of patients), hyperreflexia (95.4%), lower limb paresthesia (90.2%), pyramidal signs (82.6%), urinary complaints (82.0%), and lumbar pain (79.0%). Rapid progression was present in 21.5% of patients; mean age at TSP onset was higher among these patients than among slow progressors (P<.001). Severe spasticity, diminished vibratory sensation, and tremor were found more frequently among rapid progressors, compared with slow progressors. CONCLUSIONS HTLV-1--associated TSP is frequently diagnosed in areas of HTLV-1-endemicity. A subgroup of patients experiences rapid disease progression.
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Affiliation(s)
- E Gotuzzo
- Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
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