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Paulino-Ramirez R, Tapia L, Ruiz-Matuk C, Charow R, Budhwani H, Routy JP. Human T-cell lymphotropic virus 1/2 and human immunodeficiency virus antibodies identification among transactional sex workers and drug users in the Dominican Republic. Trans R Soc Trop Med Hyg 2020; 113:293-297. [PMID: 30892643 DOI: 10.1093/trstmh/trz012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/09/2019] [Accepted: 02/15/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) increases the risk of acquiring human T-cell lymphotropic virus (HTLV) and subsequently HTLV's progression to tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). Existing data have exclusively reported generalized rates of HIV and HTLV-1 chronic viral infections in the Dominican Republic. To our knowledge, no published studies have focused on the rates of HTLV-1/2 in transactional sex workers and drug users, both higher risk groups, in the Dominican Republic. METHODS From December 2012 to April 2013 we conducted a study to estimate the seroprevalence of HTLV-1/2 immunoglobulin G (IgG) and HIV antibodies among transactional sex workers and intravenous drug users in Santo Domingo, Dominican Republic. Serological status was analysed with behaviour and demographic data. RESULTS We collected and analysed plasma from 200 participants with a mean age of 27.4 y in men and 25.2 y in women. The overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (95% CI 7.59 to 20.23) in men and 10.59% (95% CI 4.05 to 17.13) in women. The overall weighted seroprevalence of HIV-1 was 13.91% (95% CI 7.59 to 20.23%) in men and 17.65% (95% CI 9.55 to 25.75) in women. Male intravenous drug users had an exceptionally high rate of HTLV-positive HIV co-infection, at 75% (95% CI 44.99 to 105.01). Although there an association has been found between HTLV/HIV co-infections and sex work, the adjusted odds revealed a confounding role of HIV infection. CONCLUSIONS The results highlight the urgent need for enhanced public health preventive strategies among high-risk populations in the Dominican Republic and other resource-constrained Caribbean settings, as well as global adoption of routine screening for HTLV-associated infections, particularly in these high-risk, underserved populations.
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Affiliation(s)
- Robert Paulino-Ramirez
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic
| | - Leandro Tapia
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic
| | - Carlos Ruiz-Matuk
- Instituto de Medicina Tropical & Salud Global, Universidad Iberoamericana (UNIBE), Calle Majoma 13, Los Rios, Santo Domingo, Dominican Republic
| | - Rebecca Charow
- Centro de Orientación e Investigación Integral (COIN), Calle Anibal de Espinosa 352, Santo Domingo, Dominican Republic
| | - Henna Budhwani
- University of Alabama at Birmingham (UAB), School of Public Health, Department of Health Care Organization and Policy, 1720 2nd Avenue South, Birmingham, AL
| | - Jean-Pierre Routy
- McGill University Health Centre: Glenn Site, Research Institute, Block E Suite EM 3-3232, Mezzanine 3M, 1001 Boulevard Décaire, Montreal, Quebec, Canada
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Roc L, de Mendoza C, Fernández-Alonso M, Reina G, Soriano V. Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals. Ther Adv Infect Dis 2019; 6:2049936119868028. [PMID: 31467675 PMCID: PMC6704407 DOI: 10.1177/2049936119868028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/16/2019] [Indexed: 12/28/2022] Open
Abstract
Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor–recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain.
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Affiliation(s)
- Lourdes Roc
- Microbiology Department, Hospital Miguel Servet, Zaragoza
| | - Carmen de Mendoza
- Puerta de Hierro Research Institute and University Hospital, Majadahonda, Madrid, Spain
| | | | - Gabriel Reina
- Microbiology Department, Clinica Universitaria, Pamplona
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de Mendoza C, Roc L, Benito R, Reina G, Ramos JM, Gómez C, Aguilera A, Rodríguez-Iglesias M, García-Costa J, Fernández-Alonso M, Soriano V. HTLV-1 infection in solid organ transplant donors and recipients in Spain. BMC Infect Dis 2019; 19:706. [PMID: 31399112 PMCID: PMC6688206 DOI: 10.1186/s12879-019-4346-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/31/2019] [Indexed: 11/22/2022] Open
Abstract
Background HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. Methods All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. Results A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. Conclusion The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy.
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Affiliation(s)
- Carmen de Mendoza
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.,Universidad CEU-San Pablo, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | - Vicente Soriano
- UNIR Health Sciences School and Medical Centre, Calle Almansa 101, 28040, Madrid, Spain.
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Abstract
: Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20-25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers.
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Abedi F, Mozhgani SH, Rahimzadegan M, Gudarzi H, Valizadeh N, Rezaee SA. Prevalence and phylogenic study of human T-lymphotropic virus 1 in patients with thalassemia in the northeast of Iran. Future Virol 2017. [DOI: 10.2217/fvl-2016-0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Aim: This study aimed to investigate the frequency and phylogenetic distribution of human T-lymphotropic virus type 1 (HTLV-1) in thalassemia cases. Methods: Between 2006 and 2013, a total of 100 thalassemic individuals were investigated for HTLV-1 infections. Results: Four people (4%) were reactive for HTLV antibodies. No considerable correlation was seen between factors such as age, blood transfusion history, surgery, marital status, gender and blood types. All HTLV-1 sequences belonged to the transcontinental (A) subgroup in the cosmopolitan (a) subtype. Conclusion: In addition to phylogenetic distribution, our results demonstrate that the prevalence of HTLV-1 infection among thalassemia patients in Mashhad is higher than that of previous studies.
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Affiliation(s)
- Farshid Abedi
- Department of Infectious Disease, Birjand University of Medical Sciences, Birjand, Iran
- Department of Infectious Disease, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sayed-Hamidreza Mozhgani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Rahimzadegan
- Department of Infectious Disease, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Gudarzi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Valizadeh
- Immunology Research Center, Inflammation & Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Immunology Research Center, Inflammation & Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
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Treviño A, Aguilera A, Rodríguez-Iglesias M, Hernández A, Benito R, Roc L, Ramos JM, Ortiz de Lejarazu R, Rodríguez C, del Romero J, Calderón E, García-Costa J, Poveda E, Requena S, Soriano V, de Mendoza C, on behalf of the Spanish HTLV Netwo. HTLV infection in HCV-antibody positive patients in Spain. AIDS Res Hum Retroviruses 2017; 33:1013-1017. [PMID: 28269998 DOI: 10.1089/aid.2016.0323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Since hepatitis C virus (HCV) and human T-lymphotropic virus (HTLV) share transmission routes, dual infection could be frequent. In Spain, HTLV underdiagnosis is highlighted by the high proportion of patients presenting either with tropical spastic paraparesis (TSP) or adult T-cell leukemia (ATL) at first diagnosis. We examined whether the renewed efforts for expanding HCV testing may provide a sentinel population that might selectively be targeted to unveil asymptomatic HTLV carriers. The presence of anti-HTLV antibodies was examined in 3,838 consecutive individuals with reactive HCV serology attended during the last three years at 13 hospitals distributed across the Spanish geography. Overall 71% were male and the median age was 41-years old. Foreigners represented 9% of the study population. A total of 50 individuals (1.3%) were seroreactive for HTLV, being 30 confirmed as HTLV-2 and two as HTLV-1 (0.12%). The remaining 18 had indeterminate Western blot patterns. Most individuals with HTLV-2 and HTLV indeterminate serology were HIV-positive, former injection drug users and native Spaniards. In contrast, the two HTLV-1 infections were found in men coming from Brazil and the Dominican Republic, respectively. In summary, the overall prevalence of HTLV infection in individuals living in Spain seropositive for HCV is 1.3%, more than 10-fold greater than in general outclinics in Spain. However, immigrants from HTLV-1 endemic regions and former injection drug users with HTLV-2 infection are by far the major contributory groups in HCV patients. Therefore, testing for HTLV in newly diagnosed HCV individuals would not contribute much to improve late HTLV diagnosis in Spain.
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Affiliation(s)
- Ana Treviño
- Internal Medicine Laboratory, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Antonio Aguilera
- Microbiology Department, Hospital de Conxo-CHUS, Santiago de Compostela, Spain
| | | | - Araceli Hernández
- Microbiology Department, Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain
| | - Rafael Benito
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Lourdes Roc
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
| | | | | | | | | | - Enrique Calderón
- Internal Medicine Department, Hospital Virgen del Rocío and CIBERESP, Sevilla, Spain
| | | | - Eva Poveda
- Clinical Virology Unit, INIBIC-Complejo Hospitalario Universitario, A Coruña, Spain
| | - Silvia Requena
- Internal Medicine Laboratory, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Vicente Soriano
- Infectious Diseases Unit, La Paz University Hospital and Autonomous University, Madrid, Spain
| | - Carmen de Mendoza
- Internal Medicine Laboratory, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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Screening transplant donors for HTLV-1 and -2. Blood 2016; 128:3029-3031. [PMID: 28034870 DOI: 10.1182/blood-2016-09-739433] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 11/04/2016] [Indexed: 11/20/2022] Open
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Gövert F, Krumbholz A, Witt K, Hopfner F, Feldkamp T, Korn K, Knöll A, Jansen O, Deuschl G, Fickenscher H. HTLV-1 associated myelopathy after renal transplantation. J Clin Virol 2015; 72:102-5. [DOI: 10.1016/j.jcv.2015.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 08/25/2015] [Accepted: 09/25/2015] [Indexed: 11/16/2022]
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