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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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2
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Bradshaw D, Taylor GP. HTLV-1 Transmission and HIV Pre-exposure Prophylaxis: A Scoping Review. Front Med (Lausanne) 2022; 9:881547. [PMID: 35572998 PMCID: PMC9103472 DOI: 10.3389/fmed.2022.881547] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/22/2022] [Indexed: 11/24/2022] Open
Abstract
HIV pre-exposure prophylaxis (HIV-PrEP) is effective in reducing the likelihood of HIV acquisition in HIV-negative people at high risk of exposure. Guidelines recommend testing for sexually transmitted infections (STIs) before starting, and periodically on PrEP, including bacterial infections, HIV, hepatitis C virus, and, for those who are non-immune, hepatitis B virus. Diagnosed infections can be promptly treated to reduce onward transmission. HTLV-1 is not mentioned; however, it is predominantly sexually transmitted, causes adult T-cell leukaemia/lymphoma (ATL) or myelopathy in 10% of those infected, and is associated with an increased risk of death in those without any classically HTLV-associated condition. The 2021 WHO Technical Report on HTLV-1 called for the strengthening of global public health measures against its spread. In this scoping review, we, therefore, (1) discuss the epidemiological context of HIV-PrEP and HTLV-1 transmission; (2) present current knowledge of antiretrovirals in relation to HTLV-1 transmission prevention, including nucleos(t)ide reverse transcriptase inhibitors (NRTIs) and integrase strand transfer inhibitors (INSTIs); and (3) identify knowledge gaps where data are urgently required to inform global public health measures to protect HIV-PrEP users from HTLV-1 acquisition. We suggest that systematic seroprevalence studies among PrEP-using groups, including men who have sex with men (MSM), people who inject drugs (PWIDs), and female sex workers (FSWs), are needed. Further data are required to evaluate antiretroviral efficacy in preventing HTLV-1 transmission from in vitro studies, animal models, and clinical cohorts. PrEP delivery programmes should consider prioritizing the long-acting injectable INSTI, cabotegravir, in HTLV-1 endemic settings.
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Affiliation(s)
- Daniel Bradshaw
- Virus Reference Department, UK Health Security Agency, London, United Kingdom
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom
- *Correspondence: Daniel Bradshaw
| | - Graham Philip Taylor
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom
- Imperial College London, London, United Kingdom
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3
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Pereira FM, Santos FLN, Silva ÂAO, Nascimento NM, Almeida MDCC, Carreiro RP, Galvão-Castro B, Rios Grassi MF. Distribution of Human Immunodeficiency Virus and Human T-Leukemia Virus Co-infection in Bahia, Brazil. Front Med (Lausanne) 2022; 8:788176. [PMID: 35083245 PMCID: PMC8784416 DOI: 10.3389/fmed.2021.788176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022] Open
Abstract
Human Immunodeficiency Virus (HIV) and Human T-Leukemia Virus (HTLV) are retroviruses that share similar routes of transmission. In Brazil, the prevalence of HIV and HTLV varies according to geographic region. The state of Bahia, located in the Northeast region, is considered endemic for both retroviruses. The present study aimed to characterize the frequency of HIV/HTLV coinfection and evaluate the geographic distribution of coinfection throughout the state. This cross-sectional study was conducted at the state's Central Laboratory of Public Health (LACEN-BA) and included all samples from 2004 to 2013 submitted to serological testing for anti-HIV and anti-HTLV-1/2, screened by chemiluminescence/ELISA and confirmed by Western blot. Infection rates are expressed as the number of infected individuals per 100,000 inhabitants from each municipality. A total of 129,158 samples originating from 358/417 (85.8%) municipalities in Bahia were evaluated. HTLV was detected in 2.4% of the HIV-positive samples (n = 42) compared to 0.5% of those with negative HIV serology (n = 677) (OR: 4.65; CI: 3.39–6.37). HIV/HTLV coinfection was more frequent in women (69.0%); the median age of coinfected individuals was 47.2 years [interquartile range (IQR): 41.6–55.4 years]. In the 14/417 (3.4%) municipalities where at least one case of HIV/HTLV coinfection was detected, the overall HTLV coinfection rate in HIV-positive samples was 0.25 (range: 0.17–13.84) per 100,000 inhabitants. Most cases of HIV/HTLV-1 coinfection (21/37, 57%) were concentrated in the municipality of Salvador. Isolated instances (one or two cases) of HIV/HTLV-1 coinfection were distributed across municipalities known to be endemic for HTLV infection.
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Affiliation(s)
- Felicidade Mota Pereira
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Gonçalo Moniz Public Health Central Laboratory, Laboratório Central (LACEN), Salvador, Brazil
| | - Fred Luciano Neves Santos
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Ângelo Antônio Oliveira Silva
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil
| | - Nathan Menezes Nascimento
- Bahiana School of Medicine and Public Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | | | - Roberto Perez Carreiro
- Center for Integration of Data and Health Knowledge, Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Gonçalo Moniz Institute, FIOCRUZ-BA, Salvador, Brazil
| | - Bernardo Galvão-Castro
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Bahiana School of Medicine and Public Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
| | - Maria Fernanda Rios Grassi
- Advanced Health Public Laboratory, Gonçalo Moniz Institute, Fundação Oswaldo Cruz - Bahia (FIOCRUZ-BA), Salvador, Brazil.,Bahiana School of Medicine and Public Health, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador, Brazil
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Chabay P, Lens D, Hassan R, Rodríguez Pinilla SM, Valvert Gamboa F, Rivera I, Huamán Garaicoa F, Ranuncolo SM, Barrionuevo C, Morales Sánchez A, Scholl V, De Matteo E, Preciado MV, Fuentes-Pananá EM. Lymphotropic Viruses EBV, KSHV and HTLV in Latin America: Epidemiology and Associated Malignancies. A Literature-Based Study by the RIAL-CYTED. Cancers (Basel) 2020; 12:E2166. [PMID: 32759793 PMCID: PMC7464376 DOI: 10.3390/cancers12082166] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 02/06/2023] Open
Abstract
The Epstein-Barr virus (EBV), Kaposi sarcoma herpesvirus (KSHV) and human T-lymphotropic virus (HTLV-1) are lymphomagenic viruses with region-specific induced morbidity. The RIAL-CYTED aims to increase the knowledge of lymphoma in Latin America (LA), and, as such, we systematically analyzed the literature to better understand our risk for virus-induced lymphoma. We observed that high endemicity regions for certain lymphomas, e.g., Mexico and Peru, have a high incidence of EBV-positive lymphomas of T/NK cell origin. Peru also carries the highest frequency of EBV-positive classical Hodgkin lymphoma (HL) and EBV-positive diffuse large B cell lymphoma, not otherwise specified (NOS), than any other LA country. Adult T cell lymphoma is endemic to the North of Brazil and Chile. While only few cases of KSHV-positive lymphomas were found, in spite of the close correlation of Kaposi sarcoma and the prevalence of pathogenic types of KSHV. Both EBV-associated HL and Burkitt lymphoma mainly affect young children, unlike in developed countries, in which adolescents and young adults are the most affected, correlating with an early EBV seroconversion for LA population despite of lack of infectious mononucleosis symptoms. High endemicity of KSHV and HTLV infection was observed among Amerindian populations, with differences between Amazonian and Andean populations.
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Affiliation(s)
- Paola Chabay
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Daniela Lens
- Flow Cytometry and Molecular Biology Laboratory, Departamento Básico de Medicina, Hospital de Clínicas/Facultad de Medicina, Universidad de la República, CP 11600 Montevideo, Uruguay;
| | - Rocio Hassan
- Oncovirology Laboratory, Bone Marrow Transplantation Center, National Cancer Institute “José Alencar Gomes da Silva” (INCA), Ministry of Health, 20230-130 Rio de Janeiro, Brazil;
| | | | - Fabiola Valvert Gamboa
- Department of Medical Oncology, Cancer Institute and National League against Cancer, 01011 Guatemala City, Guatemala;
| | - Iris Rivera
- Department of Hematology, Salvadoran Institute of Social Security, Medical Surgical and Oncological Hospital (ISSS), 1101 San Salvador, El Salvador;
| | - Fuad Huamán Garaicoa
- Department of Pathology, National Cancer Institute—Society to Fight Cancer (ION-SOLCA), Santiago de Guayaquil Catholic University, Guayaquil 090615, Ecuador;
| | - Stella Maris Ranuncolo
- Cell Biology Department, Institute of Oncology “Angel H. Roffo” School of Medicine, University of Buenos Aires, C1417DTB Buenos Aires, Argentina;
| | - Carlos Barrionuevo
- Department of Pathology, National Institute of Neoplastic Diseases, National University of San Marcos, 15038 Lima, Peru;
| | - Abigail Morales Sánchez
- Research Unit in Virology and Cancer, Children’s Hospital of Mexico Federico Gómez, 06720 Mexico City, Mexico;
| | - Vanesa Scholl
- Department of Integrated Genomic Medicine, Conciencia-Oncohematologic Institute of Patagonia, 8300 Neuquén, Argentina;
| | - Elena De Matteo
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Ma. Victoria Preciado
- Multidisciplinary Institute for Investigation in Pediatric Pathologies (IMIPP), CONICET-GCBA, Molecular Biology Laboratory, Pathology Division, Ricardo Gutiérrez Children’s Hospital, C1425EFD Buenos Aires, Argentina; (P.C.); (E.D.M.); (M.V.P.)
| | - Ezequiel M. Fuentes-Pananá
- Research Unit in Virology and Cancer, Children’s Hospital of Mexico Federico Gómez, 06720 Mexico City, Mexico;
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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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Oliveira-Filho AB, Araújo APS, Souza APC, Gomes CM, Silva-Oliveira GC, Martins LC, Fischer B, Machado LFA, Vallinoto ACR, Ishak R, Lemos JAR, Kupek E. Human T-lymphotropic virus 1 and 2 among people who used illicit drugs in the state of Pará, northern Brazil. Sci Rep 2019; 9:14750. [PMID: 31611600 PMCID: PMC6791863 DOI: 10.1038/s41598-019-51383-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/28/2019] [Indexed: 11/09/2022] Open
Abstract
People who used illicit drugs (PWUDs) represent an important population group for acquisition and viral dispersion. In Brazil, high rates of the human T lymphotropic virus 1 (HTLV-1) and 2 (HTLV-2) have been reported in epidemiological studies. However, the epidemiological scenario of HTLV-1/2 infections in PWUDs is still poorly understood. Thus, this cross-sectional study determined the prevalence, frequency of subtypes and factors associated with HTLV-1/2 infections among PWUDs in the Brazilian state of Pará, an area considered endemic for this virus and with poor health services. Among 826 PWUDs, 53 (6.4%) presented anti-HTLV-1/2 antibodies by EIA and 44 (5.3%) presented proviral DNA by PCR. HTLV-1 and HTLV-2 were detected in 25 (3.0%) and 19 (2.3%) PWUDs, respectively. Subtypes 1a (25/44), transcontinental (23/44) and Japanese subgroups (2/44), 2b (6/44) and 2c (13/44) were identified. Involvement in illicit/criminal activity, daily use of illicit drugs, illicit drug use over 12 years, unprotected sex with other PWUDs, changes in genitalia (including ulcers and wounds), and more than 12 sexual partners were associated with HTLV-1/2 in PWUDs. This high prevalence and intense circulation of subtypes and subgroups of HTLV-1/2 is very worrying, and indicate the need for urgent actions for its control, prevention and treatment.
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Affiliation(s)
- Aldemir B Oliveira-Filho
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, PA, Brazil.
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
| | - Ana Paula S Araújo
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, PA, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Universidade Federal do Pará, Bragança, PA, Brazil
| | - Andreia Polliana C Souza
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, PA, Brazil
- Residência Multiprofissional em Saúde da Mulher e da Criança, Hospital Santo Antonio Maria Zaccaria, Universidade Federal do Pará, Bragança, PA, Brazil
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, PA, Brazil
| | - Camila M Gomes
- Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, PA, Brazil
| | | | - Luísa C Martins
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, PA, Brazil
| | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Grafton, AK, New Zealand
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | - Ricardo Ishak
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brazil
| | - José Alexandre R Lemos
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, PA, Brazil
- Centro de Hemoterapia e Hematologia do Pará, Belém, PA, Brazil
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
- Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
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Marcon CEM, Campos KR, Silva GBD, Schuelter-Trevisol F, Schlindwein AD, Trevisol DJ, Caterino-de-Araujo A. The first survey of human T-cell lymphotropic viruses (HTLV) in HIV/AIDS patients in Santa Catarina State, Brazil. Rev Inst Med Trop Sao Paulo 2019; 61:e53. [PMID: 31618373 PMCID: PMC6792353 DOI: 10.1590/s1678-9946201961053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 09/09/2019] [Indexed: 11/22/2022] Open
Abstract
Santa Catarina is a Brazilian State that has reported the lowest prevalence of human T-cell lymphotropic viruses (HTLV-1/2) in blood donors (0.04%). Although it presents ports, airports and roads that facilitate the entrance and dissemination of new infectious agents, no information exists concerning the HTLV-1/2 infections in HIV/AIDS patients. This study searched for HTLV-1/2 antibodies in plasma samples of 625 HIV/AIDS patients from the municipality of Tubarao (Southern Santa Catarina), and disclosed 1.1% of positivity (0.48% HTLV-1, 0.48% HTLV-2 and 0.16% untypeable HTLV), and a positive correlation with the male sex (OR 4.16) and intravenous drug use (OR 35.18). Although the percentage of 1.1% appears to be low, it is 27.5 times higher than the percentage detected in blood donors. Since HTLV-1 and HTLV-2 are circulating in HIV-infected individuals in Southern Santa Catarina, and these retroviruses could cause a differently impact on the HIV/AIDS outcomes, the surveillance of HTLV-1/2 is necessary, and it could support public health policies in preventing the transmission and dissemination of these viruses in this State.
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Affiliation(s)
| | - Karoline Rodrigues Campos
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doença, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, São Paulo, Brazil
| | - Gabriela Bassi da Silva
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doença, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, São Paulo, Brazil
| | - Fabiana Schuelter-Trevisol
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde, Tubarão, Santa Catarina, Brazil
| | - Aline Daiane Schlindwein
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde, Tubarão, Santa Catarina, Brazil
| | - Daisson José Trevisol
- Universidade do Sul de Santa Catarina, Programa de Pós-Graduação em Ciências da Saúde, Tubarão, Santa Catarina, Brazil
| | - Adele Caterino-de-Araujo
- Secretaria de Estado da Saúde de São Paulo, Coordenadoria de Controle de Doença, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, São Paulo, Brazil
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Pseudotyping of HIV-1 with Human T-Lymphotropic Virus 1 (HTLV-1) Envelope Glycoprotein during HIV-1-HTLV-1 Coinfection Facilitates Direct HIV-1 Infection of Female Genital Epithelial Cells: Implications for Sexual Transmission of HIV-1. mSphere 2018; 3:3/2/e00038-18. [PMID: 29624497 PMCID: PMC5885023 DOI: 10.1128/msphere.00038-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/14/2018] [Indexed: 11/20/2022] Open
Abstract
Female genital epithelial cells cover the genital tract and provide the first line of protection against infection with sexually transmitted pathogenic viruses. These cells normally are impervious to HIV-1. We report that coinfection of cells by HIV-1 and another sexually transmitted virus, human T-lymphotropic virus 1 (HTLV-1), led to production of HIV-1 that had expanded cell tropism and was able to directly infect primary vaginal and cervical epithelial cells. HIV-1 infection of epithelial cells was blocked by neutralizing antibodies against the HTLV-1 envelope (Env) protein, indicating that the infection was mediated through HTLV-1 Env pseudotyping of HIV-1. Active replication of HIV-1 in epithelial cells was demonstrated by inhibition with anti-HIV-1 drugs. We demonstrated that HIV-1 derived from peripheral blood of HIV-1-HTLV-1-coinfected subjects could infect primary epithelial cells in an HTLV-1 Env-dependent manner. HIV-1 from subjects infected with HIV-1 alone was not able to infect epithelial cells. These results indicate that pseudotyping of HIV-1 with HTLV-1 Env can occur in vivo Our data further reveal that active replication of both HTLV-1 and HIV-1 is required for production of pseudotyped HIV-1. Our findings indicate that pseudotyping of HIV-1 with HTLV-1 Env in coinfected cells enabled HIV-1 to directly infect nonpermissive female genital epithelial cells. This phenomenon may represent a risk factor for enhanced sexual transmission of HIV-1 in regions where virus coinfection is common.IMPORTANCE Young women in certain regions of the world are at very high risk of acquiring HIV-1, and there is an urgent need to identify the factors that promote HIV-1 transmission. HIV-1 infection is frequently accompanied by infection with other pathogenic viruses. We demonstrate that coinfection of cells by HIV-1 and HTLV-1 can lead to production of HIV-1 pseudotyped with HTLV-1 Env that is able to directly infect female genital epithelial cells both in vitro and ex vivo Given the function of these epithelial cells as genital mucosal barriers to pathogenic virus transmission, the ability of HIV-1 pseudotyped with HTLV-1 Env to directly infect female genital epithelial cells represents a possible factor for increased risk of sexual transmission of HIV-1. This mechanism could be especially impactful in settings such as Sub-Saharan Africa and South America, where HIV-1 and HTLV-1 are both highly prevalent.
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Campos KR, Gonçalves MG, Costa NA, Caterino-de-Araujo A. Comparative performances of serologic and molecular assays for detecting human T lymphotropic virus type 1 and type 2 (HTLV-1 and HTLV-2) in patients infected with human immunodeficiency virus type 1 (HIV-1). Braz J Infect Dis 2017; 21:297-305. [PMID: 28343818 PMCID: PMC9428028 DOI: 10.1016/j.bjid.2017.02.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/01/2017] [Accepted: 02/03/2017] [Indexed: 11/04/2022] Open
Abstract
The present study evaluated several techniques currently available (commercial kits and in-house assays) for diagnosing human T lymphotropic viruses types 1 and 2 in two groups of patients enrolled at HIV/AIDS specialized care services in São Paulo: Group 1 (G1), n = 1608, 1237 male/371 female, median age 44.3 years old, majority using highly active antiretroviral therapy (HAART); G2, n = 1383, 930 male/453 female, median age of 35.6 years old, majority HAART naïve. Enzyme immunoassays [(EIA) Murex and Gold ELISA] were employed for human T lymphotropic viruses types 1 and 2 screening; Western blotting (WB), INNO-LIA (LIA), real-time PCR pol (qPCR), and nested-PCR-RFLP (tax) were used to confirm infection. Samples were considered human T lymphotropic viruses types 1 and 2 positive when there was reactivity using at least one of the four confirmatory assays. By serological screening, 127/2991 samples were positive or borderline, and human T lymphotropic virus infection was confirmed in 108 samples (three EIA-borderline): 56 human T lymphotropic virus type 1 [G1 (27) + G2 (29)]; 45 human T lymphotropic virus type 2 [G1 (21) + G2 (24)]; one human T lymphotropic virus type 1 + human T lymphotropic virus type 2 (G2); six human T lymphotropic virus [G1 (2) + G2 (4)]. Although there were differences in group characteristics, human T lymphotropic viruses types 1 and 2 prevalence was similar [3.1% (G1) and 4.2% (G2), p = 0.113]. The overall sensitivities of LIA, WB, qPCR, and PCR-RFLP were 97.2%, 82.4%, 68.9%, and 68.4%, respectively, with some differences among groups, likely due to the stage of human T lymphotropic virus infection and/or HAART duration. Indeterminate immunoblotting results were detected in G2, possibly due to the seroconversion period. Negative results in molecular assays could be explained by the use of HAART, the occurrence of defective provirus and/or the low circulating proviral load. In conclusion, when determining the human T lymphotropic virus infection, the findings highlight that there is a need to consider the blood samples with borderline results in screening assays. Of all the tested assays, LIA was the assay of choice for detecting human T lymphotropic virus type 1 and human T lymphotropic virus type 2 in human immunodeficiency virus type 1-infected patients.
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Affiliation(s)
- Karoline Rodrigues Campos
- Secretaria de Estado da Saúde de São Paulo, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, SP, Brazil
| | - Maria Gisele Gonçalves
- Secretaria de Estado da Saúde de São Paulo, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, SP, Brazil
| | - Nadia Aparecida Costa
- Secretaria de Estado da Saúde de São Paulo, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, SP, Brazil
| | - Adele Caterino-de-Araujo
- Secretaria de Estado da Saúde de São Paulo, Instituto Adolfo Lutz, Centro de Imunologia, São Paulo, SP, Brazil.
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10
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Silveira FSD, Bonamigo RR. Sexually Transmitted Diseases: from HPV to HTLV--clinical profile and associated factors. An Bras Dermatol 2016; 90:915-8. [PMID: 26734881 PMCID: PMC4689088 DOI: 10.1590/abd1806-4841.20153663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 09/19/2014] [Indexed: 11/22/2022] Open
Abstract
The Brazilian Ministry of Health recommends the performance of serological tests in patients with clinical signs of Sexually Transmitted Diseases. However, data are lacking to affirm the necessity of testing these patients for human T-lymphotropic virus type 1 or type 2. This is a cross-sectional study with 120 patients seen at the Sexually Transmitted Diseases unit of the Sanitary Dermatology Outpatient Clinic of Rio Grande do Sul. The serum from none of the patients was positive for human T-lymphotropic virus type 1 or type 2. Viral warts were the most frequent diagnosis. Drug use was confirmed as a risk factor and high educational levels were found to be a protective factor against Sexually Transmitted Diseases.
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11
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Nasir IA, Ahmad AE, Emeribe AU, Shehu MS, Medugu JT, Babayo A. Molecular Detection and Clinical Implications of HTLV-1 Infections among Antiretroviral Therapy-Naïve HIV-1-Infected Individuals in Abuja, Nigeria. Virology (Auckl) 2015; 6:17-23. [PMID: 26688662 PMCID: PMC4678997 DOI: 10.4137/vrt.s35331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 11/09/2015] [Accepted: 11/16/2015] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Individuals with human T-cell lymphotrophic virus type-1 (HTLV-1)/HIV-1 coinfection have been demonstrated to undergo CD4+ lymphocytosis even in the face of immunodeficiency and increased vulnerability to opportunistic pathogens that can lead to poor prognosis. OBJECTIVE This study investigated the prevalence as well as the effects of HIV-1/HTLV-1 coinfection on CD4+ cell counts, routine hematology, and biochemical parameters of study participants. MATERIALS AND METHODS This prospective cross-sectional study involved 184 blood samples collected from HIV-1-seropositive individuals attending HIV-special clinic of the University of Abuja Teaching Hospital, Gwagwalada, Nigeria. These samples were analyzed for anti-HTLV-1/2 IgM antibodies using enzyme-linked immunosorbent assay, CD4+ cell counts, and some routine hematological and biochemical parameters. All samples were also tested for HTLV-1 provirus DNA using real-time polymerase chain reaction (PCR) assay. RESULTS Of the 184 subjects studied, 9 (4.9%) were anti-HTLV-1/2 IgM seropositive; however, upon real-time PCR testing, 12 (6.5%) had detectable HTLV-1 provirus DNA. The CD4+ cell count was significantly high in HTLV-1-positive (742 ± 40.2) subjects compared to their HTLV-1-negative (380 ± 28.5) counterpart (P-value = 0.025). However, there was no significant association between HTLV-1 positivity with other hematology and biochemical parameters studied (P > 0.05). CONCLUSION All subjects (100%) who were HTLV-1/HIV-1-coinfected had normal CD4+ counts. This gives contrasting finding on the true extent of immunodeficiency of subjects. So it is suggested to be very careful in using only CD4+ counts to monitor disease progression and as indicators for antiretroviral therapy (ART) in resource-limited settings. In such conditions, there may be a need to test for HTLV-1 alongside HIV viral loads in order to begin appropriate ART regimens that contain both pathogens.
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Affiliation(s)
- Idris Abdullahi Nasir
- Department of Medical Microbiology, University of Abuja Teaching Hospital, FCT Abuja, Nigeria
| | | | | | - Muhammad Sagir Shehu
- Immunology Unit, Department of Medicine, Ahmadu Bello University, Kaduna State, Nigeria
| | - Jessy Thomas Medugu
- Department of Medical Laboratory Science, University of Maiduguri, Borno State, Nigeria
| | - Adamu Babayo
- Department of Medical Microbiology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi State, Nigeria
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Galetto LR, Lunge VR, Béria JU, Tietzmann DC, Stein AT, Simon D. Short communication: Prevalence and risk factors for human T cell lymphotropic virus infection in Southern Brazilian HIV-positive patients. AIDS Res Hum Retroviruses 2014; 30:907-11. [PMID: 24866083 DOI: 10.1089/aid.2013.0210] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
HIV/human T cell lymphotropic virus (HTLV) coinfection has a large range of prevalence in the different risk groups and geographic regions of the world. Most of the HTLV-infected people live in geographic areas where the virus is endemic, as it happens in Brazil. The aim of this study was to identify HTLV prevalence and risk factors in HIV-positive patients. A cross-sectional study was conducted with 580 HIV-positive patients (mean age of 40.6 years and 45.0% men) from a specialized HIV/AIDS diagnosis and treatment center in Southern Brazil. Sociodemographic data, HIV risk factors, and HTLV-1/2 antibodies were collected. HTLV proviral DNA was detected by polymerase chain reaction (PCR). A multivariate analysis was performed to identify risk factors for HTLV infection. HTLV antibodies were detected in 29 (5.0%) and HTLV provirus in 17 (2.9%) patients. HTLV-1 was identified in 11 (64.7%) patients and HTLV-2 in 6 (35.3%) patients. No significant differences were observed between mono and coinfected patients in clinical characteristics regarding HIV/AIDS (time since HIV diagnosis, HIV viral load, lymphocytes CD4(+) count, and use of highly active antiretroviral therapy). Blood transfusion history was significantly associated with HIV/HTLV coinfection (p=0.039). Alcohol abuse was more prevalent in HTLV-positive (47.1%) than in HIV mono-infected patients (20.4%; p=0.008). Tattooing was the only risk factor independently associated with HIV/HTLV coinfection (p=0.035). This information contributes to an understanding of the epidemiology of HIV/HTLV coinfection in Brazil.
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Affiliation(s)
- Leonardo Ramos Galetto
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Vagner Ricardo Lunge
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Jorge Umberto Béria
- Programa de Pós-Graduação em Saúde Coletiva, ULBRA, Canoas, RS, Brazil
- Curso de Medicina, ULBRA, Canoas, RS, Brazil
| | | | - Airton Tetelbom Stein
- Programa de Pós-Graduação em Saúde Coletiva, ULBRA, Canoas, RS, Brazil
- Curso de Medicina, ULBRA, Canoas, RS, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | - Daniel Simon
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
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Guimarães de Souza V, Lobato Martins M, Carneiro-Proietti ABDF, Januário JN, Ladeira RVP, Silva CMS, Pires C, Gomes SC, Martins CDS, Mochel EG. High prevalence of HTLV-1 and 2 viruses in pregnant women in São Luis, state of Maranhão, Brazil. Rev Soc Bras Med Trop 2012; 45:159-62. [PMID: 22534984 DOI: 10.1590/s0037-86822012000200004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 08/08/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Human T cell lymphotropic virus type 1 (HTLV-1) is endemic in the Caribbean, Japan, South America and regions of Africa. HTLV-2 is present in Native American populations and associated with IV drug use in Europe and North America. In Brazil, it is estimated that 1.5 million people are infected with HTLV-1/2. The study objective was to determine HTLV-1/2 prevalence in pregnant women in the prenatal care from three public services in São Luis, State of Maranhão, Brazil, and to counsel seropositive women to reduce viral transmission. METHODS A cross-sectional study was conducted from February to December 2008; women with age of 18 to 45 years, with low risk for sexually transmitted disease (STD) were invited to participate. Blood samples were collected in filter paper, and HTLV-1/2 immunoenzymatic test (ELISA) was performed as a screening test. Women with reactive results were submitted to peripheral venous blood collection for ELISA repetition, followed by Western blot (WB) and real-time PCR to confirm and discriminate the infection between virus types 1 and 2. RESULTS Of the 2,044 women tested, seven (0.3%) were ELISA reactive and confirmed positive (four were HTLV-1, and three were HTLV-2). All positive women were oriented not to breastfeed their newborns. CONCLUSIONS This study showed that the virus is present in high prevalence in that population. Further studies covering other segments of the population are necessary to better characterize the presence of HTLV-1/2 in Maranhão and to elicit measures to prevent its spread.
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Beilke MA. Retroviral coinfections: HIV and HTLV: taking stock of more than a quarter century of research. AIDS Res Hum Retroviruses 2012; 28:139-47. [PMID: 22171689 DOI: 10.1089/aid.2011.0342] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Retroviral coinfections with HIV-1 and HTLV-1 or with HIV-1 and HTLV-2 occur with variable frequencies throughout the world with the highest prevalence in large metropolitan areas in the Americas, Europe, and Africa. The recognition that retroviral coinfections exist dates back to the discovery of HIV-1 over 25 years ago. Despite the large body of published information regarding the biological and clinical significance of retroviral coinfections, controversy throughout several decades of research was fueled by several flawed epidemiologic studies and anecdotal reports that were not always supported with ample statistical and scientific evidence. However, the growing consensus obtained from recent systematic and well-devised research provides support for at least three conclusions: (1) HIV-1 and HTLV-1 coinfections are often seen in the context of patients with high CD4(+) T cell counts presenting with lymphoma or neurological complications; (2) HIV-1 and HTLV-2 coinfections have been linked in some cases to a "long term nonprogressor" phenotype; and (3) differential function and/or overexpression of the HTLV-1 and HTLV-2 Tax proteins likely play a pivotal role in the clinical and immunologic manifestations of HIV/HTLV-1 and -2 coinfections. This review will recount the chronology of work regarding retroviral coinfections from 1983 through the present.
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Affiliation(s)
- Mark A. Beilke
- Division of Infectious Diseases, Medical College of Wisconsin, Milwaukee, Wisconsin
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15
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Current status of HTLV-1 infection. Int J Hematol 2011; 94:430-4. [PMID: 21969187 DOI: 10.1007/s12185-011-0934-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 08/31/2011] [Accepted: 09/02/2011] [Indexed: 10/17/2022]
Abstract
It is 30 years since human T-cell leukemia virus type 1 (HTLV-1) was identified as the first human retrovirus. To assess the implications of the virus for human health it is very important to know the past and present prevalence. Most of the estimates of HTLV-1 prevalence are based on serological screening of blood donors, pregnant women and other selected population groups. The widely cited estimate that the number of HTLV-1 carriers in Japan is 1.2 million was calculated from data that are now more than 25 years old. Here I summarize previous reports of prevalence studies in the world and Japan. Then, a recent analysis of seroprevalence of healthy blood donors in Japan will be described in comparison with that of 1988. A decrease in the number of HTLV-1 carriers in Japan was demonstrated, however, it is still more than one million. The number has increased in the metropolitan areas, probably reflecting the migration of Japanese population. I conclude that there is a paucity of general population data in countries where HTLV-1 is endemic, and re-evaluation of HTLV-1 infection is required to understand the virus burden on the human health.
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Bhatt NB, Gudo ES, Semá C, Bila D, Di Mattei P, Augusto O, Garsia R, Jani IV. Loss of correlation between HIV viral load and CD4+ T-cell counts in HIV/HTLV-1 co-infection in treatment naive Mozambican patients. Int J STD AIDS 2010; 20:863-8. [PMID: 19948902 DOI: 10.1258/ijsa.2008.008401] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Seven hundred and four HIV-1/2-positive, antiretroviral therapy (ART) naïve patients were screened for HTLV-1 infection. Antibodies to HTLV-1 were found in 32/704 (4.5%) of the patients. Each co-infected individual was matched with two HIV mono-infected patients according to World Health Organization clinical stage, age +/-5 years and gender. Key clinical and laboratory characteristics were compared between the two groups. Mono-infected and co-infected patients displayed similar clinical characteristics. However, co-infected patients had higher absolute CD4+ T-cell counts (P = 0.001), higher percentage CD4+ T-cell counts (P < 0.001) and higher CD4/CD8 ratios (P < 0.001). Although HIV plasma RNA viral loads were inversely correlated with CD4+ T-cell-counts in mono-infected patients (P < 0.0001), a correlation was not found in co-infected individuals (P = 0.11). Patients with untreated HIV and HTLV-1 co-infection show a dissociation between immunological and HIV virological markers. Current recommendations for initiating ART and chemoprophylaxis against opportunistic infections in resource-poor settings rely on more readily available CD4+ T-cell counts without viral load parameters. These guidelines are not appropriate for co-infected individuals in whom high CD4+ T-cell counts persist despite high HIV viral load states. Thus, for co-infected patients, even in resource-poor settings, HIV viral loads are likely to contribute information crucial for the appropriate timing of ART introduction.
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Affiliation(s)
- N B Bhatt
- Department of Immunology, Instituto Nacional de Saúde, Maputo, Mozambique.
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