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Katsuya H, Cook LBM, Rowan AG, Melamed A, Turpin J, Ito J, Islam S, Miyazato P, Jek Yang Tan B, Matsuo M, Miyakawa T, Nakata H, Matsushita S, Taylor GP, Bangham CRM, Kimura S, Satou Y. Clonality of HIV-1- and HTLV-1-Infected Cells in Naturally Coinfected Individuals. J Infect Dis 2022; 225:317-326. [PMID: 33844021 DOI: 10.1093/infdis/jiab202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/11/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Coinfection with human immunodeficiency virus type 1 (HIV-1) and human T-cell leukemia virus type 1 (HTLV-1) diminishes the value of the CD4+ T-cell count in diagnosing AIDS, and increases the rate of HTLV-1-associated myelopathy. It remains elusive how HIV-1/HTLV-1 coinfection is related to such characteristics. We investigated the mutual effect of HIV-1/HTLV-1 coinfection on their integration sites (ISs) and clonal expansion. METHODS We extracted DNA from longitudinal peripheral blood samples from 7 HIV-1/HTLV-1 coinfected, and 12 HIV-1 and 13 HTLV-1 monoinfected individuals. Proviral loads (PVL) were quantified using real-time polymerase chain reaction (PCR). Viral ISs and clonality were quantified by ligation-mediated PCR followed by high-throughput sequencing. RESULTS PVL of both HIV-1 and HTLV-1 in coinfected individuals was significantly higher than that of the respective virus in monoinfected individuals. The degree of oligoclonality of both HIV-1- and HTLV-1-infected cells in coinfected individuals was also greater than in monoinfected subjects. ISs of HIV-1 in cases of coinfection were more frequently located in intergenic regions and transcriptionally silent regions, compared with HIV-1 monoinfected individuals. CONCLUSIONS HIV-1/HTLV-1 coinfection makes an impact on the distribution of viral ISs and clonality of virus-infected cells and thus may alter the risks of both HTLV-1- and HIV-1-associated disease.
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Affiliation(s)
- Hiroo Katsuya
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.,Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Lucy B M Cook
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Aileen G Rowan
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Anat Melamed
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Jocelyn Turpin
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Jumpei Ito
- Division of Systems Virology, Department of Infectious Disease Control, International Research Center for Infectious Diseases, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Saiful Islam
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Paola Miyazato
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Benjy Jek Yang Tan
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Misaki Matsuo
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Toshikazu Miyakawa
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto, Japan
| | - Hirotomo Nakata
- Department of Hematology, Rheumatology and Infectious Diseases, Kumamoto University of Medicine, Kumamoto, Japan
| | - Shuzo Matsushita
- Clinical Retrovirology, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Charles R M Bangham
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
| | - Shinya Kimura
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yorifumi Satou
- Division of Genomics and Transcriptomics, Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan.,International Research Center for Medical Sciences, Kumamoto University, Kumamoto, Japan
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Brites C, Miranda F, Luz E, Netto EM. Early and Successful Combination Antiretroviral Therapy Normalizes Survival Time in Patients Coinfected With Human Immunodeficiency Virus and Human T-cell Lymphotrophic Virus Type 1. Clin Infect Dis 2021; 71:196-200. [PMID: 31406994 DOI: 10.1093/cid/ciz756] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/05/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Coinfection with human T-cell lymphotrophic virus type 1 (HTLV-1) is associated with shorter survival for adults and children infected with human immunodeficiency virus (HIV), although the reasons remain a matter of debate. We evaluated the factors associated with survival time in a large cohort of HIV/HTLV-1-coinfected and HIV-monoinfected individuals on combination antiretroviral therapy (cART). METHODS In a nested, retrospective case-control study (1:1), we reviewed medical records of people with HIV infection on cART in a referral AIDS center in Salvador, Brazil. We matched 149 patients coinfected with HTLV-1 (cases) by age at HIV diagnosis and sex, to an equal number of HTLV-uninfected persons (controls). Death rates, survival time, baseline and current CD4 cell count, last HIV-1 RNA plasma viral load (pVL), and causes of death were compared between groups. RESULTS The overall mortality rate was 2.1 person-years (76 deaths, 53 among coinfected patients). Survival time for cases (16.7 ± 0.7 years) was significantly shorter than for controls (18.1 ± 0.4 years; P = .001). Among patients with pVL >50 copies/mL, coinfected patients had a shorter survival time (8.4 ± 0.8 years) than monoinfected ones (12.9 ± 1.4 years; P = .02), regardless of pVL magnitude. However, survival time did not differ for HIV-monoinfected (19.0 ± 0.4 years) or coinfected patients (20.2 ± 0.6 years) presenting with pVL <50 copies/mL (P = .5). Deceased coinfected patients had higher initial CD4 count (417 ± 219 cells) than monoinfected ones with the same outcome (177 ± 160 cells; P = .004), while survivors had similar CD4 cell count at baseline, regardless of HTLV status. CONCLUSIONS Successful cART is able to normalize survival for coinfected patients and should be introduced for all coinfected patients, regardless of CD4 cell count.HIV/human T-cell lymphotrophic virus type 1 coinfection is believed to decrease survival of coinfected patients. In this case-control study, we demonstrate that successful combination antiretroviral therapy (last HIV viral load <50 copies/mL) is able to improve survival of coinfected patients to levels observed for those monoinfected.
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Affiliation(s)
- Carlos Brites
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
| | - Fernanda Miranda
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
| | - Estela Luz
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
| | - Eduardo Martins Netto
- Laboratório de Pesquisa em Infectologia, Complexo Hospitalar Professor Edgard Santos, Faculdade de Medicina, Universidade Federal da Bahia, Brazil
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First Report of Prevalence of HTLV-1 Among HIV-1/2-Infected Children in Mozambique. J Acquir Immune Defic Syndr 2018; 74:e54-e56. [PMID: 27753683 DOI: 10.1097/qai.0000000000001194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Laher AE, Ebrahim O. HTLV-1, ATLL, severe hypercalcaemia and HIV-1 co-infection: an overview. Pan Afr Med J 2018; 30:61. [PMID: 30344845 PMCID: PMC6191272 DOI: 10.11604/pamj.2018.30.61.13238] [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: 07/03/2017] [Accepted: 04/30/2018] [Indexed: 11/11/2022] Open
Abstract
HIV and HTLV (Human T-ymphotropic Virus) are the only known retroviruses responsible for causing infection in humans. HTLV-1 and HIV-1 are frequent co-pathogens, however, despite its potential for accelerated progression of HIV disease and the risk of developing adult T-cell lymphoma/leukemia (ATLL), HTLV-1 is seldom considered for investigation in the HIV-1 positive individual. Severe/refractory hypercalcaemia, unresponsive to conventional calcium lowering therapy may complicate up to 70% of cases of ATLL. In addition, HTLV-1 and ATLL have both been associated with a rise in dysfunctional CD4 lymphocytes, thereby conveying a false sense of immune competence in the HIV-1 infected individual.
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Affiliation(s)
- Abdullah Ebrahim Laher
- Department of Emergency Medicine and Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, 5 Jubilee Road, Parktown, Johannesburg, 2193, South Africa
| | - Osman Ebrahim
- Department of Internal Medicine and HIV clinic, Life Brenthurst Hospital, Johannesburg, South Africa
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Augusto Â, Augusto O, Taquimo A, Nhachigule C, Siyawadya N, Tembe N, Bhatt N, Mbofana F, Gudo ES. First description of HTLV-1/2 seroprevalence in HIV-infected inmates in Mozambique. J Med Virol 2017; 89:1498-1502. [PMID: 28240367 DOI: 10.1002/jmv.24801] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 01/24/2017] [Indexed: 11/10/2022]
Abstract
No study has yet been conducted to estimate the burden of co-infection of HIV and HTLV-1/2 in inmates in sub-Saharan Africa. To investigate prevalence of co-infection in inmates in Mozambique, a total of 2140 inmates were screened for HIV, of which 515 were HIV seropositive. All HIV seropositive inmates were further screened for HTLV infection, and eight (1.55%) were co-infected. Co-infection was higher in females (3.45% [2/58; CI: 0.42-11.91]) as compared to males (1.35% [6/445; CI: 0.55-3.06]). Early screening of HTLV in prisons is urgently needed in Mozambique in order to improve the care provided to incarcerated individuals, including initiation of ART.
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Affiliation(s)
- Ângelo Augusto
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Orvalho Augusto
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Atija Taquimo
- Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Carina Nhachigule
- Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Narcisa Siyawadya
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Nelson Tembe
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Nilesh Bhatt
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Francisco Mbofana
- Direcção Nacional de Saúde Pública, Ministério da Saúde, Maputo, Mozambique
| | - Eduardo Samo Gudo
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
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Amoussa AER, Wilkinson E, Giovanetti M, de Almeida Rego FF, Araujo THA, de Souza Gonçalves M, de Oliveira T, Alcantara LCJ. HTLV-1aA introduction into Brazil and its association with the trans-Atlantic slave trade. INFECTION GENETICS AND EVOLUTION 2017; 48:95-101. [DOI: 10.1016/j.meegid.2016.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/21/2016] [Accepted: 12/06/2016] [Indexed: 10/20/2022]
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Matavele Chissumba R, Silva-Barbosa SD, Augusto Â, Maueia C, Mabunda N, Gudo ES, Bhatt N, Jani I, Savino W. CD4(+)CD25(High) Treg cells in HIV/HTLV co-infected patients with neuropathy: high expression of Alpha4 integrin and lower expression of Foxp3 transcription factor. BMC Immunol 2015; 16:52. [PMID: 26329520 PMCID: PMC4557637 DOI: 10.1186/s12865-015-0116-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 08/28/2015] [Indexed: 01/20/2023] Open
Abstract
Background Regulatory CD4 T cells (Tregs) are critical in maintaining the homeostasis of the immune system. Quantitative or phenotypic alterations and functional impairment of Tregs have been associated with the development of pathologies including those of the central nervous system. Individuals with HIV-1/HTLV-1 co-infection are more prone to develop neurological complications. The aim of this study was to characterize phenotypically Treg cells in HIV-1/HTLV-1 co-infected Mozambican individuals presenting neurological symptoms. Methods A cross-sectional study was conducted among HIV-infected individuals presentingneurological symptoms, with and without HTLV co-infection, and blood donors. Peripheral bloodmononuclear cells were stained with monoclonal antibodies conjugated with fluorochromes to quantifyTregs and activated T cells by four colors flow cytometry. Results Higher Treg cell frequency (10.6 %) was noted in HIV-1/HTLV-1 co-infected group with neurological symptoms when compared to HIV-1 mono-infected group with neurological symptoms (0.38 %, p = 0.003) and control group (0.9 %, p = 0.0105). An inverse correlation between Foxp3 and CD49d expression was observed in all study groups (rh = −0.71, p = 0.001). In addition, increased levels of Treg cells in co-infected patients were strongly associated with total activated CD4 T cells (rh = 0.8, p = 0.01). Conclusion Treg cells in co-infected patients present phenotypic alterations and might have dysfunction marked by low expression of Foxp3 and increased expression of molecules not frequently seen on Treg cells, such as CD49d. These alterations may be related to (1) changes in Treg cell trafficking and migration, possibly making those cells susceptible to HIV infection, and (2) inability to control the activation and proliferation of effector T lymphocytes.
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Affiliation(s)
- Raquel Matavele Chissumba
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Suse Dayse Silva-Barbosa
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Ângelo Augusto
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Cremildo Maueia
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Nédio Mabunda
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Eduardo Samo Gudo
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Nilesh Bhatt
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Ilesh Jani
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane 1008, 2nd floor, Maputo, Mozambique.
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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9
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Liu MQ, Tang L, Kong WH, Zhu ZR, Peng JS, Wang X, Yao ZZ, Schilling R, Zhou W. CD4+ T cell count, HIV-1 viral loads and demographic variables of newly identified patients with HIV infection in Wuhan, China. J Med Virol 2013; 85:1687-91. [PMID: 23861066 DOI: 10.1002/jmv.23627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/09/2022]
Abstract
In China, the rate of human immunodeficiency virus (HIV) testing is increasing among men who have sex with men. The purpose of the present study was to describe HIV-related biomarkers and selected demographic variables of persons with newly diagnosed HIV/AIDS, among men who have sex with men in particular, in Wuhan China. Demographic indicators, and CD4+ T cell counts and HIV-1 viral load were collected from individuals newly identified as HIV-1 antibody positive during 2011. Of 176 enrolled patients, 132 (75.0%) were men who have sex with men. This group was significantly younger and had higher CD4+ T cell counts than patients who were likely infected through heterosexual contact. Most men who have sex with men (56.6%) were discovered by initiative investigation. Among heterosexual patients CD4+ T cell counts and HIV-1 viral load were significantly correlated; among the group of men who have sex with men, no such association was found.
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Affiliation(s)
- Man-Qing Liu
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
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10
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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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Gudo ES, Bhatt NB, Augusto O, Semá C, Savino W, Ferreira OC, Jani IV. Performance of absolute CD4+ count in predicting co-infection with human T-lymphotropic virus type 1 in antiretroviral-naïve HIV-infected patients. Int J STD AIDS 2012; 23:717-23. [DOI: 10.1258/ijsa.2012.011446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Early identification of patients co-infected with HIV and human T-lymphotropic virus type 1 (HTLV-1) is essential to improve care, as CD4+ T-cell counts have been revealed to be an unreliable laboratory parameter to monitor HIV infection in co-infection. Unfortunately, HTLV-1 testing is not currently available in sub-Saharan Africa. We conducted this study to determine the performance of absolute CD4+ T-cell count estimation in guiding the clinical suspicion of co-infection. A cross-sectional survey was conducted in antiretroviral-naïve HIV (AN-HIV) patients attending an HIV outpatient clinic in Maputo city, Mozambique. Seven hundred and one AN-HIV patients were enrolled in the study. The prevalence of HTLV-1 co-infection was 4.5% (95% confidence interval [CI] 3.0–6.0%). Logistic regression analysis showed that CD4+ T-cell count was an independent predictor of co-infection ( P value: 0.000). The performance of absolute CD4+ T-cell counts in predicting co-infection was higher in symptomatic HIV patients when compared with asymptomatic HIV patients. The best performance was achieved with the cut-off of CD4+ count of 500 cells/mm3, which gave sensitivity, specificity, positive and negative predictive values of 54.2%, 87.2%, 24.0% and 96.2%, respectively. In conclusion, our data provide evidence that the absolute CD4+ T-cell count is of moderate accuracy in guiding the clinical suspicion of co-infection in AN-HIV and its implementation could improve the care provided to a significant number of HIV patients in Mozambique.
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Affiliation(s)
- E S Gudo
- Instituto Nacional de Saúde, PO Box 264, Maputo, Mozambique
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation
| | - N B Bhatt
- Instituto Nacional de Saúde, PO Box 264, Maputo, Mozambique
| | - O Augusto
- Instituto Nacional de Saúde, PO Box 264, Maputo, Mozambique
| | - C Semá
- Instituto Nacional de Saúde, PO Box 264, Maputo, Mozambique
| | - W Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation
| | - O C Ferreira
- Department of Genetics, Federal University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - I V Jani
- Instituto Nacional de Saúde, PO Box 264, Maputo, Mozambique
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Naniche D, Letang E, Nhampossa T, David C, Menendez C, Alonso P. Alterations in T cell subsets in human immunodeficiency virus-infected adults with co-infections in southern Mozambique. Am J Trop Med Hyg 2011; 85:776-81. [PMID: 21976586 DOI: 10.4269/ajtmh.2011.10-0713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
T cell activation and depletion of naive T cells are hallmarks of human immunodeficiency virus (HIV) pathogenesis. This study explored the relationships between certain co-infections (including syphilis, hepatitis B and C, human T cell lymphotrophic viruses I and II [HTLV-I/II], Kaposi sarcoma-associated herpesvirus [KSHV], Plasmodium falciparum malaria, and tuberculosis), and levels of activated CD8 and CD4 T cell subsets as well as naive and memory CD4 T cells in HIV-infected adults in a rural area of southern Mozambique. We found that syphilis infection and to a lesser extent HTLV-I/II seropositivity were independently associated with higher CD8 T cell activation (CD8+ CD38+ HLA-DR+) whereas only syphilis was associated with higher CD4 T cell activation. Furthermore, KSHV and HTLV-I/II seropositivities were independently associated with a lower percentage of naive CD4 T cells (CD4+ CD45RA+ CD62L+). These results highlight the importance of screening and prompt treatment of syphilis, and raise questions as to whether HIV-positive persons with certain chronic viral co-infections should initiate combined antiretroviral therapy at higher CD4 cell counts.
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Vicente ACP, Gudo ES, Iñiguez AM, Otsuki K, Bhatt N, Abreu CM, Vubil A, Bila D, Ferreira OC, Tanuri A, Jani IV. Genetic characterization of human T-cell lymphotropic virus type 1 in Mozambique: transcontinental lineages drive the HTLV-1 endemic. PLoS Negl Trop Dis 2011; 5:e1038. [PMID: 21532745 PMCID: PMC3075232 DOI: 10.1371/journal.pntd.0001038] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 03/15/2011] [Indexed: 11/19/2022] Open
Abstract
Background Human T-Cell Lymphotropic Virus Type 1 (HTLV-1) is the etiological agent of adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It has been estimated that 10–20 million people are infected worldwide, but no successful treatment is available. Recently, the epidemiology of this virus was addressed in blood donors from Maputo, showing rates from 0.9 to 1.2%. However, the origin and impact of HTLV endemic in this population is unknown. Objective To assess the HTLV-1 molecular epidemiology in Mozambique and to investigate their relationship with HTLV-1 lineages circulating worldwide. Methods Blood donors and HIV patients were screened for HTLV antibodies by using enzyme immunoassay, followed by Western Blot. PCR and sequencing of HTLV-1 LTR region were applied and genetic HTLV-1 subtypes were assigned by the neighbor-joining method. The mean genetic distance of Mozambican HTLV-1 lineages among the genetic clusters were determined. Human mitochondrial (mt) DNA analysis was performed and individuals classified in mtDNA haplogroups. Results LTR HTLV-1 analysis demonstrated that all isolates belong to the Transcontinental subgroup of the Cosmopolitan subtype. Mozambican HTLV-1 sequences had a high inter-strain genetic distance, reflecting in three major clusters. One cluster is associated with the South Africa sequences, one is related with Middle East and India strains and the third is a specific Mozambican cluster. Interestingly, 83.3% of HIV/HTLV-1 co-infection was observed in the Mozambican cluster. The human mtDNA haplotypes revealed that all belong to the African macrohaplogroup L with frequencies representatives of the country. Conclusions The Mozambican HTLV-1 genetic diversity detected in this study reveals that although the strains belong to the most prevalent and worldwide distributed Transcontinental subgroup of the Cosmopolitan subtype, there is a high HTLV diversity that could be correlated with at least 3 different HTLV-1 introductions in the country. The significant rate of HTLV-1a/HIV-1C co-infection, particularly in the Mozambican cluster, has important implications for the controls programs of both viruses. Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent of Adult T-Cell Leukemia/Lymphoma (ATL), the Tropical Spastic Paraparesis/HTLV-1-associated Myelopathy (TSP/HAM) and other inflammatory diseases, including dermatitis, uveitis, and myositis. It is estimated that 2–8% of the infected persons will develop a HTLV-1-associated disease during their lifetimes, frequently TSP/HAM. Thus far, there is not a specific treatment to this progressive and chronic disease. HTLV-1 has means of three transmission: (i) from mother to child during prolonged breastfeeding, (ii) between sexual partners and (iii) through blood transfusion. HTLV-1 has been characterized in 7 subtypes and the geographical distribution and the clinical impact of this infection is not well known, mainly in African population. HTLV-1 is endemic in sub-Saharan Africa. Mozambique is a country of southeastern Africa where TSP/HAM cases were reported. Recently, our group estimated the HTLV prevalence among Mozambican blood donors as 0.9%. In this work we performed a genetic analysis of HTLV-1 in blood donors and HIV/HTLV co-infected patients from Maputo, Mozambique. Our results showed the presence of three HTLV-1 clusters within the Cosmopolitan/Transcontinental subtype/subgroup. The differential rates of HIV-1/HTLV-1 co-infection in the three HTLV-1 clusters demonstrated the dynamic of the two viruses and the need for implementation of control measures focusing on both retroviruses.
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Affiliation(s)
| | - Eduardo Samo Gudo
- Departamento de Imunologia, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Alena Mayo Iñiguez
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
- * E-mail:
| | - Koko Otsuki
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Nilesh Bhatt
- Departamento de Imunologia, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Celina M. Abreu
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adolfo Vubil
- Departamento de Imunologia, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Dulce Bila
- Departamento de Imunologia, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Orlando C. Ferreira
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amílcar Tanuri
- Departamento de Genética, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ilesh V. Jani
- Departamento de Imunologia, Instituto Nacional de Saúde, Maputo, Mozambique
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14
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Abstract
With recent implementation of studies specifically designed to empirically assess the contribution of both sexual and blood-borne exposures to local HIV transmission in sub-Saharan Africa, and with the arrival of a new generation of investigators, a picture of HIV transmission routes of improved validity is emerging. Seven years ago the International Journal of STD & AIDS (IJSA) began actively encouraging reexamination of the prevailing view that penile-vaginal sex was driving African HIV epidemics, welcoming debate via manuscript submission and presentation of fresh scientific evidence. Although the IJSA-published dissenting views have largely been ignored, dismissed or fiercely resisted by established HIV researchers and allied health agencies, new approaches may yet elicit more rational, evidence-based responses. Several such contributions appear in IJSA's present theme issue on aspects of HIV epidemiology in Africa. The focus on recent empiric data, rather than on modelling or speculation, no longer leaves reasonable doubt that sexual behaviours are insufficient to explain 'Why Africa?' It is fitting that this progress was encouraged, from beginning to end, by long-time, and now departing IJSA Editor-in-Chief, Dr Wallace Dinsmore.
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