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Paloma T, Claudia CR, Naise R, Patricia B, Clevio F, Marcel Q, Pedro B, Abelardo A, Adriana B. Evaluation of nutritional status and adherence to dietary monitoring among patients with human T-cell leukemia virus type 1 infection. Clin Nutr ESPEN 2022; 52:198-207. [PMID: 36513454 DOI: 10.1016/j.clnesp.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 08/26/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS The nutritional status of people infected with Human T-Cell Leukemia Virus type 1 (HTLV-1) is rarely studied. Malnutrition affects the immune system, but the consequences of this remain unknown in HTLV-1 infection. This study aimed to analyze the nutritional status, food intake, and ability to adhere to dietary counseling in people with symptomatic HTLV-1 infection. METHODS This was a longitudinal, prospective, observational study in which the nutritional status of people with symptomatic HTLV-1 was monitored between June 2016 and August 2019 at a referral center. At the baseline (day 0) and last stage (day 90) anthropometric, bioimpedance, and dietary assessments were performed. RESULTS In total, 71 participants with symptomatic HTLV-1 infection were enrolled, the majority (43, 60.6%) of whom were female. The mean age was 59.2 (±11.1) years. Participants were often overweight or obese (40, 56.3%) had a BMI above 25 kg/m2. The average consumption of recommended fibers and liquids was positively associated with percent lean body mass (%LM). Most participants who were overweight (36.6%) or obese (19.70%) and their nutritional status and eating behavior did not change during the follow-up period. Dietary counseling was unable to promote a change in the monotony of the existing eating habits. Participants with good adherence to nutritional guidelines had higher dietary diversity scores. CONCLUSION A high proportion of participants were overweight or obese. Adherence to dietary counseling was low, and its success was limited in improving dietary diversity/nutritional status. Loss to follow-up was a limitation of this study.
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Affiliation(s)
- Torres Paloma
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil.
| | - Cople-Rodrigues Claudia
- Nutrition Institute, State University of Rio de Janeiro, Rua São Francisco Xavier 524, 12th Floor, Rio de Janeiro, RJ 20550-900, Brazil
| | - Rocha Naise
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brito Patricia
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Fonseca Clevio
- COVID-19 Hospital Center to Combat Pandemic, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Quintana Marcel
- Clinical Research Platform, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Brasil Pedro
- Research Laboratory on Immunization and Health Surveillance, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Araújo Abelardo
- Clinical Research Laboratory in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
| | - Bacelo Adriana
- Nutrition Service, Evandro Chagas National Institute of Infectious Diseases, Fiocruz Av. Brasil 4365, Rio de Janeiro, RJ 21040-900, Brazil
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Galvão-Castro B, Grassi MFR, Galvão-Castro AV, Nunes A, Galvão – Barroso AK, Araújo THA, Rathsam-Pinheiro RH, Nunes CLX, Ribeiro A, Lírio M, Gonçalves NL, Rangel SL, Dias CMCC, Ozores DP, Dubois-Mendes SM, Lima I, Silva ALP, de Jesus WLA, Santos FLN, de Oliveira JGR, de Moraes YVP, de Jesus AO, Daltro F, Boa-Sorte N, Castro-Lima H, Soliani MLC. Integrative and Multidisciplinary Care for People Living With Human T-Cell Lymphotropic Virus in Bahia, Brazil: 20 Years of Experience. Front Med (Lausanne) 2022; 9:884127. [PMID: 35746949 PMCID: PMC9210980 DOI: 10.3389/fmed.2022.884127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/31/2022] [Indexed: 11/28/2022] Open
Abstract
Brazil is home to the highest absolute number of human T-cell lymphotropic virus type-1 (HTLV-1)-infected individuals worldwide; the city of Salvador, Bahia, has the highest prevalence of HTLV-1 infection in Brazil. Due to the complex nature of several diseases associated with this retrovirus, a multidisciplinary health care approach is necessary to care for people living with HTLV-1. The Bahia School of Medicine and Public Health’s Integrative Multidisciplinary HTLV Center (CHTLV) has been providing support to people living with HTLV and their families since 2002, striving to ensure physical and mental well-being by addressing biopsychosocial aspects, providing clinical care and follow-up, including to pregnant/postpartum women, as well as comprehensive laboratory diagnostics, psychological therapy, and counseling to family members. To date, CHTLV has served a total of 2,169 HTLV-infected patients. The average patient age is 49.8 (SD 15.9) years, 70.3% are female, most are considered low-income and have low levels of education. The majority (98.9%) are HTLV-1 cases, and approximately 10% have been diagnosed with tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM), while 2.2% have infective dermatitis and 1.1% have adult T-cell lymphoma. In all, 178 pregnant/postpartum women [mean age: 32.7 (±6.5) years] have received care at CHTLV. Regarding vertical transmission, 53% of breastfed infants screened for HTLV tested positive in their second year of life, nearly 18 times the rate found in non-breastfed infants. This article documents 20 years of experience in implementing an integrative and multidisciplinary care center for people living with HTLV in Bahia, Brazil. Still, significant challenges remain regarding infection control, and HTLV-infected individuals continue to struggle with the obtainment of equitable and efficient healthcare.
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Affiliation(s)
- Bernardo Galvão-Castro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
- *Correspondence: Bernardo Galvão-Castro,
| | - Maria Fernanda Rios Grassi
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Aidê Nunes
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | | | - Regina Helena Rathsam-Pinheiro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira, Salvador, Brazil
| | - Ceuci Lima Xavier Nunes
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
- Instituto Couto Maia, Secretaria da Saúde do Estado da Bahia, Salvador, Brazil
| | - Adriele Ribeiro
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Monique Lírio
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Noilson Lázaro Gonçalves
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | | | | | - Isabela Lima
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | | | | | - Fred Luciano Neves Santos
- Laboratório Avançado de Saúde Pública, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | | | | | | | - Ney Boa-Sorte
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
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Rosadas C, Brites C, Arakaki-Sanchez D, Casseb J, Ishak R. Brazilian Protocol for Sexually Transmitted Infections 2020: human T-cell lymphotropic virus (HTLV) infection. Rev Soc Bras Med Trop 2021; 54:e2020605. [PMID: 34008723 PMCID: PMC8210483 DOI: 10.1590/0037-8682-605-2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 12/26/2022] Open
Abstract
This article addresses the Human T-lymphotropic virus (HTLV). This subject comprises the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. HTLV-1/2 infection is a public health problem globally, and Brazil has the largest number of individuals living with the virus. HTLV-1 causes several clinical manifestations of neoplasm (adult T-cell leukemia/lymphoma) and inflammatory nature, such as HTLV-1-associated myelopathy and other manifestations such as uveitis, arthritis, and infective dermatitis. These pathologies have high morbidity and mortality and negatively impact the quality of life of infected individuals. This review includes relevant information for health authorities professionals regarding viral transmission, diagnosis, treatment, and monitoring of individuals living with HTLV-1 and 2 in Brazil. HTLV-1/2 transmission can occur through blood transfusion and derivatives, injectable drug use, organ transplantation, unprotected sexual intercourse, and vertical transmission.
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Affiliation(s)
- Carolina Rosadas
- Imperial College London, Department of Infectious Disease, London, United Kingdom
| | - Carlos Brites
- Universidade Federal da Bahia, Faculdade de Medicina, Salvador, BA, Brasil
| | | | - Jorge Casseb
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brasil
| | - Ricardo Ishak
- Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, PA, Brasil
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Ishak R, Guimarães Ishak MDO, Azevedo VN, Machado LFA, Vallinoto IMC, Queiroz MAF, Costa GDLC, Guerreiro JF, Vallinoto ACR. HTLV in South America: Origins of a silent ancient human infection. Virus Evol 2020; 6:veaa053. [PMID: 33133639 PMCID: PMC7585626 DOI: 10.1093/ve/veaa053] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The description of the first human retrovirus, human T-lymphotropic virus 1 (HTLV-1), was soon associated with an aggressive lymphoma and a chronic inflammatory neurodegenerative disease. Later, other associated clinical manifestations were described, affecting diverse target organs in the human body and showing the enormous burden carried by the virus and the associated diseases. The epidemiology of HTLV-1 and HTLV-2 showed that they were largely distributed around the world, although it is possible to locate geographical areas with pockets of low and very high prevalence and incidence. Aboriginal Australians and indigenous peoples of Brazil are examples of the large spread of HTLV-1 and HTLV-2, respectively. The epidemiological link of both situations is their occurrence among isolated, epidemiologically closed or semi-closed communities. The origin of the viruses in South America shows two different branches with distinct timing of entry. HTLV-1 made its probable entrance in a more recent route through the east coast of Brazil at the beginning of the slave trade from the African continent, starting in the 16th century and lasting for more than 350 years. HTLV-2 followed the ancient route of human migration from the Asian continent, crossing the Behring Strait and then splitting in South America as the population became separated by the Andes Mountains. By that time, HTLV-2c probably arose and became isolated among the indigenous populations in the Brazilian Amazon. The study of epidemiologically closed communities of indigenous populations in Brazil allowed tracing the most likely route of entry, the generation of a new molecular subtype (HTLV-2c), the elucidation of the vertical transmission of HTLV-2, the intrafamilial aggregation of cases and the escape and spread of the virus to other areas in Brazil and abroad. Despite the burden and impact of both viruses, they are maintained as silent infections among human populations because 1, health authorities in most South American countries in which national surveillance is poor have little interest in the disease, 2, the information is commonly lost as indigenous groups do not have specific policies for HTLV and other sexually transmitted infections, and 3, health access is not feasible or properly delivered.
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Affiliation(s)
- Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Marluísa de Oliveira Guimarães Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Vânia Nakauth Azevedo
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Luiz Fernando Almeida Machado
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Izaura Maria Cayres Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Maria Alice Freitas Queiroz
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Greice de Lemos Cardoso Costa
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - João Farias Guerreiro
- Laboratório de Genética Humana e Médica, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Correa no.1, Guama, 66075-110, Belem, Para, Brazil
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