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Inomata Silva BL, da Cunha Rodrigues FE, Tsukimata MY, Botelho BJS, Santos LCC, Dos Santos Pereira Neto G, Lima ACR, André NP, Galdino SM, Monteiro DC, Yoshikawa GT, Mendonça LT, do Amaral JLA, de Britto Pereira Cruz R, Onuma DO, Vallinoto ACR, de Carvalho Klemz BN, Vallinoto IMVC. Fibromyalgia in patients infected with HTLV-1 and HTLV-2. Front Med (Lausanne) 2024; 11:1419801. [PMID: 39247631 PMCID: PMC11377305 DOI: 10.3389/fmed.2024.1419801] [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: 05/13/2024] [Accepted: 08/15/2024] [Indexed: 09/10/2024] Open
Abstract
Background Reports on the association between HTLV-2 infection and the development of diseases in the human host are rare, which has led the scientific community to believe that HTLV-2 is not an important etiological agent of lymphoproliferative or neurodegenerative disorders, which is the case for HTLV-1. In the present study, we demonstrated cases of fibromyalgia in HTLV-1 carriers and, in an unprecedented finding, in two patients with confirmed HTLV-2 infection. Methods A total of 957 individuals visited the Virology Laboratory at the Federal University of Pará for screening and confirmation tests for HTLV-1/2 infection. Individuals with confirmed HTLV-1 and HTLV-2 infection were clinically evaluated for signs and symptoms associated with infection. Results Sixty-nine individuals (7.2%) were identified as positive for HTLV infection, with 56 confirmed cases of HTLV-1 infection (5.9%), 12 cases of HTLV-2 infection (1.2%) and one case classified as undetermined (0.1%). Sixteen (23.2%) of these patients presented with rheumatological signs and complained of diffuse pain throughout the body; 12 of whom were infected by HTLV-1 (75%) and 4 were infected by HTLV-2 (25%). After anamnesis and careful evaluation, four patients were diagnosed with fibromyalgia, two of whom were infected by HTLV-1 (16.7%; 2/12) and two by HTLV-2 (50%; 2/4). The clinical follow-up and laboratory analysis results are reported in detail in this paper. Conclusion Considering the clinical cases presented herein as the first reports of patients with HTLV-2 infection with clinical symptoms of fibromyalgia, the importance of further studies on the pathogenicity of HTLV-2, similar to what have already been performed for HTLV-1, is highlighted. Our results also confirm previous evidence of an association between HTLV-1 infection and fibromyalgia.
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Affiliation(s)
- Bianca Lumi Inomata Silva
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Francisco Erivan da Cunha Rodrigues
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Márcio Yutaka Tsukimata
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | | | - Luciana Cristina Coelho Santos
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | - Gabriel Dos Santos Pereira Neto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | - Aline Cecy Rocha Lima
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | - Natália Pinheiro André
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Sarah Marques Galdino
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Danniele Chagas Monteiro
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | | | | | - Juliana Lasmar Ayres do Amaral
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | | | - Débora Oliveira Onuma
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
| | | | - Izaura Maria Vieira Cayres Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
- Faculdade de Medicina, Instituto de Ciências Médica, Universidade Federal do Pará, Belém, Brazil
- Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitário, Universidade Federal do Pará, Belém, Brazil
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Okita MT, de Matos MA, de Freitas NR, Silva ÁMDCE, Marques JMDS, Marinho TA, de Matos MAD, Martins RMB. Human T-lymphotropic virus 1/2 infection among prisoners of a major penitentiary complex of Goiás State, Central-West Brazil. Front Public Health 2024; 12:1379237. [PMID: 38706549 PMCID: PMC11069305 DOI: 10.3389/fpubh.2024.1379237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/09/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Studies on human T-lymphotropic virus 1/2 (HTLV-1/2) infection are scarce in incarcerated population. Therefore, this study estimated the prevalence of HTLV-1/2 infection among prisoners of the major penitentiary complex of Goiás State, Central-West Brazil, comparing it with available data from other Brazilian regions. Methods A cross-sectional study was conducted with 910 prisoners of the major penitentiary complex in the State of Goiás, Central-West Brazil. All participants were interviewed, and their serum samples were tested for anti-HTLV-1/2 using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, UK). Seropositive samples were submitted for confirmation by a line immunoassay (INNO-LIA HTLV I/II, Fujirebio, Europe N.V., Belgium). Results The majority of participants were males (83.1%), between 25 and 39 years old (56.1%; mean age: 31.98 years), self-reported brown ethnicity (56.2%) and reported 9 years or less of formal education (41.4%). Most reported using non-injectable illicit drugs and various sexual behaviors that present risk for sexually transmitted infections (STIs). The prevalence of anti-HTLV-1/2 was 0.33% (95% CI: 0.07-0.96), HTLV-1 (0.22%) and HTLV-2 (0.11%). The two HTLV-1 seropositive prisoners reported high-risk sexual behaviors, and the HTLV-2 seropositive individual was breastfed during childhood (> 6 months) by her mother and three other women. Conclusion These data revealed a relatively low seroprevalence of HTLV-1/2 in prisoners in Central-West Brazil, and evidence of HTLV-1 and HTLV-2 circulation in the major penitentiary complex of Goiás State. Given the prevalence of high-risk sexual behaviors, there is a crucial need to intensify education and health programs in prisons to effectively control and prevent HTLV-1/2 and other STIs.
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Affiliation(s)
- Michele Tiemi Okita
- Institute of Tropical Medicine and Public Health, Federal University of Goiás, Goiânia, Brazil
| | | | | | | | | | - Thaís Augusto Marinho
- Institute of Tropical Medicine and Public Health, Federal University of Goiás, Goiânia, Brazil
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Marinho TA, Magalhães LS, dos Santos KC, Martins TLS, Silva GRDCE, Silva ÁMDCE, Carneiro MADS, Caetano KAA, Teles SA, Martins RMB. Human T-lymphotropic virus 1/2 infection among immigrants and refugees in Central Brazil, an emerging vulnerable population. Front Public Health 2023; 11:1265100. [PMID: 37869208 PMCID: PMC10588471 DOI: 10.3389/fpubh.2023.1265100] [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: 07/21/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction Migratory flows play a significant role in the spread of human T-lymphotropic virus 1/2 (HTLV-1/2). In the last decade, a substantial migration of individuals occurred from Haiti and Venezuela to Brazil. However, data on the prevalence of HTLV-1/2 infection among these international migrants in Brazil are scarce. This study describes the prevalence of this infection among immigrants and refugees in Central Brazil. Methods A cross-sectional study was conducted with 537 international migrants in the State of Goiás, Central Brazil. Participants were interviewed, and blood samples were collected. Serological screening for anti-HTLV-1/2 was performed using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, UK), and seropositive samples were submitted for confirmation by a line immunoassay (INNO-LIA HTLV I/II, Fujirebio, Europe N.V., Belgium). Results The majority of participants were males (54.4%), between 18 and 50 years old (78%; mean age: 29.1 years), self-declared black (55.1%), reported 1 to 12 years of formal education (70.9%), and were either Venezuelans (47.9%) or Haitians (39.7%). Additionally, 50.1% were immigrants, 49% were refugees, and five were Brazilian children (0.9%) born to Haitian immigrant parents. The overall prevalence of anti-HTLV-1/2 was 0.95% (95% CI: 0.31-2.28), with HTLV-1 at 0.19% and HTLV-2 at 0.76%. All seropositive individuals (n = 5) were refugees from Venezuela, resulting in a rate of 2.26% for anti-HTLV-1/2, HTLV-1 (0.45%) and HTLV-2 (1.81%) among Venezuelan refugees. Of the demographic and behavioral characteristics evaluated, unprotected sexual intercourse and having more than one sexual partner (≥2) in the previous 12 months were associated with HTLV-1/2 seropositivity among Venezuelans. Conclusion This study revealed, despite the low seroprevalence of HTLV-1/2 among international migrants in Central Brazil, evidence of HTLV-1 and HTLV-2 infections in Venezuelan refugees. In addition, their characteristics highlight that specific social and health programs should be implemented for these emergent and socially vulnerable migrant groups.
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Affiliation(s)
- Thaís Augusto Marinho
- Institute of Tropical Medicine and Public Health, Federal University of Goiás, Goiânia, Brazil
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Ji H, Chang L, Yan Y, Wang L. Development and validation of a duplex real-time PCR for the rapid detection and quantitation of HTLV-1. Virol J 2023; 20:9. [PMID: 36650537 PMCID: PMC9843979 DOI: 10.1186/s12985-023-01970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/08/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The HTLV-1 prevalence in China varies geographically, while HTLV-2 infection has rarely been found so far. Proviral load is one of the determining factors of pathogenesis and progression of HTLV-1 related diseases. However, neither molecular assays nor commercial kits are available for HTLV-1 diagnosis in China. The objective of the present study was to develop and validate a TaqMan qPCR assay for HTLV-1 proviral load quantification. RESULTS A plasmid containing both the HTLV-1 of interest and a fragment of the RNase P (RPPH1) gene was constructed and used to establish the standard curves. The assay has a wide dynamic range (2.5 × 108 copies/reaction ~ 25 copies/reaction) and sensitive to 1 copy for HTLV-1 and RPPH1. The limit of detection for Hut102 cell concentration was 0.0218% (95% confidence interval 0.0179-0.0298%). The assay gave coefficient of variation (CV) for both the HTLV-1 and RPPH1 Ct values. All of the HTLV-1 sero-negative samples and MOT cell line (infected with HTLV-2) amplified only the RPPH1 gene by our method, presenting 100% specificity. 85 Samples confirmed positive or indeterminate by LIA were performed by established qPCR assay and WB. 90.0% (27/30) of LIA-HTLV-1-positive, 33% (2/6) of LIA-untypeable and 2% (1/49) of LIA-indeterminate samples were defined as qPCR-positive. The median PVL of LIA-positive samples (n = 27, 1.780 copies/100 cells) was much higher than that of LIA-untypeable and (n = 2, 0.271 copies/100 cells) indeterminate samples (n = 1, 0.017 copies/ 100 cells). Additionally, compared to WB, the duplex qPCR verified more positive samples, demonstrating a better sensitivity. CONCLUSION The duplex qPCR developed here with high sensitivity, good specificity and reproducibility could accurately and quantitatively detect the HTLV-1 PVLs, which can be used to confirm the initial reactive samples for an improved cost/benefit ratio as well as to monitor the clinical progression and efficacy of therapy in patients with HTLV-1 related disease.
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Affiliation(s)
- Huimin Ji
- grid.506261.60000 0001 0706 7839National Center for Clinical Laboratories, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China ,grid.414350.70000 0004 0447 1045Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People’s Republic of China
| | - Le Chang
- grid.506261.60000 0001 0706 7839National Center for Clinical Laboratories, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China ,grid.414350.70000 0004 0447 1045Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People’s Republic of China
| | - Ying Yan
- grid.506261.60000 0001 0706 7839National Center for Clinical Laboratories, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China ,grid.414350.70000 0004 0447 1045Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People’s Republic of China
| | - Lunan Wang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, People's Republic of China. .,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People's Republic of China. .,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
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de Lima ACR, Lopes FT, de Oliveira Freitas V, Assad MN, de Sousa RS, Gonçalves JSS, Gomes JLC, dos Santos BC, Lima CNC, Abreu IN, dos Santos Brito WR, Pereira KAS, da Silva Torres MK, Lima SS, Aben-Athar CYU, Guerreiro JF, Cayres Vallinoto IMV, Vallinoto ACR, Feitosa RNM. Prevalence and Risk Factors for HTLV-1/2 Infection inRiverside and Rural Populations of the State of Pará. Viruses 2022; 14:v14102262. [PMID: 36298817 PMCID: PMC9610156 DOI: 10.3390/v14102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022] Open
Abstract
Human T-lymphotropic viruses 1 and 2 (HTLV-1 and HTLV-2) infection has been described in several Amazonian populations; however, there is still a lack of data on the prevalence of the virus in riparian populations living in rural areas of the state of Pará. The present study aimed to evaluate the prevalence of HTLV-1/2 infection in four riverine communities and one rural area in the state of Pará and to describe the possible risk factors for infection. A total of 907 individuals responded to an epidemiological survey and gave blood samples collected for anti-HTLV-1/2 antibodies by immunoenzymatic assay (EIA). The serum-reactive samples were subjected to confirmation by an in-line assay (Inno-Lia) and by proviral DNA screening using real-time PCR (qPCR). The total prevalence was 0.8% (7/907) for HTLV-1/2 (CI: 0.2−1.3%), with 0.66% HTLV-1 and 0.11% HTLV-2. The prevalence by sex was 0.7% in women (4/565) and 0.9% in men (3/342). Among seropositive patients, 83.3% (5/7) reported being sexually active, and 57.1% (4/7) reported not having the habit of using condoms during their sexual relations. Intrafamily infection was also observed. The results reinforce the need for public policies to prevent and block the spread of HTLV, especially in riparian communities that are subject to difficulties in accessing the Unified Health System (Sistema Único de Saúde/SUS) because infected individuals need clinical monitoring for surveillance and early diagnosis of symptoms associated with HTLV-1.
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Affiliation(s)
- Aline Cecy Rocha de Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Felipe Teixeira Lopes
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | | | | | - Janete Silvana Souza Gonçalves
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | | | - Carlos Neandro Cordeiro Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Isabella Nogueira Abreu
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Wandrey Roberto dos Santos Brito
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Keise Adrielle Santos Pereira
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Maria Karoliny da Silva Torres
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Sandra Souza Lima
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
| | | | - João Farias Guerreiro
- Laboratório de Genética Humana e Médica, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Izaura M. V. Cayres Vallinoto
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
| | - Rosimar Neris Martins Feitosa
- Laboratório de Virologia, Universidade Federal do Pará, Belém 66075110, Brazil
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075110, Brazil
- Correspondence: ; Tel.: +55-919-9117-9811
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Costa DA, Carvalho FM, Vieira NM, Falcão GGSC, Sarmento VA, Brites C, Lins-Kusterer L. Work ability and associated factors in people living with human T-cell leukemia virus type 1. Rev Soc Bras Med Trop 2022; 55:e0111. [PMID: 35946625 PMCID: PMC9344948 DOI: 10.1590/0037-8682-0111-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an
estimated 10-15 million people worldwide. However, knowledge of the impact
of HTLV-1 infection on work ability is lacking. This study aimed to measure
the frequency and identify factors associated with poor work ability in
patients living with HTLV-1. Methods: This cross-sectional study included 207 individuals infected with HTLV-1 who
attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1
antibodies were detected in the participants’ blood by enzyme-linked
immunosorbent assay (ELISA) and confirmed by western blotting. Participants
answered a questionnaire on sociodemographic data, personal habits, clinical
data, health-related quality of life, and work ability, evaluated using the
work ability index questionnaire. A Poisson regression model with a robust
variance estimate was used to identify the factors associated with the
prevalence of poor work ability. Results: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females,
100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1
associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual
was classified as having excellent work ability. Poor work ability
prevalence was strongly associated (prevalence ratio; 95% confidence
interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms
(1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98;
0.97-0.99) component summaries of health-related quality of life. Conclusions: Poor work ability among people living with HTLV-1 is associated with
sedentarism, neurologic symptoms, and low health-related quality of
life.
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Affiliation(s)
- Dayana Alves Costa
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | - Nicolle Melo Vieira
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | | | | | - Carlos Brites
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
| | - Liliane Lins-Kusterer
- Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brasil
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de Mendoza C, Pérez L, Fernández-Ruiz M, Pena MJ, Ramos JM, Richart A, Piron M, Rando A, Miró E, Reina G, Encinas B, Rojo S, Rodriguez-Iglesias AM, Benito R, Aguilera A, Treviño A, Corral O, Soriano V. Late presentation of HTLV-1 infection in Spain reflects suboptimal testing strategies. Int J Infect Dis 2022; 122:970-975. [PMID: 35902023 DOI: 10.1016/j.ijid.2022.07.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND . Although only 10% of persons infected with HTLV-1 may develop virus-associated illnesses lifelong, missing the earlier diagnosis of asymptomatic carriers frequently leads to late presentation. METHODS . A nationwide HTLV-1 register was created in Spain in 1989. We examined the main demographics and clinical features at the time of first diagnosis during more than three decades. RESULTS . A total of 428 individuals infected with HTLV-1 had been reported in Spain until the end of 2021. Up to 96 (22%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (57%), T-cell lymphoma (34%), or Strongyloides stercoralis infestation (8%). Since 2008, HTLV-1 diagnosis has been made either at blood banks (44%) or at clinics (56%). Native Spaniards and Sub-Saharan Africans are overepresented among patients presenting with HTLV-1-associated illnesses suggesting that poor epidemiological and/or clinical suspicion leading to late presentation are more frequent in them compared to LATAM carriers (31.7% vs 20.4%, respectively; p=0.015). CONCLUSION . HTLV-1 infection in Spain is frequently diagnosed in patients presenting with characteristic illnesses. Whereas screening in blood banks mostly identifies asymptomatic LATAM carriers, a disproportionately high number of Spaniards and Africans are diagnosed too late, at the time of clinical manifestations. Expanding testing to all pregnant women and clinics for sexually transmitted infections could help to unveil HTLV-1 asymptomatic carriers.
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Affiliation(s)
- Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid.
| | - Leire Pérez
- Gregorio Marañón University Hospital, Madrid
| | | | - María José Pena
- Doctor Negrín University Hospital, Las Palmas de Gran Canaria
| | | | | | | | | | - Elisenda Miró
- Santa Creu i Sant Pau University Hospital, Barcelona
| | | | - Beatriz Encinas
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid
| | | | | | | | | | - Ana Treviño
- UNIR Health Sciences School & Medical Center, Madrid, Spain
| | - Octavio Corral
- UNIR Health Sciences School & Medical Center, Madrid, Spain
| | - Vicente Soriano
- UNIR Health Sciences School & Medical Center, Madrid, Spain.
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Aben-Athar CYUP, Sampaio EC, Pinto DS, Vallinoto ACR, Cayres Vallinoto IMV. Providing a Nursing Care Plan as a Requirement for Secondary Prevention for People Living With HTLV-1. Front Med (Lausanne) 2022; 9:854970. [PMID: 35547232 PMCID: PMC9082148 DOI: 10.3389/fmed.2022.854970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/31/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction The absence of nursing care plans aimed at people living with HTLV-1 (PLHTLV) led us to develop and test a proposed nursing care plan based on the evaluation of 55 PLHTLV to outline interventions according to the clinical stage. Methods After interviews with symptomatic patients, nursing diagnoses were made using the NANDA International Nursing Diagnoses (The International Nursing Knowledge Association). Subsequently, interventions were selected through the Classification of Nursing Interventions (NIC), and expected results were selected through the Classification of Nursing Outcomes (NOC). Results The actual diagnoses included (ii) chronic pain, (iii) impaired urinary elimination, and (iv) sexual dysfunction; the health promotion diagnosis was (i) risk-prone health behavior; and the risk diagnoses were (i) risk of feeling powerless and (ii) risk of falls in adults. Nursing care must prevent the lack of adherence to monitoring, establish goals and promote family involvement. A safe home environment requires intervention for fall prevention. Full support in understanding pharmacological and non-pharmacological therapies for chronic pain is needed. Interventions allow patients with impaired urinary function to be reintroduced to society. For sexual dysfunction, it is necessary to discuss safe sex and behavioral changes. Regarding risk behaviors, it is necessary to guide the patient/family, adapt language to the education level of these individuals, and help them better accept the condition, among other guidelines. Conclusion The development of a nursing care plan for PLHTLV is essential for preventing the rapid progression of disease and the improvement of the quality of life of PLHTLV and should be included in the multidisciplinary approach to the secondary level of prevention of HTLV-1.
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Affiliation(s)
- Cintia Yolette Urbano Pauxis Aben-Athar
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Edilson Coelho Sampaio
- Faculdade de Enfermagem, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Denise Silva Pinto
- Laboratório de Estudos em Reabilitação Funcional, Núcleo de Medicina Tropical da Universidade Federal do Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Izaura Maria Vieira Cayres Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Programa de Pós-graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
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9
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Miranda AE, Rosadas C, Assone T, Pereira GFM, Vallinoto ACR, Ishak R. Strengths, Weaknesses, Opportunities and Threats (SWOT) Analysis of the Implementation of Public Health Policies on HTLV-1 in Brazil. Front Med (Lausanne) 2022; 9:859115. [PMID: 35462992 PMCID: PMC9021745 DOI: 10.3389/fmed.2022.859115] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Human T lymphotropic virus 1 (HTLV-1) is a public health issue for most countries and imposes important consequences on patients' health and socioeconomic status. Brazil is one of the global leaders of the public health response to these viruses. The country has challenges to overcome to implement meaningful policies aiming to eliminate HTLV-1/2. An analysis of strengths, weaknesses, opportunities, and threats (SWOT) for the implementation of public health policies on HTLV-1/2 was performed. The strengths identified were the Brazilian Unified Health System (SUS); Brazilian expertise in public health programs successfully implemented; currently available policies targeting HTLV; and strong collaboration with researchers and patient's representative. Lack of awareness about HTLV, insufficient epidemiological data, lack of reference centers for patient care, insufficient availability of confirmatory tests, lack of universal antenatal screening, and absence of cost-effectiveness studies were identified as weaknesses. Some interesting opportunities included the increased interest from international organizations on HTLV, possibility of integrating HTLV into other programs, external funding for research, available online platforms, opportunity to acquire data from HTLV-1/2 surveillance to gather epidemiological information, and HTLV policies that were implemented independently by states and municipalities. In addition to the COVID-19 pandemic, existing demands from different diseases, the country's demography and its marked sociocultural diversity and the volatility of the technical team working with HTLV-1/2 at the Brazilian Ministry of Health are threats to the implementation of public policies on HTLV-1/2. This SWOT analysis will facilitate strategic planning to allow continuous progress of the Brazilian response to HTLV-1/2 infection.
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Affiliation(s)
- Angelica Espinosa Miranda
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Tatiane Assone
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
- Laboratório de Investigação Médica em Neurologia, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo, Universidade São Paulo, São Paulo, Brazil
| | - Gerson Fernando Mendes Pereira
- Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, Brazil
| | | | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
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Gonçalves MG, Fukasawa LO, Campos KR, Higa FT, Caterino-de-Araujo A. Development and Validation of Multiplex Quantitative Real-Time PCR Assays for Simultaneous Detection and Differentiation of HTLV-1 and HTLV-2, Using Different PCR Platforms and Reagent Brands. Front Microbiol 2022; 13:831594. [PMID: 35369428 PMCID: PMC8965094 DOI: 10.3389/fmicb.2022.831594] [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: 12/08/2021] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
Brazil currently has the highest number of individuals infected with human T-lymphotropic virus 1- and 2- (HTLV-1 and HTLV-2) globally. At present, neither molecular protocols nor commercial assays are available for HTLV-1/-2 diagnosis or validated by the Brazilian Ministry of Health regulatory agency (ANVISA). We developed and validated two in-house multiplex quantitative real-time PCR for HTLV-1/-2 (mqPCR_HTLV) assays, targeting the pol and tax genes, for the simultaneous identification of HTLV-1, HTLV-2, and the albumin reference gene. The robustness of the assays was evaluated on two platforms using seven commercial master mix formulations. The reactions employed double plasmids (pHTLV1-Alb and pHTLV2-Alb) for the standard curve’s construction and for expressing the detection limit of the assays. They were able to detect 10 and 10 copies of HTLV-1 and 10 and 70 copies of HTLV-2 for the tax and pol targets, respectively. High efficiency was obtained using both the platforms and all the reagents evaluated and were successfully reproduced by other analysts. DNA samples from HTLV-1/-2-infected and non-infected patients and from HIV/HTLV-coinfected patients were evaluated to determine the feasibility of their use in routine diagnosis. The mqPCR_HTLV (pol and tax) assays demonstrated an overall specificity of 100% and a sensitivity of 97.4% when testing samples from patients without HIV infection, and sensitivities of 77.1% (pol) and 74.6% (tax) in samples from HIV/HTLV-coinfected patients. In addition, they resolved the issue of HTLV western blotting (WB) indeterminate and WB-untyped results in 45.5 and 66.7% of cases, respectively. The developed mqPCR_HTLV (pol and tax) assays indicated their feasibility for efficient and reliable HTLV diagnosis in various core facility laboratories under different conditions and supplies.
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Affiliation(s)
- Maria Gisele Gonçalves
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | - Lucila Okuyama Fukasawa
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | - Karoline Rodrigues Campos
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | - Fábio Takenori Higa
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | - Adele Caterino-de-Araujo
- Centro de Imunologia, Instituto Adolfo Lutz, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
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11
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Martel M, Gotuzzo E. HTLV-1 Is Also a Sexually Transmitted Infection. Front Public Health 2022; 10:840295. [PMID: 35433594 PMCID: PMC9008201 DOI: 10.3389/fpubh.2022.840295] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
HTLV-1 is a retrovirus which causes diverse diseases in 10% of its infected population, significantly worsening their quality of life and mortality rate. Even though it is globally distributed and is endemic in many countries (including Peru), it is still highly neglected. It spreads through vertical, sexual and parenteral transmission. As no effective treatment against this virus exist, prevention is required to contain it. The World Health Organization published a technical report on the matter in 2021, with the collaboration of international HTLV-1 experts. However, neither the impact of sexual transmission (cause of the majority of adult cases and infection in non-endemic areas) nor its prevention were considered. Evidence is presented, which shows the magnitude of sexual transmission, its risk factors and preventive measures; hoping it will encourage health workers to help eradicate this infection.
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Affiliation(s)
- Mariana Martel
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eduardo Gotuzzo
- Faculty of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
- Alexander von Humboldt Institute of Tropical Medicine, Cayetano Heredia National Hospital, Lima, Peru
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12
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Vieira BA, Bidinotto AB, Dartora WJ, Pedrotti LG, de Oliveira VM, Wendland EM. Prevalence of human T-lymphotropic virus type 1 and 2 (HTLV-1/-2) infection in pregnant women in Brazil: a systematic review and meta-analysis. Sci Rep 2021; 11:15367. [PMID: 34321555 PMCID: PMC8319321 DOI: 10.1038/s41598-021-94934-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/05/2021] [Indexed: 01/17/2023] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) infection may cause serious disease, while pathogenicity of HTLV-2 is less certain. There are no screening or surveillance programs for HTLV-1/-2 infection in Brazil. By performing this systematic review, we aimed to estimate the prevalence of HTLV-1/-2 infections in pregnant women in Brazil. This review included cohort and cross-sectional studies that assessed the presence of either HTLV-1/-2 infection in pregnant women in Brazil. We searched BVS/LILACS, Cochrane Library/CENTRAL, EMBASE, PubMed/MEDLINE, Scopus, Web of Science and gray literature from inception to August 2020. We identified 246 records in total. Twenty-six of those were included in the qualitative synthesis, while 17 of them were included in the meta-analysis. The prevalence of HTLV-1 in Brazilian pregnant women, as diagnosed by a positive screening test and a subsequent positive confirmatory test, was 0.32% (95% CI 0.19-1.54), while of HTLV-2 was 0.04% (95% CI 0.02-0.08). Subgroup analysis by region showed the highest prevalence in the Northeast region (0.60%; 95% CI 0.37-0.97) for HTLV-1 and in the South region (0.16%; 95% CI 0.02-1.10) for HTLV-2. The prevalence of HTLV-1 is much higher than HTLV-2 infection in pregnant Brazilian women with important differences between regions. The prevalence of both HTLV-1/-2 are higher in the Northeast compared to Center-West region.
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Affiliation(s)
| | | | | | | | | | - Eliana Márcia Wendland
- Hospital Moinhos de Vento, Porto Alegre, Brazil.
- Public Health Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.
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