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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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de Assis IM, Callegari B, de Sousa MS. Physiotherapy Methods Applied in the Prevention of Functional Loss Associated with Human T-Lymphotropic Virus 1 Infection: An Overview. Infect Dis Rep 2023; 15:478-493. [PMID: 37736995 PMCID: PMC10514819 DOI: 10.3390/idr15050048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 08/02/2023] [Indexed: 09/23/2023] Open
Abstract
To achieve the objective of this study, we conducted a narrative review on physical therapeutic modalities applied to prevent functional losses associated with human T-lymphotropic virus 1 (HTLV-1) infections to promote health education and viable and accessible alternatives in the development of health education technology adapted to the home environment. This study comprised a qualitative stage of theoretical development to construct a digital booklet with an observational basis based on studies that reiterate themes about educational technologies as tools to conduct a home protocol of guided exercises without the direct supervision of professional physical therapists. Results indicate a lack of research on the development of health education technologies to assist patients with HTLV-1 without tropical spastic paraparesis or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). We believe that this narrative review can initiate a theoretical framework to conduct a home exercise program aimed at people with HTLV-1 who have subtle symptoms, and also at people without the clinical definition of HAM/TSP, helping to train human resources for care and research on the subject and increase scientific production in physical therapy.
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Affiliation(s)
| | - Bianca Callegari
- Institute of Health Sciences, Federal University of Pará, Belém 66055-240, Brazil;
| | - Maisa Silva de Sousa
- Center for Tropical Medicine, Federal University of Pará, Belém 66055-240, Brazil;
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Sampaio GCL, Ribeiro JR, de Almeida CN, Boa-Sorte N, Galvão-Castro B, Grassi MFR, Nunes Sá K, Dias CMCC. Human T Cell Lymphotropic Virus Type 1 Global Prevalence Associated with the Human Development Index: Systematic Review with Meta-Analysis. AIDS Res Hum Retroviruses 2023; 39:145-165. [PMID: 36571250 DOI: 10.1089/aid.2021.0230] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
In 2012, the number of people infected with human T cell lymphotropic virus type 1 (HTLV-1) was estimated to be 10 million worldwide. Prevalence varies according to geographic location, ethnic factors, sex, age, populations exposed to risk factors, income, and education, reaching countries with the worst socioeconomic scenarios. There is a need to determine the current global prevalence of HTLV-1 and examine its association with countries' human development index (HDI) to provide data for global health policy. Systematic review with meta-analysis is according to PRISMA 2020 recommendations. It was registered at PROSPERO, CRD42021223146. Prevalence or cross-sectional studies of HTLV-1 infection with at least 100 participants, screening, and confirmatory serologic testing were included. Studies with incomplete or unavailable results or with duplicate information were excluded. Data were selected by two independent investigators and analyzed using R software, a metapackage that generated the forest plots [95% confidence interval (CI)]. Heterogeneity was assessed using the I2 statistic, and funnel plot asymmetry was assessed using Egger's test. Countries were compared using an HDI cutoff ≥0.8. Methodological quality was assessed using Joanna Briggs Institute (JBI) criteria. The overall prevalence of HTLV-1 infection was 0.91% (95% CI: 0.80-1.02, p < .0001) and was higher in low HDI countries [1.18% (95% CI: 1.03-1.34)] than in high HDI countries [0.41% (95% CI: 0.27-0.57)]. Prevalence varied according to the populations studied: it was higher in the general population [1.65% (95% CI: 1.08-2.34)] compared to pregnant women [0.34% (95% CI: 0.17-0.57)] and blood donors [0.04% (95% CI: 0.01-0.08)]. Consistently, prevalence for each population group was higher in low HDI countries than in high HDI countries. The worldwide prevalence of HTLV-1 infection is highly heterogeneous, with a global prevalence of 0.91%. In high HDI countries, the observed prevalence is approximately three times lower than in low HDI countries. In the general population, the observed prevalence is about 5 times higher than in pregnant women and 41 times higher than in blood donors.
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Affiliation(s)
- Gleice Castor Lins Sampaio
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | - Jéssica Ramos Ribeiro
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
| | | | - Ney Boa-Sorte
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Health Technology Assessment Unit, Universidade Federal da Bahia (UFBA), Bahia, Brazil
| | - Bernardo Galvão-Castro
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Advanced Public Health Laboratory, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil.,Advanced Public Health Laboratory, Instituto Gonçalo Moniz, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Katia Nunes Sá
- Stricto Sensu Postgraduate Department, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Bahia, Brazil
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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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Dias ÁRN, Falcão LFM, Quaresma JAS. An Overview of Human T-Lymphotropic Virus Type 1 Lung Injury. Front Immunol 2022; 13:914498. [PMID: 35844492 PMCID: PMC9285117 DOI: 10.3389/fimmu.2022.914498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies have demonstrated the development of pulmonary impairment in individuals infected with human T-lymphotropic virus type 1 (HTLV-1). Complications, such as alveolitis and bronchiectasis, were found in individuals who developed tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) due to chronic inflammation. These patients exhibited increased levels of lymphocytes (CD4+ and CD25+), cytokines (IL-2, IL-12, and IFN-γ), inflammatory chemokines (MIP-1α and IP-10), and cell adhesion molecules (ICAM-1) in the bronchoalveolar lavage fluid, with the result of chronic inflammation and lung injury. The main lesions observed at Chest high-resolution computed tomography were centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. It can lead to progressive changes in pulmonary function with the development of restrictive and obstructive diseases. Recent studies suggest a causal relationship between HTLV-1 and pulmonary diseases, with intensification of lesions and progressive decrease in pulmonary function. This summary updates a previous publication and addresses the general lack of knowledge regarding the relationship between TSP-HAM and pulmonary disease, providing direction for future work and the management of these individuals.
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Affiliation(s)
- Ápio Ricardo Nazareth Dias
- Health and Biologic Center, State University of Pará, Belém, Brazil
- Tropical Medicine Centre, Federal University of Pará, Belém, Brazil
| | - Luiz Fábio Magno Falcão
- Health and Biologic Center, State University of Pará, Belém, Brazil
- University of São Paulo, São Paulo, Brazil
| | - Juarez Antônio Simões Quaresma
- Health and Biologic Center, State University of Pará, Belém, Brazil
- Tropical Medicine Centre, Federal University of Pará, Belém, Brazil
- *Correspondence: Juarez Antônio Simões Quaresma,
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6
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Brito WRDS, Cardoso-Costa GDL, Roland Junior LM, Pereira KAS, Lopes FT, dos Santos BC, de Lima ACR, Abreu IN, Lima CNC, Lima SS, Cayres Vallinoto IMV, dos Santos EJM, Guerreiro JF, Vallinoto ACR. Prevalence and Risk Factors for HTLV-1/2 Infection in Quilombo Remnant Communities Living in the Brazilian Amazon. Front Public Health 2022; 10:871865. [PMID: 35433598 PMCID: PMC9005874 DOI: 10.3389/fpubh.2022.871865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 12/02/2022] Open
Abstract
Human T-lymphotropic viruses 1 and 2 (HTLV-1 and HTLV-2) are retroviruses that originated on the African continent and dispersed throughout other continents through human migratory flows. This study describes the prevalence of HTLV-1 and HTLV-2 infection in residents of 11 quilombo remnant communities in the state of Pará, Brazil, and the associated risk factors. A total of 859 individuals (334 men and 525 women), aged between 7 and 91 years, participated in the study. All subjects answered a questionnaire with questions on sociodemographic characteristics and on risk factors associated with HTLV infection, and blood samples were collected and separated into plasma and leukocytes. An immunoenzymatic assay (ELISA; Murex HTLV-I+II, DiaSorin, Dartford, UK) was used as a screening test, and positive samples were subjected to line immunoassay confirmatory tests (Inno-LIA HTLV I/II Score FUJIREBIO) and DNA extraction for subsequent real-time PCR to differentiate the viral type. Four of the 859 individuals were seropositive for HTLV. HTLV-1 infection was confirmed in one individual from the Itamoari community (0.92%), and HTLV-2 infection was confirmed in two individuals from São Benedito (3.17%) and in one individual from Arimandeua (2.22%). Blood transfusion was the only risk factor associated with HTLV infection in this study. This study reports the occurrence of HTLV-1 and HTLV-2 in quilombo remnant communities in the state of Pará. Considering the African origin of the virus and its introduction into Brazil from the slave trade, the continued evaluation of quilombola communities in the state of Pará is essential to better characterize the distribution of infections in these populations and to create public health policies for the control of the spread of the virus and associated diseases.
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Affiliation(s)
- Wandrey Roberto dos Santos Brito
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Greice de Lemos Cardoso-Costa
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Lourival Marques Roland Junior
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Laboratory of Genetics of Complex Diseases, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Keise Adrielle Santos Pereira
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Felipe Teixeira Lopes
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Isabella Nogueira Abreu
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Carlos Neandro Cordeiro Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Izaura M. Vieira Cayres Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Eduardo José Melo dos Santos
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Laboratory of Genetics of Complex Diseases, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - João Farias Guerreiro
- Laboratory of Human and Medical Genetics, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
- Postgraduate Program in Biology of Infectious and Parasitic Agents, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Lopes FT, de Sousa RS, Carvalho Gomes JL, Vallinoto MC, de Lima ACR, Lima SS, Freitas FB, Feitosa RNM, Rangel da Silva ANM, Machado LFA, Aben-Athar CYP, Maia da Silva EL, Cayres Vallinoto IMV, Vallinoto ACR. The Relevance of a Diagnostic and Counseling Service for People Living With HTLV-1/2 in a Metropolis of the Brazilian Amazon. Front Public Health 2022; 10:864861. [PMID: 35419336 PMCID: PMC8995423 DOI: 10.3389/fpubh.2022.864861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To identify the prevalence of infection in the urban area of the capital city of Belém, Brazil, the Laboratory of Virology of the Federal University of Pará implemented, as a public service, serological screening for human T-lymphotropic viruses 1 and 2 (HTLV-1/2) infection and, if necessary, counseling service and referral to specialized medical care. The project is funded by the National Council of Science and Technology, the Ministry of Health of Brazil and the Pan American Health Organization. Methods From January 2020 to June 2021, 1,572 individuals of both sexes were approached to answer a questionnaire and were tested using an enzyme immunoassay (Murex HTLV-I+II, DiaSorin, Dartford, UK). Seropositive samples were confirmed as HTLV-1 and HTLV-2 infection by line immunoassay (INNO-LIA® HTLV I/II Score, Fujirebio, Japan) and/or by real-time polymerase chain reaction. G and Fisher's exact tests were applied to identify the association between epidemiological characteristics and HTLV-1/2 infection. Results Of the 1,572 screened individuals, 63.74% were females between the ages of 30 and 59 years (49.04%). Infection was confirmed in six individuals (0.38%), among whom three (0.19%) were infected with HTLV-1 and three with HTLV-2 (0.19%). Blood transfusion before 1993 was the main risk factor associated with the route of exposure to the virus (p = 0.0442). The infected individuals were referred to a counseling session with a nursing professional, and two patients who manifested signs and symptoms suggestive of myelopathy associated with HTLV were referred to a neurologist. Conclusion The implementation of the screening service revealed the occurrence of moderate endemicity of HTLV-1/2 in Belém, reinforcing the importance of continuing the service as a means of establishing an early diagnosis and providing counseling as a measure to prevent and control viral transmission in the general population.
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Affiliation(s)
- Felipe Teixeira Lopes
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Renata Santos de Sousa
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Mariana Cayres Vallinoto
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Aline Cecy Rocha de Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Sandra Souza Lima
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | | | | | - Luiz Fernando A. Machado
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Cintia Y. P. Aben-Athar
- Laboratory of Virology, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study. PLoS One 2021; 16:e0261864. [PMID: 34965281 PMCID: PMC8716036 DOI: 10.1371/journal.pone.0261864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/12/2021] [Indexed: 11/19/2022] Open
Abstract
Previous observational studies have demonstrated the development of pulmonary impairments in human T-lymphotropic virus type 1 (HTLV-1) infected individuals. The main observed lesions due to chronic inflammation of viral infection in situ are bronchiectasis and lung-scarring injuries. This lung inflammation may be the causal agent of restrictive and obstructive lung diseases, primarily in tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) patients. We conducted a prospective cohort study to compare spirometry and high-resolution computed tomography (HRCT) findings among 28 HTLV-1-carrier patients over the course of 6 years (2014–2019) (male/female: 7/21; mean age: 54.7 ± 9.5, range: 41–68 years). Chest HRCT exams revealed the development and evolution of lung lesions related to TSP-HAM: including centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. Spirometry exams showed maintenance of respiratory function, with few alterations in parameters suggestive of obstructive and restrictive disorders primarily in individuals with lung lesions and TSP-HAM. The findings of the present study indicate that pulmonary disease related to HTLV-1 is a progressive disease, with development of new lung lesions, mainly in individuals with TSP-HAM. To improve clinical management of these individuals, we recommend that individuals diagnosed with PET-MAH undergo pulmonary evaluation.
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Epidemiological and molecular profile of blood donors infected with HTLV-1/2 in the state of Pará, northern Brazil. Braz J Microbiol 2021; 52:2001-2006. [PMID: 34498218 DOI: 10.1007/s42770-021-00609-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 09/01/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The Human T-lymphotropic virus (HTLV) is a retrovirus of the genus Deltaretrovirus, which belongs to the family Retroviridae. The most important types are HTLV-1 and HTLV-2. It is estimated that between five and 10 million individuals are infected with HTLV-1, worldwide. Studies in the state of Pará indicate that it has the third highest prevalence of HTLV infections of any Brazilian state. The present study describes the epidemiological, serological, and molecular profile of blood donors from the state of Pará that were classified as unfit due to infection by HTLV-1 and 2. METHODS The present study is based on a descriptive, retrospective, and cross-sectional review of the epidemiological, serological, and molecular data on blood donations, between January 2015 and December 2019. The data were obtained from the blood bank system and were digitalized to form a database in the Statistical Package for Social Sciences program, version 20. Descriptive statistics were used to determine the absolute and relative frequencies of the qualitative variables. For the quantitative variables, the mean, standard deviation, and minimum and maximum values were calculated. A p < 0.05 significance level was adopted for all analyses. RESULTS A total of 632 samples were analyzed, of which 496 (78%) had no detectable proviral DNA and 136 (22%) had detectable HTLV. The HTLV-1 was detected in most (78%; 106/136) of these samples, while only 30 (22%) were detected for HTLV-2. The HTLV proviral DNA was detected primarily in females (69.1%), with a mean age of 40 years, with the highest frequencies of detection being recorded in single individuals (66.2%), first-time donors (74.3%), and individuals that had graduated high school (44.1%). The molecular confirmation of HTLV showed that three-quarters (78%) of the serologically reactive individuals were negative for either types 1 or 2, so the epidemiological profile of these individuals was significantly different from their detectable profile. CONCLUSIONS The HTLV is neglected in Brazil; there is thus a clear need for further research in the area of regional hemotherapy and hematology services, in order to contribute to the definition of regional infection profiles, that will be fundamental to the development of effective prophylactic practices for the prevention of the infection and the dissemination of knowledge on the dangers of HTLV in the community.
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Pereira FM, Santos FLN, de Almeida MDCC, Carreiro RP, Silva LK, Galvão-Castro B, Rios Grassi MF. Seroprevalence and Spatial Distribution of Hepatitis C Virus in Bahia, Brazil. Am J Trop Med Hyg 2021; 105:991-998. [PMID: 34424863 PMCID: PMC8592152 DOI: 10.4269/ajtmh.20-1615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/06/2021] [Indexed: 12/13/2022] Open
Abstract
In Salvador, which is the capital of the Brazilian state of Bahia, it has been estimated that 1.5% of the general population is infected with hepatitis C virus (HCV); however, the circulation of HCV throughout the state remains unknown. The present retrospective study aimed to determine anti-HCV seroprevalence and describe the geographic distribution of hepatitis C in Bahia. Data from HCV serological tests submitted to the Bahia Central Laboratory of Public Health between 2004 and 2013 were analyzed. Serology for HCV was performed using the AxSYM anti-HCV enzymatic microparticle immunoassay and chemiluminescence immunoassay. A subgroup of samples with detectable HCV-RNA was genotyped using the linear array hepatitis C virus genotyping assay. A total of 247,837 samples were analyzed. The median age of the studied population was 31 years (interquartile range, 25-44 years), and the female:male ratio was 3.9:1. The global seroprevalence of HCV in Bahia was estimated to be 1.3% (3,230/247,837), corresponding to an infection rate of 21.2/100,000 inhabitants. The seroprevalence of HCV was higher among males and increased with age. The presence of anti-HCV antibodies was detected throughout all mesoregions of Bahia, and the municipality with the highest infection rate was Ipiaú (112.04 cases/100,000 inhabitants). Genotypes 1 and 3 were found to be the most prevalent, followed by genotypes 2, 4, and 5. Our results provide evidence of the widespread distribution of previous HCV infection throughout the state of Bahia.
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Affiliation(s)
- Felicidade Mota Pereira
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Fiocruz-BA, Salvador, Bahia, Brazil
- Gonçalo Moniz Public Health Central Laboratory, Salvador, Bahia, Brazil
| | | | | | - Roberto Perez Carreiro
- Center for Integration of Data and Health Knowledge, Gonçalo Moniz Institute, Fiocruz-BA, Salvador, Bahia, Brazil
| | | | - Bernardo Galvão-Castro
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Fiocruz-BA, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Maria Fernanda Rios Grassi
- Advanced Public Health Laboratory, Gonçalo Moniz Institute, Fiocruz-BA, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
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11
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de Souza RL, Pereira MVS, da Silva RM, Sales JBDL, Gardunho DCL, Monteiro JC, Siravenha LQ, da Luz ALB, Fonseca RRDS, Oliveira-Filho AB, Ishak MDOG, Ishak R, Machado LFA. Molecular Epidemiology of HIV-1 and HTLV-1/2 Among Female Sex Workers in Four Cities in the State of Para, Northern Brazil. Front Microbiol 2020; 11:602664. [PMID: 33262753 PMCID: PMC7686468 DOI: 10.3389/fmicb.2020.602664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022] Open
Abstract
Female sex workers (FSWs) represent a key population for the acquisition of sexually transmitted infections (STI) due to their social vulnerability and the risks associated with their occupation. This study was conducted to describe the sociodemographic characteristics and sexual behavior among FSWs in cities in northern Brazil, to determine the prevalence of human immunodeficiency virus 1 (HIV-1) and human T-cell lymphotropic virus (HTLV-1/2) infections and to identify the circulating subtypes of these agents in this key population. A cross-sectional study using the Time Location Sampling (TLS) method was conducted among 339 FSWs in cities in the state of Pará from 2005 to 2006. Serological and molecular tests were performed to identify infections and viral subtypes, and bivariate and multivariate analyses were conducted to identify risk factors. Most FSWs were young, single, less educated and had at least one child. The prevalence of antibodies against HIV-1 and HTLV-1 was 2.3 and 1.7%, respectively. HIV-1 subtypes B (87.5%) and F1 (12.5%) were identified among FSWs, as were Cosmopolitan subtype (1a) and Transcontinental subgroup (A). Unprotected sex and illicit drug use were associated with HIV-1 and HTLV-1 infections using bivariate and multivariate analyses, and age ≥27 years was associated only with HIV. The important information highlighted here clearly indicates that the lack of actions to control and prevent pathogens in FSWs and the lack of strategies for health promotion in key populations can further aggravate the epidemiological scenario of viral infections in remote areas with low human development indices. Neglecting these facts may be causing the spread of these two viruses and their respective subtypes in the general population of northern Brazil.
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Affiliation(s)
- Ronaldo Lopes de Souza
- Campus de Abaetetuba, Universidade Federal do Pará, Abaetetuba, Brazil.,Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Marcelo Victor Serejo Pereira
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | | | - João Bráullio de Luna Sales
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Danilo Cesar Lima Gardunho
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Jacqueline Cortinhas Monteiro
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Leonardo Quintão Siravenha
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Anderson Luiz Bessa da Luz
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Ricardo Roberto de Souza Fonseca
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Aldemir Branco Oliveira-Filho
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
| | - Marluísa de Oliveira Guimarães Ishak
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Ricardo Ishak
- Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
| | - Luiz Fernando Almeida Machado
- Campus de Abaetetuba, Universidade Federal do Pará, Abaetetuba, Brazil.,Programa de Pós-Graduação em Biologia de Agentes Infecciosos e Parasitários, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil
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12
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Alencar SP, Souza MDC, Fonseca RRDS, Menezes CR, Azevedo VN, Ribeiro ALR, Lima SS, Laurentino RV, Barbosa MDADAP, Freitas FB, Oliveira-Filho AB, Machado LFA. Prevalence and Molecular Epidemiology of Human T-Lymphotropic Virus (HTLV) Infection in People Living With HIV/AIDS in the Pará State, Amazon Region of Brazil. Front Microbiol 2020; 11:572381. [PMID: 33193170 PMCID: PMC7642294 DOI: 10.3389/fmicb.2020.572381] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/25/2020] [Indexed: 11/17/2022] Open
Abstract
The human T-lymphotropic virus (HTLV) is part of the group of retroviruses that share similar routes of transmission to the human immunodeficiency virus (HIV). Coinfection of these viruses can affect the clinical course of both infections, and reports have shown a quicker progression to AIDS and the development of HIV-related opportunistic infections. The current study investigated the demographic characteristics, prevalence, and the subtypes of HTLV among people living with HIV/AIDS (PLWHA) in the State of Pará, Northern Brazil. Blood samples were obtained from patients who were attending a reference unit that provides medical assistance to HIV-infected individuals in the State of Pará, Brazil, during the period of May 2016 to June 2017. Plasma samples were screened by ELISA tests to detect antibodies anti-HTLV-1/2. DNA and viral types were identified by real-time polymerase chain reaction (qPCR). All samples with viral DNA were submitted to nested PCR and nucleotide sequencing. The overall coinfection rate was 1.4% (5/368), and all samples were from subtype HTLV-1a. No cases of HTLV-2 infection were detected. The prevalence of HTLV-1 was higher in females (80%), individuals between 31 and 50 years of age, heterosexual, unmarried, with low monthly income, with secondary educational level or higher, sporadic condom usage, limited number of sexual partners, and no history of sexually transmitted infections. All samples from HTLV-1-infected patients were identified as strains belonging to the subtype 1a (Cosmopolitan), subgroup A (Transcontinental). This study identified that the prevalence of HIV/HTLV coinfection has dropped from 8 to 1.3% in the current investigation. There was a shift of HTLV subtype from a predominance of HTLV-2 infection in the past to an actual exclusively HTLV-1a. There was no significant association between economic, sociodemographic, and behavioral characteristics in HIV/HTLV coinfection.
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Affiliation(s)
- Samira Peixoto Alencar
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil
| | - Marlinda de Carvalho Souza
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil
| | | | - Cláudia Ribeiro Menezes
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil
| | - Vânia Nakauth Azevedo
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belem, Brazil
| | | | - Sandra Souza Lima
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belem, Brazil
| | | | | | | | | | - Luiz Fernando Almeida Machado
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belem, Brazil
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13
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The reasons to include the serology of human T-lymphotropic virus types 1 and 2 (HTLV-1 and HTLV-2) in the clinical follow-up of patients with viral hepatitis B and C in Brazil. PLoS Negl Trop Dis 2020; 14:e0008245. [PMID: 32453768 PMCID: PMC7274452 DOI: 10.1371/journal.pntd.0008245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/05/2020] [Accepted: 03/24/2020] [Indexed: 01/29/2023] Open
Abstract
Background The WHO established targets for 2030 to globally reduce new viral hepatitis B and C infections by 90% and deaths by 65% and recommends searching for coinfections that increase the progression of chronic liver infections towards cirrhosis and hepatocellular carcinoma. Aims and methodology This study aimed to add information concerning the influence of human T-lymphotropic virus type 1 (HTLV-1) and type 2 (HTLV-2) infections in hepatitis B and C, since in Brazil, these human retroviruses are endemic but neglected. Serum samples from 1,910 patients with hepatitis B and 1,315 with hepatitis C from São Paulo, southeast Brazil, that were previously tested and grouped for HIV and HTLV-1/-2 coinfections were analyzed for hepatitis B virus (HBV) and hepatitis C virus (HCV) loads measurements and subsequent clearance using data from laboratory records. Key results Briefly, the lowest HBV viral load (VL) was detected in HBV/HTLV-2 coinfected patients, regardless of whether they were infected with HIV (all comparisons p<0.05). In contrast, higher HCV VL was detected in HCV/HIV, HCV/HIV/HTLV-1/-2 coinfected patients (all p<0.05), and the lowest HCV VL was detected in HCV/HTLV-2 coinfected patients. Curiously, 61.1% of the patients with HBV/HTLV-2 coinfection had an undetectable HBV VL at the beginning of the study versus 21.4% in the patients with HBV/HTLV-1 coinfection. Although the percentages of undetectable HCV loads in HCV/HTLV-1 and HCV/HTLV-2 coinfected patients were quite similar, during follow-up, more HCV clearance was detected in patients with HCV/HTLV-2 coinfection [OR 2.65; 95% IC (1.17–5.99)]. Major conclusions HTLV-2 positively impacts HBV and HCV viral loads and HCV clearance, while HIV and/or HTLV-1 negatively impacts HCV viral load. Thus, the search for HTLV-1/-2 in viral hepatitis B and C infected patients has virological prognostic value, which is a strong reason to suggest including HTLV serology in the follow-up of patients. The human T-lymphotropic viruses type 1 (HTLV-1) and type 2 (HTLV-2) are endemic and neglected in Brazil, and although these viruses were considered to have prognostic value when associated with HIV, e.g., HTLV-1 has been associated with fast progression and death to AIDS and more cases of lymphoma and neurological disorders, and HTLV-2 has been associated with slow progression to AIDS, their impact on hepatitis B virus (HBV) and hepatitis C virus (HCV) outcomes remain unknown. The present study analyzed the influence of HTLV-1 and HTLV-2 coinfection on HBV and HCV virological outcomes (viral load levels and virus clearance during follow-up) in serum samples from 1,910 patients with hepatitis B and 1,315 patients with hepatitis C from São Paulo, southeast Brazil. The results obtained confirmed the positive impact of HTLV-2 on HBV and HCV virological outcomes (lower HBV and HCV viral loads and increased HCV clearance when compared with HCV-monoinfected patients) and the opposite effect of HTLV-1; these findings are similar to the effects observed in HIV/AIDS patients. Taking into consideration these results and the differential impact of HTLV-1 and HTLV-2 in viral hepatitis B and C, we suggest including the serology of HTLV-1/2 in the follow-up of such patients in Brazil.
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14
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Ishak R, de Oliveira Guimarães Ishak M, Vallinoto ACR. The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil. Retrovirology 2020; 17:4. [PMID: 32059740 PMCID: PMC7023703 DOI: 10.1186/s12977-020-0512-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/09/2020] [Indexed: 12/27/2022] Open
Abstract
HTLV-1 was the first described human retrovirus and was soon found to be associated with severe clinical diseases, including a devastating lymphoma/leukemia and other inflammatory diseases. Although HTLV-2 is not usually pathogenic, it is widely distributed among native Indian populations in Brazil, particularly in the Amazon region of the country. Presently, HTLV spreads mainly by the sexual route and from mother to child, and virus persistence is an active biological factor aiding its transmission. Recently, the use of illicit drugs has been shown to be an additional risk factor, showing the influence of new habits on the epidemiology of HTLV in the region. Despite the detection of the virus in several different populations in the Amazon region of Brazil for almost 30 years, the exact prevalence of HTLV-1/2 is not well defined. The original biases in sampling and the selection of epidemiologically unsuitable populations were commonly repeated in most prevalence studies, generating unreliable and conflicting figures that do not represent the actual prevalence of HTLV. The improvements in clinical and laboratory facilities have resulted in the description of several clinical manifestations that were previously unknown in the region. The extent of the spread of the virus must be defined in this region, which is the largest geographical area of the country. As prophylaxis advances toward the use of vaccines against HTLV-1, it is important to determine who is at risk of being infected and developing a disease to successfully implement preventive measures, particularly as proposals are made to eradicate the virus among humans.
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Affiliation(s)
- Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa no.1, Belém, Pará, 66075-110, Brazil.
| | - Marluísa de Oliveira Guimarães Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa no.1, Belém, Pará, 66075-110, Brazil
| | - Antonio Carlos R Vallinoto
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Rua Augusto Corrêa no.1, Belém, Pará, 66075-110, Brazil
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15
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Dias ACL, Gomes IF, Bittencourt KC, Rocha RSB, Falcão LFM, Normando VMF. Benefits of inspiratory muscle training under indirect home supervision in patients with human T-cell lymphotropic virus type 1. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.032.e003358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The presence of human T-cell lymphotropic virus type 1 (HTLV-1) associated with neuropathy (myelopathy/tropical spastic paraparesis - HAM/TSP), can generate morphological and functional changes in the respiratory system. As a preventive therapeutic possibility for respiratory dysfunctions, it is expected that the already conceptualized inspiratory muscle training, when performed at home, can be a therapeutic resource that favors adherence to treatment. Objective: To evaluate respiratory muscle strength in patients with HTLV-1 after participating in a home respiratory muscle training protocol under indirect supervision. Method: This was a clinical, longitudinal, prospective, quantitative, and single-center trial approved by the Research Ethics Committee of the State University of Pará, opinion no. 2.695.505 and registered in clinical trials NCT03829709. Six HTLV-1 patients participated in a 5-week home respiratory muscle training protocol lasting 30 minutes daily through a linear load inspiratory muscle trainer. For the characterization of the imposed load, they were submitted to manovacuometry during pre (T0), peri (T3), and post (T5) treatment. Results: Six individuals completed the program, of which 83.33% were female and 16.66% male. With the application of respiratory muscle training, it was possible to achieve a significant increase (p < 0.011) of the maximum inspiratory pressure as shown when comparing T0 (66.8±12.58) to T5 (115.08±31.78). Conclusion: This study identified an increase in inspiratory muscle strength after HTLV-1 patients participated in a home muscle training protocol under indirect supervision.
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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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