1
|
Xu Y, Yu B. Blood-borne viruses and neurological manifestations: An overview. Rev Med Virol 2024; 34:e2552. [PMID: 38877365 DOI: 10.1002/rmv.2552] [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: 05/01/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/16/2024]
Abstract
Infections caused by blood-borne viruses, such as human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), hepatitis C virus (HCV), and hepatitis B virus (HBV), are systemic diseases that can lead to a wide range of pathological manifestations. Besides causing severe immune and hepatic disorders, these viral pathogens can also induce neurological dysfunctions via both direct and indirect mechanisms. Neurological dysfunctions are one of the most common manifestations caused by these viruses that can also serve as indicators of their infection, impacting the clinical presentation of the disease. The main neurological manifestations of these blood-borne viral pathogens consist of several central and peripheral nervous system (CNS and PNS, respectively) dysfunctions. The most common neurological manifestations of HIV, HTLV, HCV, and HBV include HIV-associated peripheral neuropathy (PN), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and HCV-/HBV-associated PN, respectively. Nonetheless, patients infected with these viruses may experience other neurological disorders, either associated with these conditions or manifesting in isolation, which can often go unnoticed or undiagnosed by physicians. The present review aims to provide an overview of the latest evidence on the relationship between blood-borne viruses and neurological disorders to highlight neurological conditions that may be somewhat overlooked by mainstream literature and physicians.
Collapse
Affiliation(s)
- Yan Xu
- Department of Bone and Joint Surgery, The First Bethune Hospital of Jilin University, Changchun, China
| | - Bo Yu
- Department of Bone and Joint Surgery, The First Bethune Hospital of Jilin University, Changchun, China
| |
Collapse
|
2
|
Rosadas C, Costa M, Senna K, Santos M, Taylor GP. Impact and economic analysis of human T-cell lymphotropic virus type 1 (HTLV-1)-targeted antenatal screening, England and Wales, 2021. Euro Surveill 2024; 29:2300537. [PMID: 38818747 PMCID: PMC11141129 DOI: 10.2807/1560-7917.es.2024.29.22.2300537] [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: 10/06/2023] [Accepted: 02/17/2024] [Indexed: 06/01/2024] Open
Abstract
BackgroundHuman T-cell lymphotropic virus type 1 (HTLV-1) is a neglected virus that can cause severe disease and be transmitted from mother to child through breastfeeding. Avoidance of breastfeeding prevents 80% of vertical transmission. The United Kingdom (UK) is currently assessing whether HTLV-1-targeted antenatal screening should be implemented.AimWe aimed to assess the impact and cost-effectiveness of a targeted programme to prevent HTLV-1 vertical transmission in England and Wales.MethodsWe estimated the number of pregnant women who have high risk of HTLV-1 infection based on their or their partner's country of birth. With data from 2021, we used a mathematical model to assess cost-effectiveness of HTLV-1 antenatal screening. We also estimated the annual number of infant infections and the number that could be prevented with screening and intervention.ResultsWe estimate that ca 99,000 pregnant women in England and Wales have high risk of HTLV-1 infection. In the absence of screening, 74 (range: 25-211) HTLV-1 infections in infants would be expected to occur every year in England and Wales. Implementation of targeted screening would prevent 58 (range: 19-164) infant infections annually. The intervention is effective (incremental 0.00333 quality-adjusted life years (QALY)) and cost-saving (GBP -57.56 (EUR -66.85)).ConclusionOur findings support implementation of HTLV-1 targeted antenatal screening to reduce vertical transmission from mothers to infants in the UK.
Collapse
Affiliation(s)
- Carolina Rosadas
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Milene Costa
- Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Núcleo de Avaliação de Tecnologias em Saúde, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Kátia Senna
- Núcleo de Avaliação de Tecnologias em Saúde, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Marisa Santos
- Núcleo de Avaliação de Tecnologias em Saúde, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Graham P Taylor
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom
- Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
3
|
Encinas B, Benito R, Rojo S, Reina G, Montiel N, Aguilera A, Eiros JM, García-Costa J, Ortega D, Arco I, Hernánez-Batancor A, Soriano V, de Mendoza C. Human T-lymphotropic virus-1 infection among Latin American pregnant women living in Spain. IJID REGIONS 2024; 10:146-149. [PMID: 38304758 PMCID: PMC10831283 DOI: 10.1016/j.ijregi.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
Objectives Human T-lymphotropic virus (HTLV) antenatal screening is not mandatory in Spain. Surveys conducted decades ago reported HTLV-1 seroprevalence rates of 0.2% among foreign pregnant women in Spain. The migrant flow to Spain from HTLV-1 endemic regions in Latin America and sub-Saharan Africa has increased during the last decade. Currently, 25% of pregnant women in Spain are foreigners. Methods From January 2021 to October 2023 a cross-sectional study was carried out in all consecutive pregnant women attended at eleven Spanish clinics. A commercial enzyme immunoassay (EIA) was used for screening of serum HTLV-1/2 antibodies. Reactive samples were confirmed by immunoblot. Results A total of 9813 pregnant women with a median age of 34 years-old were examined. Native Spaniards were 6977 (76.5%). Of 2147 foreigners (23.5%), 903566 (9.9%) were Latin Americans, 416 (4.5%) North Africans, 293 (3.2%) from Romania, and 196 (2.1%) from sub-Saharan Africa. A total of 47 samples were EIA reactive but only five were confirmed as HTLV-1 positive using immunoblot. Infected women came from Paraguay, Colombia, the Dominican Republic, Venezuela and Peru. All but one were primigravida, with ages ranging from 20 to 33 years-old. One was HIV-1 positive, and another was infected with Chlamydia trachomatis. Conclusion The overall seroprevalence for HTLV-1 among pregnant women in Spain is 0.05% but rises ten-fold (0.55%) among Latin Americans. This rate is higher than in surveys conducted decades ago. Our results support that anti-HTLV testing should be part of antenatal screening in Spain in pregnant women coming from Latin America, as it is already done with Chagas disease.
Collapse
Affiliation(s)
- Begoña Encinas
- Gynecology & Obstetrics Department, Puerta de Hierro University Hospital, Madrid, Spain
| | - Rafael Benito
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Silvia Rojo
- Microbiology Department, Hospital Clínico Universitario, Valladolid, Spain
| | - Gabriel Reina
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Natalia Montiel
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Antonio Aguilera
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
| | - José María Eiros
- Microbiology Department, Rio Hortega University Hospital, Valladolid, Spain
| | - Juan García-Costa
- Microbiology Department, Complejo Hospitalario de Ourense, Ourense, Spain
| | - Diego Ortega
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Irene Arco
- Microbiology Department, General University Hospital of Alicante, Pintor Baeza, Alicante, Spain
| | - Araceli Hernánez-Batancor
- Microbioligy Department, Hospital insular Unidad De Traslados, Avenida Maritima del Sur, Las Palmas de Gran Canaria, Spain
| | - Vicente Soriano
- International University of La Rioja (UNIR) Health Sciences School & Medical Center, Madrid, Spain
| | - Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | - Spanish HTLV Network
- Gynecology & Obstetrics Department, Puerta de Hierro University Hospital, Madrid, Spain
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- Microbiology Department, Hospital Clínico Universitario, Valladolid, Spain
- Microbiology Department, Clínica Universidad de Navarra, Pamplona, Spain
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
- Microbiology Department, Rio Hortega University Hospital, Valladolid, Spain
- Microbiology Department, Complejo Hospitalario de Ourense, Ourense, Spain
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
- Microbiology Department, General University Hospital of Alicante, Pintor Baeza, Alicante, Spain
- Microbioligy Department, Hospital insular Unidad De Traslados, Avenida Maritima del Sur, Las Palmas de Gran Canaria, Spain
- International University of La Rioja (UNIR) Health Sciences School & Medical Center, Madrid, Spain
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| |
Collapse
|
4
|
Ayerdi O, Benito R, Ortega D, Aguilera A, Montiel N, Pintos I, Díaz de Santiago A, Baza B, Soriano V, de Mendoza C. HTLV infection in persons with sexually transmitted diseases in Spain. Front Immunol 2023; 14:1277793. [PMID: 38143748 PMCID: PMC10740202 DOI: 10.3389/fimmu.2023.1277793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background HTLV-1 infection is a neglected disease, despite estimates of 10 million people infected worldwide and producing life-threatening illnesses in 10% of carriers. Sexual transmission is the main route of contagion. However, HTLV-1 is not listed among sexually transmitted infections (STIs). Methods Serum from all consecutive individuals who had attended six STI clinics across Spain during the last 12 months were tested for HTLV antibodies using a commercial enzyme immunoassay (EIA). Reactive samples were confirmed by immunoblot. Results A total of 2,524 samples were examined. The majority (1,936; 76.7%) belonged to men, of whom 676 (34.9%) were men who have sex with men (MSM) receiving HIV pre-exposure prophylaxis. Although native Spaniards predominated (1,470; 58.2%), up to 593 (23.5%) came from Latin America and 139 (5.5%) were African. A total of 26 individuals were initially EIA reactive and immunoblot confirmed 5 as HTLV-1 and 7 as HTLV-2. All but one HTLV-1+ case came from Latin America. Three were men and two were women. Among Latin Americans, the HTLV-1 seroprevalence was 0.67%. In contrast, all seven HTLV-2+ were native Spaniards and former injection drug users, and all but one were HIV+. Conclusion The rate of HTLV infection among individuals with STIs in Spain is 0.5%, which is greater than in the general population. These results support the introduction of universal HTLV screening in persons who attend clinics for STIs.
Collapse
Affiliation(s)
- Oskar Ayerdi
- Sexually transmitted Infections Clinic, Centro Sanitario Sandoval, Madrid, Spain
| | - Rafael Benito
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Diego Ortega
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Antonio Aguilera
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
| | - Natalia Montiel
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Ilduara Pintos
- Internal Medicine Laboratory, Puerta de Hierro University Hospital and Research Foundation-IDIPHISA, Madrid, Spain
| | - Alberto Díaz de Santiago
- Internal Medicine Laboratory, Puerta de Hierro University Hospital and Research Foundation-IDIPHISA, Madrid, Spain
| | - Begoña Baza
- Sexually transmitted Infections Clinic, Centro Sanitario Sandoval, Madrid, Spain
| | - Vicente Soriano
- Public Health Unit, UNIR Health Sciences School and Medical Center, Madrid, Spain
| | - Carmen de Mendoza
- Internal Medicine Laboratory, Puerta de Hierro University Hospital and Research Foundation-IDIPHISA, Madrid, Spain
| |
Collapse
|
5
|
de-Mendoza C, Pérez L, Rando A, Reina G, Aguilera A, Benito R, Eirós JM, Rodríguez-Avial I, Ortega D, Pozuelo MJ, Pena MJ, Soriano V. HTLV-1-associated myelopathy in Spain. J Clin Virol 2023; 169:105619. [PMID: 38000189 DOI: 10.1016/j.jcv.2023.105619] [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: 09/17/2023] [Revised: 10/27/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND HTLV-1 infection is a neglected disease. Over 10 million people are infected worldwide, with hot spots of high endemicity across all continents. Roughly 5% of HTLV-1 carriers develop HTLV-1-associated myelopathy (HAM), a progressive subacute neurological disabling disease. METHODS We report the main features of patients diagnosed with HAM up to date in Spain, a non-endemic country with a relatively high migrant flow from Latin America and Equatorial Africa, where HTLV-1 is endemic. RESULTS A total of 451 cases of HTLV-1 had been recorded in Spain until the end of year 2022. HAM had been diagnosed in 58 (12.9%). The current incidence is of 2-3 new cases per year. Women represent 76%. Mean age at diagnosis is 49 years-old. Nearly 60% are Latin Americans. Although sexual transmission is the most likely route of HTLV-1 acquisition, up to 6 individuals had been infected following solid organ transplantation. Rapid onset myelopathy developed in all but one of these transplant recipients from three HTLV-1-positive donors. HTLV-1 subtype 1a transcontinental was the only variant recognized in HAM patients. HTLV-1 proviral load was significantly greater in HAM patients than in asymptomatic HTLV-1 carriers (677 vs 104 HTLV-1 DNA copies/104 PBMC; p = 0.012). Symptom relief medications and physiotherapy have been the only treatment providing some benefit to HAM patients. Neither significant clinical nor virological efficacy was noticed using antiretrovirals in at least 9 HAM patients. Two thirds of HAM patients ended up in a wheelchair and with urinary/fecal sphincter incontinence. CONCLUSION HAM is the most frequent clinical manifestation of HTLV-1 infection in Spain, a non-endemic country. Middle aged women migrants from Latin America are the most frequently affected. Two thirds end up in a wheelchair despite using antiretroviral therapy.
Collapse
Affiliation(s)
- Carmen de-Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | - Leire Pérez
- Gregorio Marañón University Hospital, Madrid, Spain
| | | | | | | | - Rafael Benito
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | | | | | - María José Pena
- Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Vicente Soriano
- UNIR Health Sciences School & Medical Center, UNIR-Citei, Madrid, Spain.
| |
Collapse
|
6
|
Ji H, Chang L, Yan Y, Sun H, Liu Y, Wang L. Genetic typing and intrafamilial transmission of human T-lymphotropic virus type 1 in non-endemic areas of China. Front Microbiol 2023; 14:1288990. [PMID: 37920260 PMCID: PMC10619906 DOI: 10.3389/fmicb.2023.1288990] [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: 09/05/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023] Open
Abstract
The origin and intrafamilial transmission of Human T-Lymphotropic Virus Type 1 (HTLV-1) in non-endemic populations such as China is still unknown. In this study, donors from blood banks/centers in China (including 28 provinces and Shenzhen city) during 2019 and 2021 were screened for HTLV-1/2 antibody, and all the reactive samples were tested using a line immunoassay (LIA) and quantitative polymerase chain reaction (qPCR). Samples that can be detected using qPCR were amplified and sequenced for the long terminal repeat (LTR) region. The positive donors were contacted to identify their relatives. As a result, 4,451,883 blood donors were totally tested, and 50 of them were confirmed to be HTLV-1/2 positive. Viral LTR sequences genotyped from 26 HTLV-1 carriers demonstrated that all had the HTLV-1a genotype, of which Transcontinental and Japanese subgroups accounted for half each. There were 17 family members of 11 index donors detected, and the HTLV-1 infection rate in the spouses of male index donors (83.3%, 5/6) was significantly higher than that in the husbands of female index donors (0.0%, 0/4). However, 7 children of HTLV-1 positive women were tested and found negative. Therefore, our findings indicated that HTLV-1 is spreading silently from high-endemic to low-endemic areas in China. To prevent further HTLV-1/2 transmission, an efficient HTLV-1/2 screening strategy and counseling of the virus carriers are essential.
Collapse
Affiliation(s)
- Huimin Ji
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Le Chang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Huizhen Sun
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
| | - Yi Liu
- 63750 Military Hospital of the People's Liberation Army, Xi'an, Shaanxi, China
| | - Lunan Wang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
7
|
de Mendoza C, Rando A, Miró E, Pena MJ, Rodríguez-Avial I, Ortega D, González-Praetorius A, Reina G, Pintos I, Pozuelo MJ, Soriano V. Adult T-cell leukemia/lymphoma in HTLV-1 non-endemic regions. J Clin Virol 2023; 167:105578. [PMID: 37660433 DOI: 10.1016/j.jcv.2023.105578] [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: 06/26/2023] [Revised: 07/31/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND HTLV-1 infection is a neglected disease, despite producing neurological and lymphoproliferative severe illnesses and affect over 10 million people worldwide. Roughly 5% of HTLV-1 carriers develop Adult T-cell leukemia/lymphoma (ATLL), one of the most aggressive hematological malignancies. METHODS A national HTLV-1 register exists since 1989 in Spain, a non-endemic country with a large migrant flow from Latin America and Equatorial Africa, where HTLV-1 is endemic. The main features of all patients diagnosed with ATLL in Spain up to date are reported. RESULTS A total of 451 cases of HTLV-1 infection had been reported in Spain until the end of year 2022. ATLL had been diagnosed in 35 (7.8%). The current average incidence of ATLL in Spain is of two cases per year. Women represent 57% of ATLL patients. Mean age at diagnosis was 47 years-old. Roughly 57% were Latin Americans and 26% Africans. At diagnosis, the majority presented with acute or lymphoma clinical forms. Survival was shorter than one year in most of them. Mean HTLV-1 proviral load was significantly greater in ATLL patients than in asymptomatic HTLV-1 carriers (2,305 vs 104 copies/104 PBMC). HTLV-1 subtyping in 6 ATLL patients found the 1a transcontinental variant (n = 4) and the Japanese variant (n = 2). All ATLL patients were negative for HIV-1, did not develop HTLV-1-associated myelopathy and were not transplant recipients. CONCLUSION The rate of ATLL is very low in Spain and mostly associated to migrants from HTLV-1 endemic regions. Given the poor clinical outcome of ATLL, HTLV-1 testing should be performed at least once in all migrants coming from HTLV-1 endemic countries and in natives who have lived in or had sex partners from such regions.
Collapse
Affiliation(s)
- Carmen de Mendoza
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | | | - Elisenda Miró
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María José Pena
- Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | - Ilduara Pintos
- Puerta de Hierro University Hospital & Research Foundation-IDIPHISA, Madrid, Spain
| | | | - Vicente Soriano
- UNIR Health Sciences School & Medical Center, Madrid, Spain.
| |
Collapse
|
8
|
Marino-Merlo F, Grelli S, Mastino A, Lai M, Ferrari P, Nicolini A, Pistello M, Macchi B. Human T-Cell Leukemia Virus Type 1 Oncogenesis between Active Expression and Latency: A Possible Source for the Development of Therapeutic Targets. Int J Mol Sci 2023; 24:14807. [PMID: 37834255 PMCID: PMC10572738 DOI: 10.3390/ijms241914807] [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: 08/13/2023] [Revised: 09/16/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The human T-cell leukemia virus type 1 (HTLV-1) is the only known human oncogenic retrovirus. HTLV-1 can cause a type of cancer called adult T-cell leukemia/lymphoma (ATL). The virus is transmitted through the body fluids of infected individuals, primarily breast milk, blood, and semen. At least 5-10 million people in the world are infected with HTLV-1. In addition to ATL, HTLV-1 infection can also cause HTLV-I-associated myelopathy (HAM/TSP). ATL is characterized by a low viral expression and poor prognosis. The oncogenic mechanism triggered by HTLV-1 is extremely complex and the molecular pathways are not fully understood. However, viral regulatory proteins Tax and HTLV-1 bZIP factor (HBZ) have been shown to play key roles in the transformation of HTLV-1-infected T cells. Moreover, several studies have shown that the final fate of HTLV-1-infected transformed Tcell clones is the result of a complex interplay of HTLV-1 oncogenic protein expression with cellular transcription factors that subvert the cell cycle and disrupt regulated cell death, thereby exerting their transforming effects. This review provides updated information on the mechanisms underlying the transforming action of HTLV-1 and highlights potential therapeutic targets to combat ATL.
Collapse
Affiliation(s)
- Francesca Marino-Merlo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98166 Messina, Italy;
| | - Sandro Grelli
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Antonio Mastino
- The Institute of Translational Pharmacology, CNR, 00133 Rome, Italy;
| | - Michele Lai
- Retrovirus Center and Virology Section, Department of Translational Research, University of Pisa, 56100 Pisa, Italy; (M.L.); (M.P.)
| | - Paola Ferrari
- Unit of Oncology, Department of Medical and Oncological Area, Azienda Ospedaliera—Universitaria Pisana, 56125 Pisa, Italy;
| | - Andrea Nicolini
- Department of Oncology, Transplantations and New Technologies in Medicine, University of Pisa, 56126 Pisa, Italy
| | - Mauro Pistello
- Retrovirus Center and Virology Section, Department of Translational Research, University of Pisa, 56100 Pisa, Italy; (M.L.); (M.P.)
| | - Beatrice Macchi
- Department of Chemical Science and Technology, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| |
Collapse
|
9
|
Correa LP, da Costa Farias F, Dos Santos Barile KA, Palmeira MK, de Melo Amaral CE. Human T-lymphotropic virus 2 (HTLV-2) prevalence of blood donors in the state of Pará, Brazil. Braz J Microbiol 2023; 54:1745-1750. [PMID: 37454039 PMCID: PMC10484891 DOI: 10.1007/s42770-023-01067-2] [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: 04/18/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION The present study had the objective to describe the molecular prevalence and epidemiological aspects of the human T-lymphotropic virus 2 (HTLV-2) infection in the blood donor population of the Pará state. METHODS The present study is a descriptive, retrospective, and cross-sectional review of epidemiological, serological, and molecular data on inapt blood donors in the State Center for Hematology and Hemotherapy from January 2015 to December 2021. The data were digitalized to create a database using the Statistical Package for Social Sciences program. The prevalence of HTLV-2 was calculated based on the total number of donations during the study period. Descriptive frequency was used to analyze the qualitative data. RESULTS A total of 665,568 blood donations were made. Out of these, 1884 (0.2%) samples presented serological detection to HTLV and further were evaluated using molecular confirmatory tests. Out of these, 36 samples were positive for HTLV-2 using qPCR Taqman assay based on pol gene region (0.005%). The HTLV-2 was found to be more prevalent in women (63.9%); aged between 39 and 59 years (55.6%); residents of the metropolitan region of Belém (80.6%); with self-declared race as brown (80.6%); individuals who had completed high school (58.6%); and first-time donors (58.3%) CONCLUSION: The present study identified the presence of HTLV-2 (1 HTLV-2 case/20,000 donations; 0.005%) in the specific population of blood donors in Pará state. These findings can contribute to the existing literature on the subject both for specific population groups under study and for understanding the prevalence of HTLV-2 in the general population.
Collapse
Affiliation(s)
- Lucas Pinheiro Correa
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Rua de Óbidos 179, apto. 1001, Belém, PA, 66020-446, Brazil.
| | - Fatyene da Costa Farias
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Rua de Óbidos 179, apto. 1001, Belém, PA, 66020-446, Brazil
| | - Katarine Antonia Dos Santos Barile
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Rua de Óbidos 179, apto. 1001, Belém, PA, 66020-446, Brazil
- Fundação Centro de Hemoterapia e Hematologia do Pará (HEMOPA), Belém, Pará, Brazil
| | - Maurício Koury Palmeira
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Rua de Óbidos 179, apto. 1001, Belém, PA, 66020-446, Brazil
- Fundação Centro de Hemoterapia e Hematologia do Pará (HEMOPA), Belém, Pará, Brazil
| | - Carlos Eduardo de Melo Amaral
- Centro Universitário Metropolitano da Amazônia (UNIFAMAZ), Rua de Óbidos 179, apto. 1001, Belém, PA, 66020-446, Brazil
- Fundação Centro de Hemoterapia e Hematologia do Pará (HEMOPA), Belém, Pará, Brazil
| |
Collapse
|
10
|
Mashkani B, Jalili Nik M, Rezaee SA, Boostani R. Advances in the treatment of human T-cell lymphotropic virus type-I associated myelopathy. Expert Rev Neurother 2023; 23:1233-1248. [PMID: 37933802 DOI: 10.1080/14737175.2023.2272639] [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: 08/21/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Nearly 2-3% of those 10 to 20 million individuals infected with the Human T-cell lymphotropic virus type-1 (HTLV-1); are predisposed to developing HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It is a neuro-inflammatory disease; differentiated from multiple sclerosis based on the presence of typical neurologic symptoms, confirmation of HTLV-1 infection, and other molecular biomarkers. AREAS COVERED A brief review of the epidemiology, host immune responses, and molecular pathogenesis of HAM/TSP is followed by detailed discussions about the host-related risk factors for developing HAM/TSP and success/failure stories of the attempted management strategies. EXPERT OPINION Currently, there is no effective treatment for HAM/TSP. Anti-retroviral therapy, peculiar cytokines (IFN-α), some anti-oxidants, and allograft bone marrow transplantation have been used for treating these patients with limited success. Under current conditions, asymptomatic carriers should be examined periodically by a neurologist for early signs of spinal cord injury. Then it is crucial to determine the progress rate to adapt the best management plan for each patient. Corticosteroid therapy is most beneficial in those with acute myelitis. However, slow-progressing patients are best managed using a combination of symptomatic and physical therapy. Additionally, preventive measures should be taken to decrease further spread of HTLV-1 infection.
Collapse
Affiliation(s)
- Baratali Mashkani
- Department of clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Jalili Nik
- Department of clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Inflammation and Inflammatory Diseases division, Immunology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Boostani
- Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
11
|
Abdelmoumen K, Alsibai KD, Rabier S, Nacher M, Wankpo NB, Gessain A, Santa F, Hermine O, Marçais A, Couppié P, Droz JP, Epelboin L. Adult T-cell leukemia and lymphoma in French Guiana: a retrospective analysis with real-life data from 2009 to 2019. LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100492. [PMID: 37139265 PMCID: PMC10149364 DOI: 10.1016/j.lana.2023.100492] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 02/18/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023]
Abstract
Background Adult T-cell leukemia/lymphoma (ATL), one of the most aggressive cancers in the world, occurs in 5% of the 10 million people living with HTLV-1 worldwide. French Guiana, a French overseas territory in South America, is one of the highest endemic areas of HTLV-1 worldwide. Here, we describe the demographic and clinical characteristics and outcome of ATL in this area. Methods We retrospectively collected data from all patients diagnosed between 2009 and 2019. Patients were distributed according to Shimoyama's classification. Prognostic factors were explored through univariate analysis. Findings Over the 10-year study period, 41 patients with a median age of 54 years at diagnosis were identified, among whom 56% were women. Sixteen (39%) patients were Maroons, a cultural group descendant of the runaway enslaved Africans from former Dutch Guiana. Among the study population, 23 (56%) had an acute type, 14 (34%) a lymphoma type, and one and one chronic and primary cutaneous tumour, respectively. First-lines of treatment included either chemotherapy or Zidovudine combined with pegylated interferon alpha. The 4-year overall survival was 11.4% for the entire population with 0% and 11% for lymphoma and acute forms, respectively. The median progression-free survival was 93 and 115 days for the acute and lymphoma groups (p = 0.37), respectively. Among the twenty-nine patients who died, 8 (28%) died of toxicity, 7 (24%) died of disease progression and the cause of death remained unknown in 14 (48%) patients. Due to the overall poor prognosis, no significant prognostic factors could be identified. Interpretation This study provides real-life data from ATL patients in French Guiana, a remote territory in a middle-income region. Patients, mostly Maroons, presented with a younger age and the prognosis was worse than expected compared to Japanese patients. Funding None.
Collapse
Affiliation(s)
- Karim Abdelmoumen
- Department of Internal Medicine, University of la Réunion, Reunion Island, France
- Department of Dermatology, Cayenne Hospital, French Guiana, France
- Corresponding author. Université de La Réunion, département de médecine interne, Site du Tampon-Campus Sud, 117 Rue du Général Ailleret, 97430 Le Tampon, La Réunion; Unité des Maladies infectieuses et tropicales, CH de Cayenne Andrée Rosemon, 97300, French Guiana, France.
| | | | | | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles Guyane – CIC Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, and French Guiana University, French Guiana, France
| | - N'detodji-Bill Wankpo
- Oncology Program, Centre Hospitalier de l’Ouest-Guyane, Saint-Laurent du Maroni, French Guiana, France
| | - Antoine Gessain
- Epidemiology and Physiopathology of Oncogenic Viruses, Pasteur Institute, Paris, France
| | - Florin Santa
- Department of Oncology, Cayenne Hospital, French Guiana, France
| | - Olivier Hermine
- Department of Hematology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, INSERM UMR 1163 et CNRS ERL 8254, Institut Imagine, Université Paris Cité, Paris, France
| | - Ambroise Marçais
- Department of Hematology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, INSERM UMR 1151 and CNRS, Institut Necker, Université Paris Cité, Paris, France
| | - Pierre Couppié
- Department of Dermatology, Cayenne Hospital, French Guiana, France
| | - Jean-Pierre Droz
- Department of Medical Oncology, Centre Léon-Bérard, Lyon, France
- Claude-Bernard Lyon University, Lyon, France
| | - Loïc Epelboin
- Corevih Guyane, Cayenne Hospital, French Guiana, France
- Infectious and Tropical Diseases Unit, Cayenne Hospital and French Guiana University, French Guiana, France
| |
Collapse
|
12
|
Itabashi K, Miyazawa T, Uchimaru K. How Can We Prevent Mother-to-Child Transmission of HTLV-1? Int J Mol Sci 2023; 24:ijms24086961. [PMID: 37108125 PMCID: PMC10138424 DOI: 10.3390/ijms24086961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
The perception of human T-cell leukemia virus type 1 (HTlV-1) infection as a "silent disease" has recently given way to concern that its presence may be having a variety of effects. HTLV-1 is known to cause adult T-cell leukemia (ATL), an aggressive cancer of peripheral CD4 T cells; however, it is also responsible for HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Most patients develop ATL as a result of HTLV-1 mother-to-child transmission. The primary route of mother-to-child transmission is through the mother's milk. In the absence of effective drug therapy, total artificial nutrition such as exclusive formula feeding is a reliable means of preventing mother-to-child transmission after birth, except for a small percentage of prenatal infections. A recent study found that the rate of mother-to-child transmission with short-term breastfeeding (within 90 days) did not exceed that of total artificial nutrition. Because these preventive measures are in exchange for the benefits of breastfeeding, clinical applications of antiretroviral drugs and immunotherapy with vaccines and neutralizing antibodies are urgently needed.
Collapse
Affiliation(s)
- Kazuo Itabashi
- Aiseikai-Memorial Ibaraki Welfare and Medical Center, Ibaraki 3100836, Japan
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, Tokyo 1428666, Japan
| | - Kaoru Uchimaru
- Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo 1088639, Japan
- Laboratory of Tumor Cell Biology, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo 1088639, Japan
| |
Collapse
|
13
|
Diakite M, Shaw-Saliba K, Lau CY. Malignancy and viral infections in Sub-Saharan Africa: A review. FRONTIERS IN VIROLOGY (LAUSANNE, SWITZERLAND) 2023; 3:1103737. [PMID: 37476029 PMCID: PMC10358275 DOI: 10.3389/fviro.2023.1103737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The burden of malignancy related to viral infection is increasing in Sub-Saharan Africa (SSA). In 2018, approximately 2 million new cancer cases worldwide were attributable to infection. Prevention or treatment of these infections could reduce cancer cases by 23% in less developed regions and about 7% in developed regions. Contemporaneous increases in longevity and changes in lifestyle have contributed to the cancer burden in SSA. African hospitals are reporting more cases of cancer related to infection (e.g., cervical cancer in women and stomach and liver cancer in men). SSA populations also have elevated underlying prevalence of viral infections compared to other regions. Of 10 infectious agents identified as carcinogenic by the International Agency for Research on Cancer, six are viruses: hepatitis B and C viruses (HBV and HCV, respectively), Epstein-Barr virus (EBV), high-risk types of human papillomavirus (HPV), Human T-cell lymphotropic virus type 1 (HTLV-1), and Kaposi's sarcoma herpesvirus (KSHV, also known as human herpesvirus type 8, HHV-8). Human immunodeficiency virus type 1 (HIV) also facilitates oncogenesis. EBV is associated with lymphomas and nasopharyngeal carcinoma; HBV and HCV are associated with hepatocellular carcinoma; KSHV causes Kaposi's sarcoma; HTLV-1 causes T-cell leukemia and lymphoma; HPV causes carcinoma of the oropharynx and anogenital squamous cell cancer. HIV-1, for which SSA has the greatest global burden, has been linked to increasing risk of malignancy through immunologic dysregulation and clonal hematopoiesis. Public health approaches to prevent infection, such as vaccination, safer injection techniques, screening of blood products, antimicrobial treatments and safer sexual practices could reduce the burden of cancer in Africa. In SSA, inequalities in access to cancer screening and treatment are exacerbated by the perception of cancer as taboo. National level cancer registries, new screening strategies for detection of viral infection and public health messaging should be prioritized in SSA's battle against malignancy. In this review, we discuss the impact of carcinogenic viruses in SSA with a focus on regional epidemiology.
Collapse
Affiliation(s)
- Mahamadou Diakite
- University Clinical Research Center, University of Sciences, Techniques, and Technologies, Bamako, Mali
| | - Kathryn Shaw-Saliba
- Collaborative Clinical Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, United States
| | - Chuen-Yen Lau
- HIV Dynamics and Replication Program, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD, United States
| |
Collapse
|
14
|
Owatari S, Tokunaga M, Nakamura D, Uozumi K, Sagara Y, Nakamura H, Haraguchi K, Nakano N, Yoshimitsu M, Ito Y, Utsunomiya A, Otsuka M, Hanada S, Iwanaga M, Ishitsuka K. A decrease in newly diagnosed patients with adult T-cell leukemia/lymphoma in Kagoshima, a highly endemic area of HTLV-1 in southwestern Japan. Leuk Lymphoma 2023; 64:865-873. [PMID: 36772789 DOI: 10.1080/10428194.2023.2173524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell leukemia virus type-I (HTLV-1). This study investigated whether the number of newly diagnosed patients with ATL is decreasing in the background of a declining number of individuals infected by HTLV-1 in Kagoshima, Japan, one of the most endemic areas of HTLV-1 in the world. We retrospectively analyzed the number of newly diagnosed patients with ATL between January 2001 and December 2021 in three major hospitals. The number of newly diagnosed patients with B-cell non-Hodgkin lymphoma (B-NHL) in the same period was examined as an internal control. One thousand eighteen and 2,029 patients with ATL and B-NHL were registered, respectively. The age-adjusted incidence of ATL steadily increased between 2001 and 2012, whereas that between 2013 and 2021 decreased. Despite the limitation of its retrospective nature, this is the first report indicating a decrease in ATL patients in Japan.
Collapse
Affiliation(s)
- Satsuki Owatari
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Masahito Tokunaga
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Daisuke Nakamura
- Department of Hematology and Rheumatology, Kagoshima University, Kagoshima, Japan
| | - Kimiharu Uozumi
- Department of Medical Oncology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Yasuko Sagara
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Fukuoka, Japan
| | - Hitomi Nakamura
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Fukuoka, Japan
| | - Koichi Haraguchi
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Nobuaki Nakano
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology, Kagoshima University, Kagoshima, Japan
| | - Yoshikiyo Ito
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Atae Utsunomiya
- Department of Hematology, Imamura General Hospital, Kagoshima, Japan
| | - Maki Otsuka
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Shuichi Hanada
- Department of Hematology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Masako Iwanaga
- Department of Medical Technology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kenji Ishitsuka
- Department of Hematology and Rheumatology, Kagoshima University, Kagoshima, Japan
| |
Collapse
|
15
|
Martin F, Gilks CF, Gibb R, Jenkins A, Protani M, Francis F, Redmond AM, Neilsen G, Mudge D, Wolley M, Binotto E, Norton R, Nimmo GR, Heney C. Human T-cell leukaemia virus type 1 and Adult T-cell leukaemia/lymphoma in Queensland, Australia: a retrospective cross-sectional study. Sex Transm Infect 2023; 99:50-52. [PMID: 35523573 PMCID: PMC9887394 DOI: 10.1136/sextrans-2021-055241] [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: 09/10/2021] [Accepted: 04/01/2022] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Human T-cell leukaemia virus type 1 (HTLV-1), an STI, is reported to be highly prevalent in Indigenous communities in Central Australia. HTLV-1 is an incurable, chronic infection which can cause Adult T-cell leukaemia/lymphoma (ATL). ATL is associated with high morbidity and mortality, with limited treatment options. We studied the prevalence of HTLV-1 and ATL in the state of Queensland, Australia. METHODS Serum samples stored at healthcare services in Brisbane, Townsville and Cairns and at haemodialysis units in Brisbane (2018-2019) were screened for HTLV-1/2 antibodies using the Abbott ARCHITECT chemiluminescent microparticle immunoassay (CMIA) for antibodies against gp46-I, gp46-II and GD21 (Abbott CMIA, ARCHITECT). Reactive samples were confirmed through Western blot. Pooled Australian National Cancer Registry surveillance data reporting on cases coded for ATL (2004-2015) were analysed. RESULTS Two out of 2000 hospital and health services samples were confirmed HTLV-1-positive (0.1%, 95% CI 0.02% to 0.4%), both in older women, one Indigenous and one non-Indigenous. All 540 haemodialysis samples tested negative for HTLV. All samples were HTLV-2-negative. Ten out of 42 (24.8%) reported cases of ATL in Australia were from Queensland (crude incidence rate 0.025/100 000; 95% CI 0.011 to 0.045); most cases were seen in adult men of non-Indigenous origin. Nineteen deaths due to ATL were recorded in Australia. CONCLUSION We confirm that HTLV-1 and ATL were detected in Queensland in Indigenous and non-Indigenous people. These results highlight the need for HTLV-1 prevalence studies in populations at risk of STIs to allow the implementation of focused public health sexual and mother-to-child transmission prevention strategies.
Collapse
Affiliation(s)
- Fabiola Martin
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Charles F Gilks
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Robert Gibb
- Department of Microbiology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
| | - Alana Jenkins
- Department of Microbiology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
| | - Melinda Protani
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Fleur Francis
- Pathology Queensland, Townsville University Hospital, Queensland Health, Townsville, Queensland, Australia
| | - Andrew M Redmond
- Department of Infectious Diseases Unit, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia
| | - Graham Neilsen
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - David Mudge
- Department of Nephrology, Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland Health, The University of Queensland Faculty of Medicine, Brisbane, Queensland, Australia
| | - Martin Wolley
- Kidney Health Service, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland, Australia
| | - Enzo Binotto
- Pathology Queensland, Cairns Hospital, Queensland Health, Cairns, Queensland, Australia
| | - Robert Norton
- Pathology Queensland, Townsville University Hospital, Queensland Health, Townsville, Queensland, Australia
| | - Graeme R Nimmo
- Department of Microbiology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
| | - Claire Heney
- Department of Microbiology, Pathology Queensland, Queensland Health, Brisbane, Queensland, Australia
| |
Collapse
|
16
|
Gessain A, Ramassamy JL, Afonso PV, Cassar O. Geographic distribution, clinical epidemiology and genetic diversity of the human oncogenic retrovirus HTLV-1 in Africa, the world's largest endemic area. Front Immunol 2023; 14:1043600. [PMID: 36817417 PMCID: PMC9935834 DOI: 10.3389/fimmu.2023.1043600] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/04/2023] [Indexed: 02/05/2023] Open
Abstract
The African continent is considered the largest high endemic area for the oncogenic retrovirus HTLV-1 with an estimated two to five million infected individuals. However, data on epidemiological aspects, in particular prevalence, risk factors and geographical distribution, are still very limited for many regions: on the one hand, few large-scale and representative studies have been performed and, on the other hand, many studies do not include confirmatory tests, resulting in indeterminate serological results, and a likely overestimation of HTLV-1 seroprevalence. For this review, we included the most robust studies published since 1984 on the prevalence of HTLV-1 and the two major diseases associated with this infection in people living in Africa and the Indian Ocean islands: adult T-cell leukemia (ATL) and tropical spastic paraparesis or HTLV-1-associated myelopathy (HAM/TSP). We also considered most of the book chapters and abstracts published at the 20 international conferences on HTLV and related viruses held since 1985, as well as the results of recent meta-analyses regarding the status of HTLV-1 in West and sub-Saharan Africa. Based on this bibliography, it appears that HTLV-1 distribution is very heterogeneous in Africa: The highest prevalences of HTLV-1 are reported in western, central and southern Africa, while eastern and northern Africa show lower prevalences. In highly endemic areas, the HTLV-1 prevalence in the adult population ranges from 0.3 to 3%, increases with age, and is highest among women. In rural areas of Gabon and the Democratic Republic of the Congo (DRC), HTLV-1 prevalence can reach up to 10-25% in elder women. HTLV-1-associated diseases in African patients have rarely been reported in situ on hospital wards, by local physicians. With the exception of the Republic of South Africa, DRC and Senegal, most reports on ATL and HAM/TSP in African patients have been published by European and American clinicians and involve immigrants or medical returnees to Europe (France and the UK) and the United States. There is clearly a huge underreporting of these diseases on the African continent. The genetic diversity of HTLV-1 is greatest in Africa, where six distinct genotypes (a, b, d, e, f, g) have been identified. The most frequent genotype in central Africa is genotype b. The other genotypes found in central Africa (d, e, f and g) are very rare. The vast majority of HTLV-1 strains from West and North Africa belong to genotype a, the so-called 'Cosmopolitan' genotype. These strains form five clades roughly reflecting the geographic origin of the infected individuals. We have recently shown that some of these clades are the result of recombination between a-WA and a-NA strains. Almost all sequences from southern Africa belong to Transcontinental a-genotype subgroup.
Collapse
Affiliation(s)
- Antoine Gessain
- Institut Pasteur, Université Paris Cité, CNRS UMR 3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Paris, France
| | - Jill-Léa Ramassamy
- Institut Pasteur, Université Paris Cité, CNRS UMR 3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Paris, France
| | - Philippe V Afonso
- Institut Pasteur, Université Paris Cité, CNRS UMR 3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Paris, France
| | - Olivier Cassar
- Institut Pasteur, Université Paris Cité, CNRS UMR 3569, Unité d'Épidémiologie et Physiopathologie des Virus Oncogènes, Paris, France
| |
Collapse
|
17
|
Chishiki M, Nishiyama K, Suzutani T, Hiruta S, Ichikawa H, Haneda K, Maeda H, Shimizu H, Kanai Y, Ogasawara K, Go H, Sato M, Momoi N, Nollet KE, Ohto H, Hosoya M. Sterilization efficacy of a new water-free breast milk pasteurizer. Pediatr Int 2023; 65:e15574. [PMID: 37428826 DOI: 10.1111/ped.15574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/22/2023] [Accepted: 05/05/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Breast milk, nature's optimum source of nutrition for infants, can contain undesirable microorganisms that cause severe morbidity. After an outbreak of multidrug-resistant Escherichia coli among neonates receiving breast milk donated by another mother in our neonatal intensive care unit (NICU), we were motivated to develop a high-grade breast milk pasteurizer (BMP) designed to thaw and pasteurize breast milk at 63°C for 30 min in a sealed bag without having to open the bag or immerse it in water. METHODS Pre-existing bacteria and spiked cytomegalovirus (CMV) were measured pre- and post-pasteurization in frozen breast milk donated by mothers of children admitted to the NICU. RESULTS Among 48 breast milk samples (mean ± standard deviation [SD]), pre-existing bacterial counts of 5.1±1.1 × 104 colony forming units (cfu)/mL decreased to less than 10 cfu/mL (below detection level) in 45 samples after pasteurization for 30 min. In three samples, 10-110 cfu/mL persisted. As no CMV was detected in any of the 48 samples, CMV at ≥5 × 104 pfu/mL was spiked into 11 breast milk samples. After just 10 min of pasteurization, infectious CMV was not detected (threshold <50 pfu/mL) in any sample. CONCLUSION A new BMP was shown to pasteurize milk effectively with more than a 3-log reduction of microorganisms. Compared to conventional pasteurizers, this device reduces the effort involved in pasteurizing breast milk, avoids various contamination risks, and may reduce the risk of infectious disease transmission via breast milk.
Collapse
Affiliation(s)
- Mina Chishiki
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kyoko Nishiyama
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tatsuo Suzutani
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shun Hiruta
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hirotaka Ichikawa
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kentaro Haneda
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hajime Maeda
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiromi Shimizu
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuji Kanai
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kei Ogasawara
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hayato Go
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Maki Sato
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| |
Collapse
|
18
|
Nakano K, Watanabe T. Tuning Rex rules HTLV-1 pathogenesis. Front Immunol 2022; 13:959962. [PMID: 36189216 PMCID: PMC9523361 DOI: 10.3389/fimmu.2022.959962] [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: 06/02/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
HTLV-1 is an oncovirus causing ATL and other inflammatory diseases such as HAM/TSP and HU in about 5% of infected individuals. It is also known that HTLV-1-infected cells maintain a disease-free, immortalized, latent state throughout the lifetimes of about 95% of infected individuals. We believe that the stable maintenance of disease-free infected cells in the carrier is an intrinsic characteristic of HTLV-1 that has been acquired during its evolution in the human life cycle. We speculate that the pathogenesis of the virus is ruled by the orchestrated functions of viral proteins. In particular, the regulation of Rex, the conductor of viral replication rate, is expected to be closely related to the viral program in the early active viral replication followed by the stable latency in HTLV-1 infected T cells. HTLV-1 and HIV-1 belong to the family Retroviridae and share the same tropism, e.g., human CD4+ T cells. These viruses show significant similarities in the viral genomic structure and the molecular mechanism of the replication cycle. However, HTLV-1 and HIV-1 infected T cells show different phenotypes, especially in the level of virion production. We speculate that how the activity of HTLV-1 Rex and its counterpart HIV-1 Rev are regulated may be closely related to the properties of respective infected T cells. In this review, we compare various pathological aspects of HTLV-1 and HIV-1. In particular, we investigated the presence or absence of a virally encoded "regulatory valve" for HTLV-1 Rex or HIV-1 Rev to explore its importance in the regulation of viral particle production in infected T cells. Finally, wereaffirm Rex as the key conductor for viral replication and viral pathogenesis based on our recent study on the novel functional aspects of Rex. Since the activity of Rex is closely related to the viral replication rate, we hypothesize that the "regulatory valve" on the Rex activity may have been selectively evolved to achieve the "scenario" with early viral particle production and the subsequent long, stable deep latency in HTLV-1 infected cells.
Collapse
Affiliation(s)
- Kazumi Nakano
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Toshiki Watanabe
- Department of Practical Management of Medical Information, Graduate School of Medicine, St. Marianna University, Kawasaki, Japan
| |
Collapse
|
19
|
Barr RS, Drysdale SB, Boullier M, Lyall H, Cook L, Collins GP, Kelly DF, Phelan L, Taylor GP. A Review of the Prevention of Mother-to-Child Transmission of Human T-Cell Lymphotrophic Virus Type 1 (HTLV-1) With a Proposed Management Algorithm. Front Med (Lausanne) 2022; 9:941647. [PMID: 35872787 PMCID: PMC9304803 DOI: 10.3389/fmed.2022.941647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/10/2022] [Indexed: 01/06/2023] Open
Abstract
Human T cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that is endemic in a number of regions across the world. There are an estimated 5–10 million people infected worldwide. Japan is currently the only country with a national antenatal screening programme in place. HTLV-1 is primarily transmitted sexually in adulthood, however it can be transmitted from mother-to-child perinatally. This can occur transplacentally, during the birth process or via breastmilk. If HTLV-1 is transmitted perinatally then the lifetime risk of adult T cell leukemia/lymphoma rises from 5 to 20%, therefore prevention of mother-to-child transmission of HTLV-1 is a public health priority. There are reliable immunological and molecular tests available for HTLV-1 diagnosis during pregnancy and screening should be considered on a country by country basis. Further research on best management is needed particularly for pregnancies in women with high HTLV-1 viral load. A first step would be to establish an international registry of cases and to monitor outcomes for neonates and mothers. We have summarized key risk factors for mother-to-child transmission of HTLV-1 and subsequently propose a pragmatic guideline for management of mothers and infants in pregnancy and the perinatal period to reduce the risk of transmission. This is clinically relevant in order to reduce mother-to-child transmission of HTLV-1 and it's complications.
Collapse
Affiliation(s)
- Rachael S. Barr
- Department of Paediatrics, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- *Correspondence: Rachael S. Barr
| | - Simon B. Drysdale
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, United Kingdom
- Oxford Vaccine Group and NIHR Oxford Biomedical Research Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Mary Boullier
- Paediatric Infectious Diseases Research Group, Institute of Infection and Immunity, St. George's, University of London, London, United Kingdom
| | - Hermione Lyall
- Department of Paediatric Infectious Diseases, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Lucy Cook
- National Centre for Human Retrovirology, Imperial College Healthcare NHS Trust, London, United Kingdom
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| | - Graham P. Collins
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Dominic F. Kelly
- Oxford Vaccine Group and NIHR Oxford Biomedical Research Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
- Level 2, Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Lorna Phelan
- Department of Obstetrics and Gynaecology, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Graham P. Taylor
- Section of Virology, Department of Infectious Disease, Imperial College London, London, United Kingdom
| |
Collapse
|
20
|
Updates on the Epidemiology of the Human T-Cell Leukemia Virus Type 1 Infection in the Countries of the Eastern Mediterranean Regional Office of the World Health Organization with Special Emphasis on the Situation in Iran. Viruses 2022; 14:v14040664. [PMID: 35458394 PMCID: PMC9029775 DOI: 10.3390/v14040664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/12/2022] [Accepted: 03/21/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The epidemiology and prevalence of the Human T-cell leukemia virus type-1 (HTLV-1) infection represent a recommended priority by global health agencies. An in-depth revision to update the status of this infection in countries including those of the Eastern Mediterranean Regional Office (EMRO) of the World Health Organization is hence required. Methods: Ninety-seven studies evaluating the HTLV-1 infection in low- and high-risk populations in EMRO countries were retrieved from the international electronic databases and were used to assess the epidemiological status of the infection in these countries. Results: Most epidemiologic reports were published from Iran, with more than 50% of Iranian prisoners and around 4% of healthy individuals reported to have the infection. In Egypt, a considerable prevalence of the virus spans around 1.11% of blood donors. Foci of HTLV-1 infection are also present in some countries and require a careful epidemiological evaluation. In the other EMRO countries, a lower prevalence that does not exceed 1% was reported. Conclusion: The epidemiology and prevalence of HTLV-1 in the EMRO countries require a tight revision and update. Published studies reveal a scarce distribution of the virus in the African countries of EMRO, while a lower prevalence is denoted in the Asian countries of EMRO, except in Iran, where the prevalence is high.
Collapse
|
21
|
Millen S, Thoma-Kress AK. Milk Transmission of HTLV-1 and the Need for Innovative Prevention Strategies. Front Med (Lausanne) 2022; 9:867147. [PMID: 35360738 PMCID: PMC8962517 DOI: 10.3389/fmed.2022.867147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Breastfeeding is recommended by the World Health Organization for at least 6 months up to 2 years of age, and breast milk protects against several diseases and infections. Intriguingly, few viruses are transmitted via breastfeeding including Human T-cell leukemia virus Type 1 (HTLV-1). HTLV-1 is a highly oncogenic yet neglected retrovirus, which primarily infects CD4+ T-cells in vivo and causes incurable diseases like HTLV-1-associated inflammatory conditions or Adult T-cell leukemia/lymphoma (ATLL) after lifelong viral persistence. Worldwide, at least 5–10 million people are HTLV-1-infected and most of them are unaware of their infection posing the risk of silent transmissions. HTLV-1 is transmitted via cell-containing body fluids such as blood products, semen, and breast milk, which constitutes the major route of mother-to-child transmission (MTCT). Risk of transmission increases with the duration of breastfeeding, however, abstinence from breastfeeding as it is recommended in some endemic countries is not an option in resource-limited settings or underrepresented areas and populations. Despite significant progress in understanding details of HTLV-1 cell-to-cell transmission, it is still not fully understood, which cells in which organs get infected via the oral route, how these cells get infected, how breast milk affects this route of infection and how to inhibit oral transmission despite breastfeeding, which is an urgent need especially in underrepresented areas of the world. Here, we review these questions and provide an outlook how future research could help to uncover prevention strategies that might ultimately allow infants to benefit from breastfeeding while reducing the risk of HTLV-1 transmission.
Collapse
|
22
|
James IC, Mejía-Mertel J, Gil Artunduaga MA, Rojas-Hernández JP. Case Series: Pediatric Human T-Lymphotropic Virus Type 1 and Its Clinical Expression. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.824067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PurposeHuman T-lymphotropic Virus type 1 (HTLV-1) was the first retrovirus to be identified and associated with oncogenic activity. It is estimated that approximately 10–20 million people in the world are infected with it. The clinical manifestations most commonly associated with HTLV-1 infection include T-cell leukemia/lymphoma and myelopathy associated to HTLV-1 infection. The purpose of this study is to describe clinical and demographic characteristics in pediatric patients with HTLV-1 infection.Methodology and PatientsAmbispective case series analysis, with collection of medical records and subsequent description of demographic data (sex, origin, age) and clinical characteristics in 16 patients with HTLV-1 infection were collected. Twelve of these patients were part of an initially reported cohort and four were recruited later in the study. The patients were collected between January 2017 and July 2021 in a pediatric institution in Cali, in a reference hospital in the southwest region of Colombia.ResultsThirteen of a total of sixteen patients came from the Colombian Pacific coast, where nine were with significant nutritional deficiencies. Seven showed dermatological compromise. Eight patients presented images compatible with inflammation and chronic lung injury, and six of the eight patients were with opportunistic infections. Coinfection with other microorganisms was also observed where one case presented with meningeal tuberculosis, another patient presented with simultaneous infections, namely, malaria, leptospirosis and toxoplasmosis, and a third patient presented intestinal parasitosis and soft tissue infection by Streptococcus pyogenes. Three patients had concomitant autoimmune diseases and a fourth patient was highly suspicious of having polymyositis.ConclusionsThe different clinical findings with simultaneous HTLV-1 infection broaden the panorama to suspect infection by this virus. More studies are required to achieve a direct association between structural lung disease, autoimmune diseases, immunodeficiency and HTLV-1 infection. This study aims to raise interest and awareness of an ancient but neglected disease.
Collapse
|
23
|
BoLA-DRB3 Polymorphism Controls Proviral Load and Infectivity of Bovine Leukemia Virus (BLV) in Milk. Pathogens 2022; 11:pathogens11020210. [PMID: 35215153 PMCID: PMC8879029 DOI: 10.3390/pathogens11020210] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022] Open
Abstract
Bovine leukemia virus (BLV), which causes enzootic bovine leukosis, is transmitted to calves through the milk of BLV-infected dams. Bovine leukocyte antigen (BoLA)-DRB3 is a polymorphic gene associated with BLV infectivity and proviral load (PVL). However, the effect of BoLA-DRB3 polymorphism on the infectivity and PVL of milk from BLV-infected dams remains unknown. This study examined milk from 259 BLV-infected dams, including susceptible dams carrying at least one BoLA-DRB3*012:01 or *015:01 allele with high PVL, resistant dams carrying at least one BoLA-DRB3*002:01, *009:02, or *014:01:01 allele with low PVL, and neutral dams carrying other alleles. The detection rate of BLV provirus and PVL were significantly higher in milk from susceptible dams than in that from resistant dams. This result was confirmed in a three-year follow-up study in which milk from susceptible dams showed a higher BLV provirus detection rate over a longer period than that from resistant dams. The visualization of infectivity of milk cells using a luminescence syncytium induction assay showed that the infectious risk of milk from BLV-infected dams was markedly high for susceptible dams compared to resistant ones. This is the first report confirming that BoLA-DRB3 polymorphism affects the PVL and infectivity of milk from BLV-infected dams.
Collapse
|
24
|
Itabashi K, Miyazawa T. Mother-to-Child Transmission of Human T-Cell Leukemia Virus Type 1: Mechanisms and Nutritional Strategies for Prevention. Cancers (Basel) 2021; 13:cancers13164100. [PMID: 34439253 PMCID: PMC8394315 DOI: 10.3390/cancers13164100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/29/2021] [Accepted: 08/13/2021] [Indexed: 12/17/2022] Open
Abstract
Approximately 95% of mother-to-child transmission (MTCT) of human T-cell leukemia virus type-1 (HTLV-1) is derived from prolonged breastfeeding, which is a major cause of adult T-cell leukemia (ATL). Exclusive formula feeding (ExFF) is therefore generally used to prevent MTCT. A recent cohort study revealed that 55% of pregnant carriers chose short-term breastfeeding for ≤3 months in Japan. Our meta-analysis showed that there was no significant increase in the risk of MTCT when breastfeeding was carried out for ≤3 months compared with ExFF (pooled relative risk (RR), 0.72; 95% confidence interval (CI), 0.30-1.77), but there was an almost threefold increase in risk when breastfeeding was carried out for up to 6 months (pooled RR, 2.91; 95% CI, 1.69-5.03). Thus, short-term breastfeeding for ≤3 months may be useful in preventing MTCT. Breastmilk is the best nutritional source for infants, and any approach to minimizing MTCT by avoiding or limiting breastfeeding must be balanced against the impact on the child's health and mother-child bonding. To minimize the need for nutritional interventions, it is necessary to identify factors that predispose children born to carrier mothers to MTCT and thereby predict MTCT development with a high degree of accuracy.
Collapse
Affiliation(s)
- Kazuo Itabashi
- Aiseikai Memorial Ibaraki Welfare Medical Center, 1872-1 Motoyoshida-cho, Mito-City 310-0836, Japan
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
- Correspondence: ; Tel.: +81-29-353-7171; Fax: +81-29-353-6112
| | - Tokuo Miyazawa
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;
| |
Collapse
|
25
|
Natural Infection of Dairy Cows with Bovine Leukemia Virus Affects Immunoglobulin Levels in Saliva and Serum but Not Milk. Pathogens 2021; 10:pathogens10070907. [PMID: 34358057 PMCID: PMC8308649 DOI: 10.3390/pathogens10070907] [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: 06/08/2021] [Revised: 07/11/2021] [Accepted: 07/15/2021] [Indexed: 11/26/2022] Open
Abstract
Bovine leukemia virus (BLV) is a retroviral infection that disrupts the immune function of infected animals. It is widespread among U.S. dairy cattle. In this pilot study, the average total IgA and IgM concentrations in milk, saliva, and serum samples from BLV ELISA-positive (ELISA+) dairy cows were compared against samples from BLV ELISA-negative (ELISA−) cows using the Kruskal–Wallis test (with ties). The results from ELISA+ cows were also stratified by lymphocyte count (LC) and proviral load (PVL). In milk and saliva from ELISA+ cows, the average total IgA and IgM concentrations were decreased compared to ELISA− cows, although this was only statistically significant for saliva IgM in cows with low PVL (p = 0.0424). Numerically, the average total IgA concentrations were 33.6% lower in milk and 23.7% lower in saliva, and the average total IgM concentrations were 42.4% lower in milk and 15.5% lower in saliva. No significant differences were observed in the total serum IgA concentrations, regardless of PVL and LC. The total serum IgM from ELISA+ cows was significantly decreased (p = 0.0223), with the largest decreases occurring in the highest PVL and LC subgroups. This pilot study is a first step in investigating the impact of BLV on mucosal immunity and will require further exploration in each of the various stages of disease progression.
Collapse
|
26
|
Desgraupes S, Hubert M, Gessain A, Ceccaldi PE, Vidy A. Mother-to-Child Transmission of Arboviruses during Breastfeeding: From Epidemiology to Cellular Mechanisms. Viruses 2021; 13:1312. [PMID: 34372518 PMCID: PMC8310101 DOI: 10.3390/v13071312] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 12/20/2022] Open
Abstract
Most viruses use several entry sites and modes of transmission to infect their host (parenteral, sexual, respiratory, oro-fecal, transplacental, transcutaneous, etc.). Some of them are known to be essentially transmitted via arthropod bites (mosquitoes, ticks, phlebotomes, sandflies, etc.), and are thus named arthropod-borne viruses, or arboviruses. During the last decades, several arboviruses have emerged or re-emerged in different countries in the form of notable outbreaks, resulting in a growing interest from scientific and medical communities as well as an increase in epidemiological studies. These studies have highlighted the existence of other modes of transmission. Among them, mother-to-child transmission (MTCT) during breastfeeding was highlighted for the vaccine strain of yellow fever virus (YFV) and Zika virus (ZIKV), and suggested for other arboviruses such as Chikungunya virus (CHIKV), dengue virus (DENV), and West Nile virus (WNV). In this review, we summarize all epidemiological and clinical clues that suggest the existence of breastfeeding as a neglected route for MTCT of arboviruses and we decipher some of the mechanisms that chronologically occur during MTCT via breastfeeding by focusing on ZIKV transmission process.
Collapse
Affiliation(s)
- Sophie Desgraupes
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Mathieu Hubert
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Antoine Gessain
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Pierre-Emmanuel Ceccaldi
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| | - Aurore Vidy
- Unité Épidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, 75015 Paris, France; (M.H.); (A.G.); (P.-E.C.)
- Université de Paris, 75013 Paris, France
- UMR Centre National de la Recherche Scientifique 3569, Institut Pasteur, 75015 Paris, France
| |
Collapse
|
27
|
Van de Perre P, Molès J, Nagot N, Tuaillon E, Ceccaldi P, Goga A, Prendergast AJ, Rollins N. Revisiting Koch's postulate to determine the plausibility of viral transmission by human milk. Pediatr Allergy Immunol 2021; 32:835-842. [PMID: 33594740 PMCID: PMC8359252 DOI: 10.1111/pai.13473] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 12/18/2022]
Abstract
As breastfeeding is of utmost importance for child development and survival, identifying whether breast milk is a route of transmission for human viruses is critical. Based on the principle of Koch's postulate, we propose an analytical framework to determine the plausibility of viral transmission by breast milk. This framework is based on five criteria: viral infection in children receiving breast milk from infected mothers; the presence of virus, viral antigen, or viral genome in the breast milk of infected mothers; the evidence for the virus in breast milk being infectious; the attempts to rule out other transmission modalities; and the reproduction of viral transmission by oral inoculation in an animal model. We searched for evidence in published reports to determine whether the 5 criteria are fulfilled for 16 human viruses that are suspected to be transmissible by breast milk. We considered breast milk transmission is proven if all 5 criteria are fulfilled, as probable if 4 of the 5 criteria are met, as possible if 3 of the 5 criteria are fulfilled, and as unlikely if less than 3 criteria are met. Only five viruses have proven transmission through breast milk: human T-cell lymphotropic virus 1, human immunodeficiency virus, human cytomegalovirus, dengue virus, and Zika virus. The other 11 viruses fulfilled some but not all criteria and were categorized accordingly. Our framework analysis is useful for guiding public health recommendations and for identifying knowledge gaps amenable to original experiments.
Collapse
Affiliation(s)
- Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Jean‐Pierre Molès
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging InfectionsUniversity of MontpellierINSERMEtablissement Français du SangAntilles UniversityMontpellierFrance
- CHU MontpellierMontpellierFrance
| | - Pierre‐Emmanuel Ceccaldi
- Unité Epidémiologie et Physiopathologie des Virus OncogènesCNRS UMR 3569Institut PasteurUniversité de ParisParisFrance
| | - Ameena Goga
- HIV Prevention Research UnitSouth African Medical Research CouncilCape TownSouth Africa
- Department of Paediatrics and Child HealthUniversity of PretoriaPretoriaSouth Africa
| | - Andrew J. Prendergast
- Blizard InstituteQueen Mary University of LondonUK
- Zvitambo Institute for Maternal and Child Health ResearchHarareZimbabwe
| | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
| |
Collapse
|
28
|
Suzuki S, Hoshi SI, Sekizawa A, Sagara Y, Kinoshita K, Kitamura T. Recent Prevalence of Human T-cell Leukemia Virus Type 1 Carrier Associated with Horizontal Transmission in Pregnant Japanese Women. Jpn J Infect Dis 2021; 74:576-578. [PMID: 33952772 DOI: 10.7883/yoken.jjid.2021.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study was conducted to examine the number of human T-cell leukemia virus type 1 (HTLV-1) carrier and how horizontal transmission affects the prevalence of HTLV-1 carrier in pregnant Japanese women in 2019. We requested 2,214 obstetrical facilities to provide information of HTLV-1 tests in pregnant women who delivered in 2019. The estimated number of HTLV-1 carrier in pregnant Japanese women was 952. At least 10% or more of the HTLV-1 carriers were those due to horizontal transmission.
Collapse
Affiliation(s)
- Shunji Suzuki
- Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Japan.,Japan Association of Obstetricians and Gynecologists, Japan
| | | | | | - Yoko Sagara
- Japan Association of Obstetricians and Gynecologists, Japan
| | | | | |
Collapse
|
29
|
Gordon CA, Shield JM, Bradbury RS, Muhi S, Page W, Judd JA, Lee R, Biggs BA, Ross K, Kurscheid J, Gray DJ, McManus DP. HTLV-I and Strongyloides in Australia: The worm lurking beneath. ADVANCES IN PARASITOLOGY 2021; 111:119-201. [PMID: 33482974 DOI: 10.1016/bs.apar.2020.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Strongyloidiasis and HTLV-I (human T-lymphotropic virus-1) are important infections that are endemic in many countries around the world with an estimated 370 million infected with Strongyloides stercoralis alone, and 5-10 million with HTVL-I. Co-infections with these pathogens are associated with significant morbidity and can be fatal. HTLV-I infects T-cells thus causing dysregulation of the immune system which has been linked to dissemination and hyperinfection of S. stercoralis leading to bacterial sepsis which can result in death. Both of these pathogens are endemic in Australia primarily in remote communities in Queensland, the Northern Territory, and Western Australia. Other cases in Australia have occurred in immigrants and refugees, returned travellers, and Australian Defence Force personnel. HTLV-I infection is lifelong with no known cure. Strongyloidiasis is a long-term chronic disease that can remain latent for decades, as shown by infections diagnosed in prisoners of war from World War II and the Vietnam War testing positive decades after they returned from these conflicts. This review aims to shed light on concomitant infections of HTLV-I with S. stercoralis primarily in Australia but in the global context as well.
Collapse
Affiliation(s)
- Catherine A Gordon
- Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Jennifer M Shield
- Department of Pharmacy and Biomedical Sciences, La Trobe University, Bendigo, VIC, Australia; Department of Medicine, The Peter Doherty Institute for Infection and Immunity, University of Melbourne and the Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Richard S Bradbury
- School of Health and Life Sciences, Federation University, Berwick, VIC, Australia
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Wendy Page
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Jenni A Judd
- School of Health Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia; Centre for Indigenous Health Equity Research, Central Queensland University, Bundaberg, QLD, Australia
| | - Rogan Lee
- Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - Beverley-Ann Biggs
- Department of Medicine, The Peter Doherty Institute for Infection and Immunity, University of Melbourne and the Royal Melbourne Hospital, Melbourne, VIC, Australia; Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Kirstin Ross
- College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Johanna Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Donald P McManus
- Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| |
Collapse
|
30
|
Sagara Y, Nakamura H, Yamamoto M, Ezaki T, Koga T, Shimamura M, Satake M, Irita K. Estimation of the window period of human T-cell leukemia virus type 1 and 2 tests by a lookback study of seroconverters among Japanese voluntary blood donors. Transfusion 2020; 61:484-493. [PMID: 33368334 DOI: 10.1111/trf.16213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Japan is endemic for human T-cell leukemia virus type 1 (HTLV-1), and the horizontal transmission of HTLV-1 is often reported. However, the window period (WP) for serologic or molecular screening is unclear. STUDY DESIGN AND METHODS Results for anti-HTLV-1 screening and confirmatory tests obtained from 648 591 repeated blood donors in the Kyushu district, one of the most endemic areas of HTLV-1 in the world, were evaluated. A lookback study was conducted for seroconverters. RESULTS During 2012 to 2019, 436 seroconverters (155 men, 281women) were identified with use of a screening chemiluminescence enzyme-immunoassay (CLEIA) and multiple confirmatory tests. Because the period between the latest seronegative donation and seroconversion was highly variable (2.1-276.7 months), 19 cases that seroconverted within 6 months were subjected to the analysis. The WP of the particle agglutination assay and CLEIA was estimated to be 2.2 ± 0.6 and 2.6 ± 1.7 months, respectively. The WP of the indirect immunofluorescence assay was 4.8 ± 6.5 months. Although the WP of western blotting was estimated to be 6.3 ± 8.7 months, four cases were still indeterminate through the study period. Chemiluminescence and line immunoassays, the current screening and confirmatory tests used in the Japanese blood program, showed the shortest WP of 2.2 ± 0.6 months. The WP of real-time polymerase chain reaction for HTLV-1 was estimated to be 4.1 ± 7.8 months. CONCLUSIONS The WP in commercially available testing systems for HTLV-1/2 was determined for natural infection among repeated blood donors. Considering the HTLV-1 WP will help increase transfusion safety and facilitate the accurate diagnosis of HTLV-1 infection.
Collapse
Affiliation(s)
- Yasuko Sagara
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Hitomi Nakamura
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Midori Yamamoto
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Toshinobu Ezaki
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Tomohide Koga
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Masuhiro Shimamura
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| | - Masahiro Satake
- CEO of Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - Kazuo Irita
- Department of Quality, Japanese Red Cross Kyushu Block Blood Center, Chikushino, Japan
| |
Collapse
|
31
|
Bartlett PC, Ruggiero VJ, Hutchinson HC, Droscha CJ, Norby B, Sporer KRB, Taxis TM. Current Developments in the Epidemiology and Control of Enzootic Bovine Leukosis as Caused by Bovine Leukemia Virus. Pathogens 2020; 9:E1058. [PMID: 33352855 PMCID: PMC7766781 DOI: 10.3390/pathogens9121058] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023] Open
Abstract
Enzootic Bovine Leukosis (EBL) caused by the bovine leukemia virus (BLV) has been eradicated in over 20 countries. In contrast, the U.S. and many other nations are experiencing increasing prevalence in the absence of efforts to control transmission. Recent studies have shown that BLV infection in dairy cattle has a greater impact beyond the long-recognized lymphoma development that occurs in <5% of infected cattle. Like other retroviruses, BLV appears to cause multiple immune system disruptions, affecting both cellular and humoral immunity, which are likely responsible for increasingly documented associations with decreased dairy production and decreased productive lifespan. Realization of these economic losses has increased interest in controlling BLV using technology that was unavailable decades ago, when many nations eradicated BLV via traditional antibody testing and slaughter methods. This traditional control is not economically feasible for many nations where the average herd antibody prevalence is rapidly approaching 50%. The ELISA screening of cattle with follow-up testing via qPCR for proviral load helps prioritize the most infectious cattle for segregation or culling. The efficacy of this approach has been demonstrated in at least four herds. Breeding cattle for resistance to BLV disease progression also appears to hold promise, and several laboratories are working on BLV vaccines. There are many research priorities for a wide variety of disciplines, especially including the need to investigate the reports linking BLV and human breast cancer.
Collapse
Affiliation(s)
- Paul C. Bartlett
- College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA; (V.J.R.); (B.N.)
| | - Vickie J. Ruggiero
- College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA; (V.J.R.); (B.N.)
| | | | - Casey J. Droscha
- CentralStar Cooperative, East Lansing, MI 48910, USA; (C.J.D.); (K.R.B.S.)
| | - Bo Norby
- College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA; (V.J.R.); (B.N.)
| | - Kelly R. B. Sporer
- CentralStar Cooperative, East Lansing, MI 48910, USA; (C.J.D.); (K.R.B.S.)
| | - Tasia M. Taxis
- Department of Animal Science, Michigan State University, East Lansing, MI 48824, USA;
| |
Collapse
|
32
|
Hubert M, Jeannin P, Burlaud-Gaillard J, Roingeard P, Gessain A, Ceccaldi PE, Vidy A. Evidence That Zika Virus Is Transmitted by Breastfeeding to Newborn A129 ( Ifnar1 Knock-Out) Mice and Is Able to Infect and Cross a Tight Monolayer of Human Intestinal Epithelial Cells. Front Microbiol 2020; 11:524678. [PMID: 33193119 PMCID: PMC7649816 DOI: 10.3389/fmicb.2020.524678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 09/30/2020] [Indexed: 12/13/2022] Open
Abstract
Zika virus (ZIKV) belongs to the Flavivirus genus in the Flaviviridae family. Mainly transmitted via mosquito bites (Aedes aegypti, Aedes albopictus), ZIKV has been classified in the large category of arthropod-borne viruses, or arboviruses. However, during the past two outbreaks in French Polynesia (2013–2014) and Latin America (2015–2016), several cases of ZIKV human-to-human transmission were reported, either vertically via transplacental route but also horizontally after sexual intercourse. Interestingly, high viral burdens were detected in the colostrum and breast milk of infected women and mother-to-child transmission of ZIKV during breastfeeding was recently highlighted. In a previous study, we highlighted the implication of the mammary epithelium (blood–milk barrier) in ZIKV infectious particles excretion in breast milk. However, mechanisms of their further transmissibility to the newborn via oral route through contaminated breast milk remain unknown. In this study, we provide the first experimental proof-of-concept of the existence of the breastfeeding as a route for mother-to-child transmission of ZIKV and characterized the neonatal oral transmission in a well-established mouse model of ZIKV infection. From a mechanistical point-of-view, we demonstrated for the first time that ZIKV was able to infect and cross an in vitro model of tight human intestinal epithelium without altering its barrier integrity, permitting us to consider the gut as an entry site for ZIKV after oral exposure. By combining in vitro and in vivo experiments, this study strengthens the plausibility of mother-to-child transmission of ZIKV during breastfeeding and helps to better characterize underlying mechanisms, such as the crossing of the newborn intestinal epithelium by ZIKV. As a consequence, these data could serve as a basis for a reflection about the implementation of measures to prevent ZIKV transmission, while keeping in mind breastfeeding-associated benefits.
Collapse
Affiliation(s)
- Mathieu Hubert
- Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, Paris, France.,Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Université de Paris, Paris, France.,Centre National de la Recherche Scientifique, Département Virologie, Institut Pasteur, UMR 3569, Paris, France
| | - Patricia Jeannin
- Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, Paris, France.,Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Université de Paris, Paris, France.,Centre National de la Recherche Scientifique, Département Virologie, Institut Pasteur, UMR 3569, Paris, France
| | - Julien Burlaud-Gaillard
- INSERM U1259, Université de Tours et CHU de Tours, Tours, France.,Plate-forme IBiSA de Microscopie Electronique, Université de Tours et CHU de Tours, Tours, France
| | - Philippe Roingeard
- INSERM U1259, Université de Tours et CHU de Tours, Tours, France.,Plate-forme IBiSA de Microscopie Electronique, Université de Tours et CHU de Tours, Tours, France
| | - Antoine Gessain
- Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, Paris, France.,Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Université de Paris, Paris, France.,Centre National de la Recherche Scientifique, Département Virologie, Institut Pasteur, UMR 3569, Paris, France
| | - Pierre-Emmanuel Ceccaldi
- Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, Paris, France.,Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Université de Paris, Paris, France.,Centre National de la Recherche Scientifique, Département Virologie, Institut Pasteur, UMR 3569, Paris, France
| | - Aurore Vidy
- Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Département Virologie, Institut Pasteur, Paris, France.,Unité Epidémiologie et Physiopathologie des Virus Oncogènes, Université de Paris, Paris, France.,Centre National de la Recherche Scientifique, Département Virologie, Institut Pasteur, UMR 3569, Paris, France
| |
Collapse
|
33
|
Yonemoto N, Suzuki S, Sekizawa A, Hoshi S, Sagara Y, Itabashi K. Implementation of nationwide screening of pregnant women for HTLV-1 infection in Japan: analysis of a repeated cross-sectional study. BMC Public Health 2020; 20:1150. [PMID: 32698800 PMCID: PMC7374850 DOI: 10.1186/s12889-020-09258-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/14/2020] [Indexed: 01/15/2023] Open
Abstract
Background Screening of pregnant women carrying human T-lymphotropic virus type 1 (HTLV-1) has a crucial role in reducing the number of HTLV-1 carriers. A national HTLV-1 screening program for pregnant women was started in 2011 in Japan. The purpose of this study is to report on the implementation of this nationwide screening program. Methods This was a retrospective repeated cross-sectional study. We used datasets from surveys of HTLV-1-antibody-positive pregnant women performed by the Japan Association of Obstetricians and Gynecologists in 2011, 2013, and 2016. Outcomes for evaluation included the number of persons (pregnant women) who conducted the screening test, the number of positive persons (women) identified by these tests, and the proportion of positive persons to the number of persons (women) who conducted the tests. Results Numbers of target facilities changed yearly: 1857 in 2011, 2544 in 2013, and 2376 in 2016. The mean number of screening-test participants increased per facility, but the median increased or decreased. The mean number of positive individuals identified decreased. Multivariate analysis results revealed the number of screenings was slightly reduced yearly, although areas (Kanto and Kinki) and high volume in facility types increased. Regarding the positive rates, some areas (Hokkaido/Tohoku, Kanto, and Chugoku/Shikoku) exhibited decreases or increases by facility type. The number of western blotting (WB) implementations decreased in 2016, positive rates identified by WB decreased in 2016 in all areas, and the number of facility types increased. The number of PCR participants increased in 2016 in Kanto and Kinki, but a decrease in facility type was observed. Positive rates were decreased in all areas (except the central region) but facility types were increased. Conclusions The nationwide screening program for HTLV-1 in Japan was almost fully implemented. However, regional variations in screening tests were observed during this implementation. Thus, some incentives are needed to encourage proper implementation across all regions.
Collapse
Affiliation(s)
- Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, Japan. .,Department of Public Health, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, Japan.
| | - Shunji Suzuki
- Japan Association of Obstetricians and Gynecologists, 14 Yahatacho, Ichigaya-Hachimanmachi, Shinjuku-ku, Tokyo, 162-0844, Japan.,Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo, 124-0012, Japan
| | - Akihiko Sekizawa
- Japan Association of Obstetricians and Gynecologists, 14 Yahatacho, Ichigaya-Hachimanmachi, Shinjuku-ku, Tokyo, 162-0844, Japan.,Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| | - Shinichi Hoshi
- Japan Association of Obstetricians and Gynecologists, 14 Yahatacho, Ichigaya-Hachimanmachi, Shinjuku-ku, Tokyo, 162-0844, Japan
| | - Yoko Sagara
- Japan Association of Obstetricians and Gynecologists, 14 Yahatacho, Ichigaya-Hachimanmachi, Shinjuku-ku, Tokyo, 162-0844, Japan
| | - Kazuo Itabashi
- Department of Pediatrics, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan
| |
Collapse
|
34
|
Prendergast AJ, Goga AE, Waitt C, Gessain A, Taylor GP, Rollins N, Abrams EJ, Lyall EH, de Perre PV. Transmission of CMV, HTLV-1, and HIV through breastmilk. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 3:264-273. [PMID: 30878119 DOI: 10.1016/s2352-4642(19)30024-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022]
Abstract
Breastfeeding is a crucial child survival intervention. However, the potential for transmission of viral infections from mother to child presents the dilemma of how best to interpret the benefits and risks of breastfeeding in different settings. In this Review, we compare the transmission dynamics, risk factors, and outcomes of infection with three chronic viruses transmitted through breastmilk: cytomegalovirus, human T-cell lymphotropic virus type 1, and HIV. We provide an overview of intervention approaches and discuss scientific, policy, and programming gaps in the understanding of these major global infections.
Collapse
Affiliation(s)
- Andrew J Prendergast
- Blizard Institute, Queen Mary University of London, London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
| | - Ameena E Goga
- South African Medical Research Council, Cape Town, South Africa; Department of Paediatrics, University of Pretoria, Hatfield, South Africa
| | - Catriona Waitt
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK; Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Elaine J Abrams
- ICAP at Columbia, Mailman School of Public Health, and Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - E Hermione Lyall
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infection, INSERM, University Montpellier, Etablissement Français du Sang, CHU de Montpellier, Montpellier, France
| |
Collapse
|
35
|
Ramassamy JL, Cassar O, Toumbiri M, Diané A, Idam Mamimandjiami A, Bengone C, Ntsame-Ndong JM, Mouinga-Ondémé A, Gessain A. High prevalence of human T-cell leukemia virus type-1b genotype among blood donors in Gabon, Central Africa. Transfusion 2020; 60:1483-1491. [PMID: 32415686 PMCID: PMC7496943 DOI: 10.1111/trf.15838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/26/2020] [Accepted: 03/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The African continent is considered to be the largest endemic area of HTLV‐1 infection, with at least several million infected individuals. Systematic screening of blood donors can prevent the transmission of HTLV‐1 in blood. Gabon is one of the countries with the highest prevalence of HTLV‐1 worldwide, and yet the routine testing of blood donors has still not been introduced. METHODS All blood donations collected between April and July 2017 at the Centre National de Transfusion Sanguine of Gabon were studied. Plasma samples were screened by ELISA for the presence of HTLV‐1/2 antibodies. Western blot (WB) and polymerase chain reaction (PCR) tests were used for confirmation. RESULTS In total, 3123 blood donors were tested, including 1740 repeat and 1378 first‐time blood donors (FTBDs). Of them, 132 samples tested positive for HTLV‐1/2 by ELISA (4.2%). WB and PCR confirmed HTLV‐1 infection for 23 individuals. The overall prevalence of HTLV‐1 was 0.74% [95% CI 0.47%‐1.10%], 1% in FTBD, and 0.5% in repeat donors. Age and sex‐adjusted prevalence was five‐fold lower in FTBD than in the general adult population of rural areas of Gabon. All detected HTLV‐1 strains belonged to the central African HTLV‐1b genotype but were highly diverse. CONCLUSION We report an overall prevalence of HTLV‐1 of 0.74%, one of the highest values reported for blood donors in Africa. Given the high risk of HTLV‐1 transmission in blood, it is necessary to conduct cost‐effectiveness studies to determine the need and feasibility of implementing screening of HTLV‐1 in blood donors in Gabon.
Collapse
Affiliation(s)
- Jill-Léa Ramassamy
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France.,Université de Paris, Paris, France
| | - Olivier Cassar
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France
| | - Manoushka Toumbiri
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Abdoulaye Diané
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Antony Idam Mamimandjiami
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France.,Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon.,Ecole Doctorale Régionale d'Afrique Centrale, Infectiologie Tropicale, Franceville, Gabon
| | - Calixte Bengone
- Centre National de Transfusion sanguine (CNTS), Libreville, Gabon
| | | | - Augustin Mouinga-Ondémé
- Unité des infections rétrovirales et pathologies associées, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Antoine Gessain
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France
| |
Collapse
|
36
|
Keikha M, Ghazvini K, Eslami M, Yousefi B, Casseb J, Yousefi M, Karbalaei M. Molecular targeting of PD-1 signaling pathway as a novel therapeutic approach in HTLV-1 infection. Microb Pathog 2020; 144:104198. [PMID: 32283259 DOI: 10.1016/j.micpath.2020.104198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 02/08/2023]
Abstract
HTLV-1, the first human oncogenic retrovirus, is a type C retrovirus that belongs to the Deltaretrovirus genus. The HTLV-1 genome has 8.5 kbp length, and consists of major genes such as gag, pol, pro, env, and pX region. This retrovirus is considered as one of the most deadly infectious agent for peripheral-blood mononuclear cells (PBMC). The infection of HTLV-1 can lead to dangerous complications, such as infective dermatitis (ID), uveitis, arthritis, lymphadenitis, arthropathies, Sjögren's Syndrome (SS), and particularly HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) or Adult T-Cell Leukemia Lymphoma (ATLL). At the moment, Zidovudine (AZT) plus IFN-α is the only treatment available for HTLV-1 infections. Based on scientific studies, alongside the therapeutic regimens, intrinsic mechanisms also play a determinant role in reducing the signs of disease. Programmed cell death-1 (PD-1) signaling pathway, one of the most important checkpoints, has recently received interest, such as the development of a novel generation of anti-tumors. In the present study, we discuss the role of PD-1 signaling pathway in HTLV-1 infection as well as its application as a novel approach for treatment of HTLV-1 infections.
Collapse
Affiliation(s)
- Masoud Keikha
- Antimicrobial Resistance Research Center, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiarash Ghazvini
- Antimicrobial Resistance Research Center, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Eslami
- Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Bahman Yousefi
- Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Jorge Casseb
- Institute of Tropical Medicine of São Paulo/Laboratory of Dermatology and Immunodeficiencies, Department of Dermatology, University of São Paulo Medical School, São Paulo, SP, 01246-100, Brazil
| | - Masoud Yousefi
- Antimicrobial Resistance Research Center, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mohsen Karbalaei
- Department of Microbiology and Virology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran.
| |
Collapse
|
37
|
Pandey NV. DNA viruses and cancer: insights from evolutionary biology. Virusdisease 2020; 31:1-9. [PMID: 32206692 PMCID: PMC7085488 DOI: 10.1007/s13337-019-00563-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/23/2019] [Indexed: 12/13/2022] Open
Abstract
When it comes to understanding the exact mechanisms behind the virus induced cancers, we have often turned to molecular biology. It would be fair to argue that our understanding of cancers caused by viruses has significantly improved since the isolation of Epstein-Barr virus from Burkitt's lymphoma. However they are some important questions that remain unexplored like what advantage do viruses derive by inducing carcinogenesis? Why do viruses code for the so called oncogenes? Why DNA viruses are disproportionately linked to cancers? These questions have been addressed from the lens of evolutionary biology in this review. The evolutionary analysis of virus induced cancer suggests that persistent strategy of infection could be a stable strategy for DNA viruses and also the main culprit behind their tendency to cause cancer. The framework presented in the review not only explains wider observations about cancer caused by viruses but also offers fresh predictions to test the hypothesis.
Collapse
|
38
|
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.
Collapse
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
| |
Collapse
|
39
|
Eusebio-Ponce E, Anguita E, Paulino-Ramirez R, Candel FJ. HTLV-1 infection: An emerging risk. Pathogenesis, epidemiology, diagnosis and associated diseases. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2019; 32:485-496. [PMID: 31648512 PMCID: PMC6913074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 10/16/2019] [Indexed: 11/11/2022]
Abstract
The Human T-Lymphotropic Virus type 1 (HTLV-1) affects up to 10 million people worldwide. It is directly associated to one of the most aggressive T cell malignancies: Adult T Cell Leukemia-Lymphoma (ATLL) and a progressive neurological disorder, Tropical Spastic Paraparesis/ HTLV-1 Associated Myelopathy (TSP/HAM). Also, infected patients tend to have more severe forms of infectious diseases such as Strongyloidiasis and Tuberculosis. HTLV spreads through parenteral, sexual, and vertical (mother-to-child) routes. Effective viral transmission is produced mainly by cell to cell mechanism, unlike other retroviruses such as HIV, which usually spread infecting cells in a cell-free form. HTLV also has a peculiar distribution, with clusters of high endemicity in nearby areas of very low prevalence or absence of the virus. This could be explained by factors including a possible founder effect, the predominance of mother to child transmission and the cell-to-cell trans-mission mechanisms. More data on viral epidemiology are needed in order to develop strategies in endemic areas aimed at reducing viral dissemination. In this review, we critically analyze HTLV-1 pathogenesis, epidemiology, diagnosis, associated diseases, preventive strategies, and treatments, with emphasis to the emerging risk for Europe and particularly Spain, focusing on prevention methods to avoid viral transmission and associated diseases.
Collapse
Affiliation(s)
| | | | | | - F J Candel
- Francisco Javier Candel, Clinical Microbiology and Infectious Diseases Department. Transplant Coordination Unit. Instituto de Medicina de Laboratorio (IML), Instituto de Investigación Sanitaria San Carlos (IdISSC). Hospital Clínico San Carlos. Madrid, Spain. Avda Profesor Martín Lagos s/n, 28040 Madrid, Spain.
| |
Collapse
|
40
|
Sodré Barmpas DB, Monteiro DLM, Taquette SR, Rodrigues NCP, Trajano AJB, Cunha JDC, Nunes CL, Villela LHC, Teixeira SAM, Sztajnbok DCDN, Bóia MN. Pregnancy outcomes and mother-to-child transmission rate in HTLV-1/2 infected women attending two public hospitals in the metropolitan area of Rio de Janeiro. PLoS Negl Trop Dis 2019; 13:e0007404. [PMID: 31181057 PMCID: PMC6586357 DOI: 10.1371/journal.pntd.0007404] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 06/20/2019] [Accepted: 04/22/2019] [Indexed: 11/30/2022] Open
Abstract
HTLV-1/2 are transmitted sexually, by whole cell blood products and from mother-to-child (MTC), mainly through breastfeeding. HTLV-1/2 prevalence in pregnant women is high in Rio de Janeiro, however there were no local studies addressing the rate of adverse pregnancy outcomes (APO) and MTC transmission. The aim was to study sociodemographic characteristics which may be associated to HTLV-1/2 infection and describe pregnancy outcomes and MTC transmission in HTLV-1/2-positive women. The cross-sectional study screened 1,628 pregnant women in of Rio de Janeiro (2012–2014) and found 12 asymptomatic carrier mothers (prevalence = 0.74%). Pregnancy outcome information was retrieved from medical records. Sociodemographic characteristics were similar between the positive and negative groups except for maternal age, which was higher in carrier mothers. The incidence of adverse pregnancy outcomes was similar in infected and non-infected patients (p = 0.33), however there was a high rate of premature rupture of membranes (PROM) amid infected mothers (3/12). Multilevel logistic regression found that for each additional year of age, the chance of being HTLV-1/2-positive increased 11% and that having another sexually transmitted infection (STI) increased 9 times the chance of being infected. Carrier mothers had more antenatal visits (OR = 5.26). Among the children of HTLV-1/2-positive mothers there was one fetal death, one infant death and one loss of follow-up. After two years of follow-up there was one case of MTC transmission (1/9). The mother reported breastfeeding for one month only. Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy outcomes and the MTC transmission rate is important to guide public health policies on antenatal screening and management. HTLV-1/2 are retroviruses transmitted by sex, blood products and from mother to child (MTC), mainly through breastfeeding. There is currently no vaccine, treatment or cure. Although it’s mostly asymptomatic it can cause disabling and even lethal diseases in carriers. The prevalence of HTLV-1/2 in pregnant women at the metropolitan area of Rio de Janeiro is high (0.74%). Our aim was to study the sociodemographic characteristics which may be associated to HTLV-1/2 infection and describe pregnancy outcomes and MTC transmission in the infected population. Apart from being slightly older, there were no differences in the carrier mothers’ sociodemographic profile. Pregnant women with sexually transmitted infections had a 9-fold chance of being HTLV-1/2 positive. Although adverse pregnancy outcomes were not increased, infected mothers had a high rate of ruptured membranes. Among the children of HTLV-1/2-positive mothers there was one fetal death, one infant death and one loss of follow-up. There was one case of MTC transmission (1/9), after one month of breastfeeding. Knowledge about factors associated to HTLV-1/2 infection, its impact on pregnancy, and the MTC transmission rate is important to guide further research and public health policies.
Collapse
Affiliation(s)
| | - Denise Leite Maia Monteiro
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Gynecology and Obstetrics, Centro Universitário Serra dos Órgãos (UNIFESO), Teresópolis, RJ, Brazil
| | - Stella Regina Taquette
- Department of Internal Medicine, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Nádia Cristina Pinheiro Rodrigues
- Department of Epidemiology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Epidemiology, Escola Nacional de Saúde Pública (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Alexandre José Baptista Trajano
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
- Department of Gynecology and Obstetrics, Universidade Unigranrio, Rio de Janeiro, RJ, Brazil
| | - Juliana de Castro Cunha
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Camila Lattanzi Nunes
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Sérgio A. M. Teixeira
- Department of Obstetrics, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | - Márcio Neves Bóia
- Department of Epidemiology, Escola Nacional de Saúde Pública (Fiocruz), Rio de Janeiro, RJ, Brazil
- Department of Infectology, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|
41
|
Husseini AA, Saeed KMI, Yurdcu E, Sertoz R, Bozdayi AM. Epidemiology of blood-borne viral infections in Afghanistan. Arch Virol 2019; 164:2083-2090. [PMID: 31134354 DOI: 10.1007/s00705-019-04285-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/20/2019] [Indexed: 12/30/2022]
Abstract
Although a few studies have been done on transmissible blood-borne viral infections in high-risk groups, little attention has been given to assessing the infection status of the general population in Afghanistan. To investigate the epidemiological status in the general population, we tested the serological markers of hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis delta virus (HDV), human immunodeficiency virus 1 (HIV-1) and human T-cell leukemia virus (HTLV) infections. In total, 492 samples were selected randomly from Nangarhar, Herat, Mazar-e Sharif, Kandahar, and Kabul from subjects between 25 and 70 years old. The samples were tested for the presence of HBsAg, anti-HBs, anti-HBc, anti-HDV, anti-HCV, anti-HIV-1 and anti-HTLV I/II antibodies using chemiluminescent immunoassays on Abbott Architect automated platforms. In addition, 220 HBsAg-positive samples identified among 5897 samples from the general population of the same regions of Afghanistan were included in the study and tested for both HBsAg and anti-HDV to investigate HDV prevalence in the country. Viral loads of HBV, HCV and HDV were determined in all seropositive samples using Ampliprep/Cobas TaqMan HBV, HCV, Test Roche (CA, USA), and an in-house method, respectively. Out of 492 samples, 31 (6.3%), 136 (27.6%) and 149 (30.3%) were found to be positive for HBsAg, anti-HBs and anti-HBc, respectively. Anti-HDV positivity was detected in five (2.1%) out of 234 HBsAg-positive samples (including 14 of the randomly selected samples that were not among the 220 previously identified as HBsAg positive). Only eight out of 492 (1.6%) subjects were positive for anti-HCV antibodies. Seven out of 489 (1.4%) were positive for anti-HIV-1 antibodies, and three out of 466 cases (0.6%) were positive for anti-HTLV I/II antibodies. These results suggest that Afghanistan is an intermediate endemic region for HBV, HDV and HCV infection. The prevalence of HIV-1 seems to be significantly higher than the global prevalence and that of the eastern Mediterranean region. In addition, the HTLV I/II screening results suggest that these viruses should be monitored in Afghanistan to confirm the trend observed in the current study.
Collapse
Affiliation(s)
- Abbas Ali Husseini
- Institute of Hepatology, Ankara University, School of Medicine, Cebeci Hospitals, Dikimevi, 06620, Ankara, Turkey
| | - Khwaja Mir Islam Saeed
- Grant and Service Contract Management Unit (GCMU), Ministry of Public Health, Kabul, Afghanistan
| | - Esra Yurdcu
- Institute of Hepatology, Ankara University, School of Medicine, Cebeci Hospitals, Dikimevi, 06620, Ankara, Turkey
| | - Rüçhan Sertoz
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - A Mithat Bozdayi
- Institute of Hepatology, Ankara University, School of Medicine, Cebeci Hospitals, Dikimevi, 06620, Ankara, Turkey.
| |
Collapse
|
42
|
Rosadas C, Taylor GP. Mother-to-Child HTLV-1 Transmission: Unmet Research Needs. Front Microbiol 2019; 10:999. [PMID: 31134031 PMCID: PMC6517543 DOI: 10.3389/fmicb.2019.00999] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/18/2019] [Indexed: 02/04/2023] Open
Abstract
Mother-to-child transmission (MTCT) of Human T-cell lymphotropic virus type 1 (HTLV-1) causes lifelong infection. At least 5–10 million individuals worldwide are currently living with HTLV-1. Studies of regional variation are required to better understand the contribution of MTCT to the global burden of infection. Although most infected individuals remain asymptomatic ∼10% develop high morbidity, high mortality disease. Infection early in life is associated with a higher risk of disease development. Adult T-cell leukemia (ATL), which is caused by HTLV-1 and has a median survival of 8 months is linked to MTCT, indeed evidence of ATL following infection as an adult is sparse. Infective dermatitis also only occurs following neonatal infection. Whilst HTLV-1-associated myelopathy (HAM) follows sexual and iatrogenic infection approximately 30% of patients presenting with HAM/TSP acquired the infection through their mothers. HAM/TSP is a disabling neurodegenerative disease that greatly impact patient’s quality of life. To date there is no cure for HTLV-1 infection other than bone marrow transplantation for ATL nor any measure to prevent HTLV-1 associated diseases in an infected individual. In this context, prevention of MTCT is expected to contribute disproportionately to reducing both the incidence of HTLV-1 and the burden of HTLV-1 associated diseases. In order to successfully avoid HTLV-1 MTCT, it is important to understand all the variables involved in this route of infection. Questions remain regarding frequency and risk factors for in utero peri-partum transmission whilst little is known about the efficacy of pre-labor cesarean section to reduce these infections. Understanding the contribution of peripartum infection to the burden of disease will be important to gauge the risk-benefit of interventions in this area. Few studies have examined the impact of HTLV-1 infection on fertility or pregnancy outcomes nor the susceptibility of the mother to infection during pregnancy and lactation. Whilst breast-feeding is strongly associated with transmission and avoidance of breast-feeding a proven intervention little is known about the mechanism of transmission from the breast milk to the infant and there have been no clinical trials of antiretroviral therapy (ARV) to prevent this route of transmission.
Collapse
Affiliation(s)
- Carolina Rosadas
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| | - Graham P Taylor
- Retrovirology and GU Medicine, Department of Medicine, Imperial College London, London, United Kingdom
| |
Collapse
|
43
|
Human T Cell Lymphotrophic virus infection among sexually active individuals in Nigeria: A cross sectional study. SCIENTIFIC AFRICAN 2019. [DOI: 10.1016/j.sciaf.2019.e00072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
|
44
|
Martino G, Zanelli M, Marra A, Quintini M, Zizzo M, Ascani S, Martelli MP, Falini B. Flower cells of tropical descent: a challenging case of adult T-cell leukemia/lymphoma. TUMORI JOURNAL 2019; 105:NP38-NP42. [PMID: 31041884 DOI: 10.1177/0300891619847756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Adult T-cell leukemia/lymphoma (ATLL) is an aggressive disease associated with human T-lymphotropic virus type 1 infection, with a very high prevalence in tropical areas but exceptionally rare in Europe and Western countries. CASE PRESENTATION We describe a challenging case of ATLL in a young male patient with Brazilian origin and adopted as a child by an Italian family, presenting to our clinic with atypical T-lymphocytosis and life-threatening lung infections. CONCLUSIONS Diagnosis of ATLL outside of endemic areas can be difficult, requiring a high index of clinical suspicion with careful evaluation of the patient's clinical history. Prognosis is affected by disease stage at presentation and degree of immunosuppression. Few effective treatments are available, although new molecular insights have highlighted the role of host immune response and immune checkpoint blockade inhibitors, given the overexpression of PD-L1 on lymphoma cells and on microenvironment cells.
Collapse
Affiliation(s)
- Giovanni Martino
- Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia, Italy
| | - Andrea Marra
- Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
| | - Martina Quintini
- Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Ascani
- Department of Experimental Medicine, Section of Pathologic Anatomy and Histology Medical School, University of Perugia, Italy
| | | | - Brunangelo Falini
- Hematology and Clinical Immunology, University of Perugia, Perugia, Italy
| |
Collapse
|
45
|
Vermeulen M, Sykes W, Coleman C, Custer B, Jacobs G, Jaza J, Kaidarova Z, Hlela C, Gessain A, Cassar O, Poole C, Ingram C, Murphy EL, Reddy R. The prevalence of human T-lymphotropic virus type 1 & 2 (HTLV-1/2) in South African blood donors. Vox Sang 2019; 114:451-458. [PMID: 30950074 DOI: 10.1111/vox.12778] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Donated blood is not currently screened for human T-cell lymphotropic virus (HTLV) in South Africa. Several small studies have detected HTLV-1 in South Africa, but prevalence by geographic region or population group is unavailable. MATERIALS AND METHODS We performed a large seroprevalence study of South African blood donors during 3 months in 2013. All geographic regions except the Western Cape were included, and Black and Coloured (local term for mixed race) donors were oversampled. Identity-unlinked plasma samples were screened with the Abbott Prism HTLV-1/2 assay, and repeatedly reactive samples were tested by the Inno-LIA HTLV-1/2 Score confirmatory assay. Odds ratios were calculated with multivariable logistic regression. RESULTS Of 46 752 donors tested, 133 (0·28%) were initially reactive, 111 (0·24%) repeatedly reactive and 57 (0·12%) confirmed positive for HTLV-1; none were HTLV-2 positive. Prevalence was 0·062% weighted to annual blood donations but highly concentrated in the Black population group (OR = 20·24 CI: 2·77-147·88); higher in females than males (OR = 1·81 CI: 1·06-3·08); and in donors aged >50 years compared to ages 16-19 (OR = 6·4 CI: 2·95-13·86). After controlling for age, sex and population group, there was no difference in prevalence between new and repeat blood donors or among geographic regions within South Africa. CONCLUSIONS We conclude that HTLV-1 infection is widespread among the Black population of South Africa and its epidemiology is similar to other endemic areas. Because South Africa is increasing its recruitment of Black blood donors, the implications for blood screening require further consideration.
Collapse
Affiliation(s)
| | - Wendy Sykes
- South African National Blood Service, Roodepoort, South Africa
| | - Charl Coleman
- South African National Blood Service, Roodepoort, South Africa
| | - Brian Custer
- Vitalant Research Institute, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
| | | | - Jabulisile Jaza
- South African National Blood Service, Roodepoort, South Africa
| | | | - Carol Hlela
- Red Cross Children's Hospital, Cape Town, South Africa
| | - Antoine Gessain
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, Paris, France.,CNRS, UMR3569, Paris, France
| | - Olivier Cassar
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, Paris, France.,CNRS, UMR3569, Paris, France
| | - Colwyn Poole
- South African National Blood Service, Roodepoort, South Africa
| | | | - Edward L Murphy
- Vitalant Research Institute, San Francisco, CA, USA.,University of California San Francisco, San Francisco, CA, USA
| | - Ravi Reddy
- South African National Blood Service, Roodepoort, South Africa
| |
Collapse
|
46
|
Jensen MM, Olesen JS, Kjerulff B, Byberg S, da Silva ZJ, Rodrigues A, Jespersen S, Wejse C, Aaby P, Erikstrup C, Hønge BL. HTLV prevalence is no longer following the decreasing HIV prevalence - 20 years of retroviral surveillance in Guinea-Bissau, West Africa. Acta Trop 2019; 192:144-150. [PMID: 30771284 DOI: 10.1016/j.actatropica.2019.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 02/09/2019] [Accepted: 02/12/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND The HIV-2 and HTLV-1 prevalences in Bissau have followed similar trends in surveys from 1996 and 2006 with HTLV-1 prevalences of 3.6% and 2.3%, respectively. However, following the introduction of antiretroviral treatment (ART) and informative campaigns about HIV, the epidemics may have shifted. To evaluate the current HTLV prevalence and the continued association with HIV, we performed a third survey. METHODS A cross-sectional survey was performed from November 2014 to February 2016. In total, 2583 participants were interviewed, tested for HIV, and had blood samples collected. Samples were analysed for anti-HTLV using chemiluminescence and immunoblot assays. We calculated the HTLV prevalence for 2016 and examined risk factors for HTLV and associations with HIV using binominal regression. RESULTS The prevalence of HTLV was 2.8% (71/2583), 1.5% (16/1,089) for men and 3.7% (55/1,494) for women. Old age, female sex, HIV-2 infection and sharing a house with a HTLV- infected person were strong risk factors for HTLV. In contrast to previous studies, we found a non-significant increase in prevalence among the 15-24 year-olds since 2006, supporting ongoing transmission. CONCLUSIONS The HTLV prevalence in Bissau showed a non-significant increase. We found evidence supporting continuous vertical and horizontal routes of transmissions.
Collapse
|
47
|
De Mendoza C, Pirón M, Gonzalez R, Jiménez A, Caballero E, Roc L, Benito R, Ramos JM, Soriano V. Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain. Open Forum Infect Dis 2019; 6:ofz036. [PMID: 30815504 PMCID: PMC6386801 DOI: 10.1093/ofid/ofz036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 01/15/2019] [Indexed: 01/05/2023] Open
Abstract
Background Although only 8%–10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods A nationwide HTLV-1 register was created in Spain in 1989. A total of 351 infected persons had been reported by the end of 2017. We examined all new HTLV-1 diagnoses during the last decade and compared their clinical presentation. Results A total of 247 individuals with HTLV-1 infection had been reported in Spain since year 2008. The incidence has remained stable with 20–25 new diagnoses yearly. Women represented 62%. Only 12% were native Spaniards, most of whom were foreigners from Latin America (72.5%). Up to 57 (23%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (n = 24; 42.1%), T-cell lymphoma (n = 19; 33.3%), or Strongyloides stercoralis infestation (n = 8; 14%). Human T-cell leukemia virus type 1 diagnosis had been made either at blood banks (n = 109; 44%) or at clinics (n = 138; 56%). It is interesting to note that Spaniards and especially Africans were overrepresented among patients presenting with HTLV-1-associated illnesses, suggesting that misdiagnosis and late presentation are more frequent in these populations compared to Latin Americans. Conclusions Given that 23% of new HTLV-1 diagnoses in Spain are symptomatic, underdiagnosis must be common. Although screening in blood banks mostly identifies asymptomatic Latin American carriers, a disproportionately high number of Spaniards and Africans are unveiled too late, that is, they already suffer from classic HTLV-1 illnesses.
Collapse
Affiliation(s)
- Carmen De Mendoza
- Puerta de Hierro Research Institute and University Hospital, Majadahonda, Madrid
| | | | | | - Ana Jiménez
- Centro de Hemoterapia de Castilla-León, Valladolid
| | | | | | - Rafael Benito
- Hospital Clínico Universitario Lozano Blesa, Zaragoza
| | | | - Vicente Soriano
- UNIR Health Sciences School, Madrid.,La Paz University Hospital, Madrid, Spain
| | | |
Collapse
|
48
|
Konishi M, Ishizaki H, Kameyama KI, Murakami K, Yamamoto T. The effectiveness of colostral antibodies for preventing bovine leukemia virus (BLV) infection in vitro. BMC Vet Res 2018; 14:419. [PMID: 30594182 PMCID: PMC6311012 DOI: 10.1186/s12917-018-1724-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/29/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leukosis (EBL). The incidence of EBL in Japan is increasing annually; and the cases of EBL in cattle younger than 2 years old has been reported. Therefore, it is vital to find a method to control BLV infection, especially in young calves. In this study, to evaluate the protective ability of colostral antibodies against BLV infection, as well as the potential for BLV infection mediated by colostrum/milk, we investigated temporal fluctuations in the anti-BLV antibody titer and BLV proviral load (PVL) in colostrum/milk and peripheral blood of six infected dams during lactation. The association between PVL and antibody titer in colostrum and peripheral blood was then investigated using samples from a further twenty-seven cattle. Antibody concentrations were measured with a Syncytium-induction Inhibition Assay using colostral/milk whey and serum. PVL in peripheral blood and colostrum was measured by real-time PCR. RESULTS Colostral antibodies showed high inhibitory activity until day 3 of lactation. The antibody titer and PVL in peripheral blood showed lesser changes than those in colostrum/milk throughout lactation. The colostral antibody titer was significantly higher than the serum antibody titer in all samples, whereas the colostrum PVL was significantly lower than the blood PVL. The blood PVL showed a significant correlation with serum antibody titer, colostrum PVL, and colostral antibody titer. However, there were no major correlations between the serum and colostral antibody titers. CONCLUSIONS This is the first report investigating the temporal changes in colostral antibody titer in terms of inhibiting BLV infection in vitro. The results of antibody detection by Syncytium-induction Inhibition Assay suggested that the protective activity of the colostral antibodies against BLV infection would be conferred by anti-BLV gp51 antibody. The high antibody titer of colostral whey suggests that colostral whey could be a potential source of antibodies with a low risk of infection in neonatal calves.
Collapse
Affiliation(s)
- Misako Konishi
- Epidemiology Unit, Division of Viral Disease and Epidemiology, National Institute of Animal Health, NARO 3-1-5 Kannondai, Tsukuba, Ibaraki, 305-0856, Japan
| | - Hiroshi Ishizaki
- Grazing Animal Unit, Division of Grassland Farming, Institute of Livestock and Grassland Science, NARO. 768 Senbonmatsu, Nasushiobara, Tochigi, 329-2793, Japan
| | - Ken-Ichiro Kameyama
- National Institute of Animal Health, NARO, Exotic Diseases Research Station Josuihoncho, Kodaira, Tokyo, 187-0022, Japan
| | - Kenji Murakami
- Cooperative Department of Veterinary Medicine, Iwate University Faculty of Agriculture, 3-18-8 Ueda, Morioka, Iwate, 020-8550, Japan
| | - Takehisa Yamamoto
- Epidemiology Unit, Division of Viral Disease and Epidemiology, National Institute of Animal Health, NARO 3-1-5 Kannondai, Tsukuba, Ibaraki, 305-0856, Japan.
| |
Collapse
|
49
|
Akinboyo IC, Crane GM, Chen L, Arav-Boger R. A 17-Year-Old Boy With Right Face Palsy, Left Leg Weakness, and Lytic Skull-Bone Lesions. J Pediatric Infect Dis Soc 2018; 7:350-354. [PMID: 29373673 PMCID: PMC6276027 DOI: 10.1093/jpids/pix101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 10/18/2017] [Indexed: 11/13/2022]
Abstract
Human T-cell lymphotropic virus (HTLV), an infection that is endemic in certain parts of Asia, Africa, and South America, has been associated with malignancy and neurological deficits. Here, we describe a pediatric patient with chronic HTLV-I infection who developed complications associated with HTLV-I (ie, adult T-cell leukemia/lymphoma and HTLV-I-associated myelopathy/tropical spastic paraparesis). To our knowledge, this presentation in a child has never been described. The patient underwent a bone marrow transplant and, at the time of this writing, was in remission. This case report highlights the fact that HTLV-related complications, previously expected to occur after decades of infection, also can occur in pediatric patients, particularly those who acquired HTLV-I perinatally.
Collapse
Affiliation(s)
- Ibukunoluwa C Akinboyo
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland,Correspondence: I. C. Akinboyo, 200 N Wolfe St., Room 3155, Baltimore, MD 21287 ()
| | - Genevieve M Crane
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Lingling Chen
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ravit Arav-Boger
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
50
|
Rosadas C, Malik B, Taylor GP, Puccioni-Sohler M. Estimation of HTLV-1 vertical transmission cases in Brazil per annum. PLoS Negl Trop Dis 2018; 12:e0006913. [PMID: 30418973 PMCID: PMC6261628 DOI: 10.1371/journal.pntd.0006913] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/28/2018] [Accepted: 10/11/2018] [Indexed: 12/14/2022] Open
Abstract
Background Brazil has at least 800,000 HTLV-1 infected individuals. HTLV-1 can be transmitted via sexual intercourse, contact with blood and from mother to child, mainly by breastfeeding. Treatments for the high morbidity/mortality associated diseases (ATL and HAM/TSP) are limited, therefore, infection prevention is of utmost importance. However, antenatal screening is not routinely performed in Brazil. A lack of data regarding the number of individuals infected via breastfeeding impairs the development of government policies. The objective is to estimate the number of HTLV-1 infections occurring annually due to mother to child transmission (MTCT) in Brazil, nationally and regionally. Methodology To estimate HTLV-1 MTCT in Brazil the following variables are modelled: number of births, prevalence of HTLV-1 infection in pregnant women, breastfeeding duration rate and transmission risk according to breastfeeding period. The number of cases of HAM/TSP and ATL attributable to MTCT are also estimated. Principal findings In 2008, there were 2,934,828 live births in Brazil. HTLV prevalence in pregnant women in Brazil ranges between 0.1–1.05% by region. An estimated 16,548 HTLV-1 infected women are pregnant each year. According to the breastfeeding pattern and HTLV-1 prevalence of each region there are an estimated 3,024 new cases of HTLV-1 infection due to MTCT annually of which 2,610 are preventable through infant feeding advice. These 3,024 transmissions will result in 120–604 cases of ATL and 8–272 of HAM/TSP. North-East region comprises the high number of MTCT cases, followed by South-East. Conclusions/significance A high number of new HTLV-1 infections due to MTCT occur every year in Brazil. Antenatal screening and avoiding breastfeeding are essential to prevent subsequent development of HTLV-1-associated diseases. The human T-cell lymphotropic virus type 1 (HTLV-1) causes lifelong infection in humans. Although most infected individuals remain asymptomatic HTLV-1 causes severe disease in at least 5% of carriers. In the present study we estimate the number of HTLV-1 infections that occur annually due to mother to child transmission (MTCT) in Brazil and within its regions. The high number of estimated cases due to MTCT (3,024) which will give rise in adult life to HTLV-1associated diseases suggest the importance of performing HTLV-1 antenatal screening in Brazil to reduce the dissemination of this infection and to thus prevent a blood cancer to which most individuals succumb within 8 months of presentation and in others a disabling disease of the spinal cord.
Collapse
Affiliation(s)
- Carolina Rosadas
- Imperial College London, London, United Kingdom
- Universidade Estácio, Rio de Janeiro, Brazil
- * E-mail:
| | | | | | - Marzia Puccioni-Sohler
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Universidade Federal do Estado Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|