Linfoma gástrico primario de células T, no asociado a HTLV-1, con metástasis cutánea y neumoperitoneo / Non-HTLV-1-associated primary gastric T-cell lymphoma with cutaneous metastasis and pneumoperitoneum

Introducción: Los linfomas gástricos primarios representan menos del 5% de los linfomas no Hodgkin (LNH). La gran mayoría de linfomas gástricos primarios son linfomas de células B de alto grado. Los linfomas gástricos primarios de células T son muy raros y usualmente se asocian a infección por HTLV-1 en regiones endémicas. Material y método. Describimos el caso de una paciente mujer de mediana edad que se presentó con neumoperitoneo debido a ulcera gástrica perforada, síndrome consuntivo y lesiones cutáneas y orales. Resultados. La histopatología e inmunohistoquímica confirmaron linfoma gástrico primario de células T con compromiso cutáneo. La serología para HTLV-1, virus del Epstein-Barr y VIH fueron negativas. Conclusión. La finalidad de este reporte es dar a conocer esta forma de presentación sumamente rara de linfoma gástrico primario.

Background: Primary gastric lymphomas account for less than5%ofnon-Hodgkinlymphomas(NHL).Thevast majority of primary gastric lymphomas are high-grade B-cell lymphomas. Primary gastric T-cell lymphomas are very rare and are usually associated with HTLV-1 infection in endemic regions. We describe Material and methods.the case of a middle-aged female patient who presented with pneumoperitoneum due to a perforated gastric ulcer, wasting syndrome, and skin and oral lesions. . Results: Histopathology and immunohistochemistry confirmed primary gastric T-cell lymphoma with skin involvement. The serologyfor HTLV-1,Epstein-Barr virus and HIVwere negative. The aim of this report is to present Conclusion: this extremely rare presentation of primary gastric lymphoma

Prevalencia de marcadores infecciosos y factores asociados en donantes de un banco de sangre peruano / Prevalence of infection markers and associated factors in donors of a peruvian blood bank

RESUMEN Se buscó determinar la prevalencia de marcadores infecciosos en donantes de un banco de sangre en Perú y valorar si las variables sociodemográficas del donante se asocian con la presencia de estos marcadores. Se realizó un estudio transversal analítico en 5942 donantes de un banco de sangre durante el 2018. Se determinó la positividad a inmunodeficiencia humana (VIH), hepatitis B (VHB), hepatitis C (VHC) y HTLV I-II; además de sífilis y enfermedad de Chagas. La prevalencia de VIH fue 0,81%, VHB 6,19%, VHC 0,12%, HTLV I-II 0,66%, enfermedad de Chagas 2,76% y sífilis 1,73%. Diversos factores sociodemográficos se asociaron con la positividad de marcadores infecciosos. El tipo de donación predominante fue no voluntaria (96%) y el 53% presentó historia de donación previa. Las prevalencias de marcadores infecciosos de VIH, VHB, enfermedad de Chagas y sífilis en los donantes de sangre fueron altas comparadas con otros países de la región.

ABSTRACT We aimed to determine the prevalence of infection markers in donors of a Peruvian blood bank and to assess whether donor sociodemographic variables are associated with the presence of these markers. An analytical cross-sectional study was carried out in 5942 donors of a blood bank, whose data was collected during 2018. Positivity to human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and HTLV I-II was determined, in addition to syphilis and Chagas disease. The prevalence of HIV was 0.81%; for HBV it was 6.19%; for HCV, 0.12%; for HTLV I-II, 0.66%; for Chagas disease, 2.76% and for syphilis it was 1.73%. Several sociodemographic factors were associated with infection markers positivity. The predominant donation type was non-voluntary (96%) and 53% had history of previous donation. The prevalence of infection markers for HIV, HBV, Chagas disease and syphilis in blood donors was high compared to other countries in the region.

Metaanálisis de la validez del inmunodiagnóstico del virus linfotrópico de células T humanas i/ii en bancos de sangre, 2000-2018 / Meta-analysis regarding the validity of the immunodiagnosis of human T-cell lymphotropic virus I/II in blood banks, 2000-2018 / Meta-análise da validade do imunodiagnóstico do vírus linfotrópico de células t humanas I/II em bancos de sangue, 2000-2018

Resumen Objetivo: Evaluar la validez del inmunodiagnóstico del htlv i/ii en bancos de sangre, con base en estudios publicados en la literatura científica. Metodología: Se efectuó un metaanálisis de pruebas diagnósticas siguiendo la guía prisma y las recomendaciones de Cochrane. Se evaluó la calidad metodológica con quadas y se garantizó la reproducibilidad y la exhaustividad. Se realizó también un análisis de efectos aleatorios para la sensibilidad, la especificidad, los cocientes de probabilidad, la razón de momios diagnóstica y la curva característica operativa del receptor (roc) con sus intervalos de confianza (ic) del 95 %. Resultados: Se tamizaron 4604 estudios, de los cuales solo tres cumplieron el protocolo. Se evaluaron 548 infectados con htlv i/ii y 6643 sanos. El inmunodiagnóstico de htlv i/ii presentó una sensibilidad del 99 % (ic95 % = 98,0-99,0), especificidad del 100 % (ic95 % = 99,9-100), cocientes de probabilidad positivo de 315,8 (ic95 % = 128,2-778,5) y negativo de 0,02 (ic95 % = 0,01-0,04), razón de momios diagnóstica de 24373 (ic95 % = 6864-86545) y área bajo la curva roc del 99,9 %. Conclusión: Se dispone de pocos estudios en este campo del inmunodiagnóstico htlv i/ii. El elevado número de sujetos analizados evidenció alta validez del inmunodiagnóstico, lo que resulta determinante para garantizar la inocuidad de las unidades de sangre, la detección de portadores asintomáticos, la disminución de la transmisión y el inicio de tratamiento.

Abstract Objective: To evaluate the validity of the immunodiagnosis of htlv i/ii in blood banks, based on studies published in the scientific literature. Methodology: A meta-analysis of diagnostic tests was carried out following the PRISMA guidelines and Cochrane recommendations. The methodological quality was evaluated with QUADAS, and reproducibility and completeness were guaranteed. A random effects analysis was also performed with respect to sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and receiver operating characteristic curve (ROC) with their 95 % confidence intervals (CI). Results: 4,604 studies were screened, of which only three complied with the protocol. 548 subjects infected with HTLV I/II and 6,643 healthy subjects were evaluated. The immunodiagnosis of HTLV I/II had a sensitivity of 99 % (95 % CI = 98.0-99.0), a specificity of 100 % (95 % CI = 99.9-100), a positive likelihood ratio of 315.8 (95 % CI = 128.2-778.5) and a negative likelihood ratio of 0.02 (95 % CI = 0.01-0.04), a diagnostic odds ratio of 24,373 (95 % CI = 6,864-86,545), and an area under the ROC curve of 99.9 %. Conclusion: Few studies are available in the field of HTLV I/II immunodiagnosis. The high number of subjects analyzed showed high validity of the immunodiagnosis, which is decisive to guarantee the safety of the blood units, the detection of asymptomatic carriers, the decrease in transmission, and the start of treatment.

Resumo Objetivo: Avaliar a validade do imunodiagnóstico do HTLV I/II nos bancos de sangue, baseados nos estudos publicados na literatura científica. Metodologia: Foi realizada uma meta-análise de testes diagnósticos seguindo a guia PRISMA e as recomendações de Cochrane. Foi avaliada a qualidade metodológica com QUADAS e garantiu-se a reprodutibilidade e a integridade. Realizou-se também uma análise de efeitos aleatórios para a sensibilidade, a especificidade, os quocientes de probabilidade, a razão de probabilidade diagnóstica e a Curva Característica de Operação do Receptor (Curva ROC) com seus Intervalos de Confiança (IC) de 95%. Resultados: Foram selecionados 4604 estudos, dos quais somente 3 cumpriram com o protocolo. Foram avaliados 548 infectados com o vírus HTLV I/II e 6.643 saudáveis. O imunodiagnóstico de HTLV I/II apresentou uma sensibilidade de 99% (IC95% = 98,0-99,0), especificidade de 100% (IC95%= 99,9-100), quocientes de probalidade positiva de 315,8 (IC95% = 128,2-778,5) e negativo de 0,02 (IC95% = 0,01-0,04), razão de probabilidade diagnóstica de 24373 (IC95% = 6864-86545) e área sob a curva ROC de 99,9%. Conclusão: São poucos os estudos disponíveis neste campo do imunodiagnóstico HTLV I/II. O elevado número de pessoas analisadas evidenciou alta validade do imunodiagnóstico, o que é decisivo para garantir a inocuidade das unidades de sangue, a detecção de portadores assintomáticos, a diminuição da transmissão e o início do tratamento.

Percepção subjetiva de esforço e recuperação da fadiga pós-sessão fisioterapêutica em pacientes com paraparesia espástica tropical / Subjective effort perception and fatigue recovery after physical therapy session in patients with tropical spastic paraparesis

Introdução: Vírus Linfotrópico de Células T Humana do Tipo-1 (HTLV-1) é um retrovírus que afeta os linfócitos T humano e desencadeia inflamação na medula, levando à paraparesia espástica tropical/mielopatia associada ao HTLV-1 (PET/MAH) com prejuízos funcionais. Tais disfunções podem influenciar nos efeitos da fisioterapia, gerando diferentes níveis de fadiga. Objetivo: Avaliar a percepção subjetiva de esforço e de recuperação de indivíduos com PET/MAH após sessão única de fisioterapia. Métodos: Incluíram-se 12 participantes sintomáticos para PET/MAH, de ambos os sexos, que foram submetidos uma vez ao protocolo fisioterapêutico. Os instrumentos avaliativos foram: Escala Modificada de Borg, Escala de Percepção Subjetiva de Recuperação (1º, 5º e 10º minuto após a sessão) e Escala de Incapacidade Neurológica do Instituto de Pesquisa Clínica Evandro Chagas ­ 2 (EIPEC). Resultados: Encontrou-se correlação moderada entre idade e taxa de percepção subjetiva de recuperação ao 1º (r = - 0,4923) e 5º (r = - 0,4913) minuto e entre índice do EIPEC-2 e taxa de percepção subjetiva de recuperação ao 1º (r = 0,3592) e 5º (r = - 0,3772) minuto. Conclusão: Indivíduos deste estudo com maior idade e grau de incapacidade neurológica têm menor percepção subjetiva de recuperação. (AU)

Introduction: Human T-Cell Lymphotropic Virus Type-1 (HTLV-1) is a retrovirus that affects human T lymphocytes and triggers inflammation in the spinal cord, leading to tropical spastic paraparesis / HTLV-1 associated myelopathy (TSP/HAM) with functional impairments. Such dysfunctions can influence the effects of physical therapy, generating different levels of fatigue. Objective: To evaluate the subjective perception of effort and recovery of individuals with TSP/HAM after a single session of physical therapy. Methods: 12 symptomatic participants for TSP/HAM, of both sexes, who were submitted once to a physiotherapeutic protocol were included. The evaluative instruments were: Modified Borg Scale, Scale of Subjective Perception of Recovery (1st, 5th and 10th minute after the session) and Scale of Neurological Disability at the Evandro Chagas Clinical Research Institute - 2 (EIPEC). Results: A moderate correlation was found between age and subjective perception rate of recovery at the 1st (r = - 0.4923) and 5th (r = - 0.4913) minute and between the EIPEC-2 index and the subjective perception rate of recovery at the 1st (r = 0.3592) and 5th (r = - 0.3772) minute. Conclusion: Individuals in this study with older age and degree of neurological disability have less subjective perception of recovery. (AU)

Paraparesia espástica tropical y atrofia cerebelosa / Tropical spastic paraparesis and cerebelar atrophy

Resumen Antecedentes: El virus linfotrópico T tipo I (HTLV-I) origina la paraparesia espástica tropical (PET) en el 3% de los infectados, afectando predominante mujeres. Excepcionalmente la PET puede asociar un síndrome vestibular central y atrofia cerebelosa. Propósito: Presentar un nuevo y excepcional caso de paraparesia espástica y atrofia cerebelosa. Sugerir una interpretación patogénica del predominio femenino en esta patología Paciente: Mujer de 20 años de talla baja y menuda, infectada con HTLV-I durante la lactancia. Aproximadamente a los 15 años inició un síndrome ataxo-espástico progresivo, con grave alteración de la marcha, posteriormente agregó daño cognitivo y atrofia cerebelosa en la RM. Se constató a su ingreso una elevada carga viral y altos niveles de proteína Tax. Fue tratada con 4 mg betametasona diarios durante 10 días, que mejoraron la marcha. Conclusión: La PET es una axonopatía de la vía motora central, originada por la crónica perturbación del transporte axoplásmico, atribuible a la presencia de elevados niveles de la proteína Tax del virus. Circunstancialmente este aumento de Tax logra dañar axones del centro oval (deterioro cognitivo) o del vermis cerebeloso (síndrome vestibular central). La PET afecta mayoritariamente a mujeres 3:1, prevalencia que hace aparecer a las mujeres con una mayor vulnerabilidad en su SNC. Sin embargo, esta aparente minusvalía, sería debida a un aumento en la concentración de Tax en el SNC de ellas, causado por la adversa relación entre peso corporal y cantidad absoluta de Tax, que fue evidente en nuestra paciente, quien dio la clave para esta hipótesis.

Background: Lymphotropic Virus Type I (HTLV-I) causes Tropical Spastic Paraparesis (PET) in 3% of infected patients; in whom have been described exceptionally associated a central vestibular syndrome and cerebellar atrophy. Those alterations of CNS are predominating in women. Purpose: To present a new case of the exceptional form of spastic paraparesis and cerebellar atrophy. To suggest a pathogenic interpretation of female predominance in this pathology Patient: A 20-year-old woman of small size, infected with HTLV-I during lactation. Approximately at 15 years of age he started a progressive ataxo-spastic syndrome, later cognitive damage and cerebellar atrophy were added. Upon admission, high viral load and high levels of Tax protein, leukemoid lymphocytes and Sicca syndrome were observed. Conclusion: PET is an axonopathy of the central motor pathway, originated by a chronic disturbance of axoplasmic transport, attributable to the action of elevated levels of Tax protein in the CNS. In addition axons of the oval center (cognitive impairment) or the cerebellar vermis (central vestibular syndrome) are occasionally damaged. Although PET mainly affects 3: 1 women, this prevalence increases in accordance with the increase of neurological damage. The apparent greater vulnerability of the CNS in women would be due to the higher concentration of Tax in the CNS of them, originated in the adverse relationship between body weight and absolute amount of Tax, which was evident in our patient, who gave the key to this hypothesis.

Depression and anxiety disorders among patients with human T-cell lymphotropic virus type-1: a cross-sectional study with a comparison group

Abstract INTRODUCTION: Studies have linked human T-cell lymphotropic virus type-1 (HTLV-1) to psychiatric disease. METHODS: Patients with HTLV-1 were compared to patients seen by family doctors using a semi-structured questionnaire and the Hospital Anxiety and Depression Scale. RESULTS: Participants with (n=58) and without (n=340) HTLV were compared. Anxiety and depression were associated with greater age, being a woman, spastic paraparesis (depression: PR=4.50, 95% CI: 3.10-6.53; anxiety: PR=2.96, 95% CI: 2.08-4.21), and asymptomatic HTLV (depression: PR=4.34, 95% CI: 3.02-6.24; anxiety: PR=2.81, 95% CI: 2.06-3.85). CONCLUSIONS: Symptomatic and asymptomatic patients with HTLV-1 experienced more anxiety and depression than uninfected patients.

Impacto da infecção por HTLV-1 nas manifestações clínicas e no tratamento de pacientes com estrongiloidíase / Impact of HTLV-1 infection on clinical presentations and treatment of strongyloidiasis patients

A estrongiloidíase é uma enfermidade que acomete cerca de 100 milhões de pessoas em todo mundo. Essa parasitose apresenta alta prevalência e tem maior gravidade clínica entre indivíduos imunossuprimidos, principalmente aqueles portadores do vírus linfotrópico de células T humana tipo 1 (HTLV). Este fato torna a coinfecção por esse vírus em pacientes parasitados por Strongyloides stercoralis um grave problema de saúde pública. O presente estudo teve por objetivo revisar os estudos sobre coinfecção por HTLV/S. stercoralis. Foi realizada busca eletrônica completa de dados disponíveis sobre a coinfecção entre o vírus e S. stercoralis. As publicações foram capturadas a partir das bases de dados PubMed e SciELO, sendo utilizados os seguintes descritores "vírus linfotrópico de células T humanas tipo 1", "HTLV-1", "S. stercoralis" e "estrongiloidiase". A infecção por HTLV em pacientes parasitados representa fator de risco para o desenvolvimento de estrongiloidíase grave e, nesses indivíduos, o tratamento recomendado deve ser realizado e monitorado para garantir o sucesso terapêutico.(AU)

Strongyloidiasis is a disease that affects approximately 100 million people worldwide. This parasitosis is highly prevalent and more clinically severe among immunosuppressed individuals, particularly those with Human T-lymphotropic virus 1 (HTLV-1). This fact makes the co-infection with this virus in patients parasitized by Strongyloides stercoralis a serious public health problem. The present study aimed at reviewing the studies of co-infection with HTLV/S. stercoralis. A complete electronic search for available data about the co-infection of the virusand S. stercoralis was performed. The publications were obtained from the databases PubMed and SciELO, with the following descriptors being used: "Human T-lymphotropic Virus type 1, "HTLV-1", S. stercoralis, and "strongyloidiasis". The infection with HTLV in infected patients is a risk factor for the development of severe strongyloidiasis, and for these individuals the recommended treatment should be performed and monitored to ensure therapeutic success.(AU)

Infección por el virus linfotrópico humano de células T tipo 1 (HTLV-1) y paraparesia espástica. Avances y diagnóstico 35 años después de su descubrimiento / Human T-lymphotropic virus type 1 (HTLV-1) infection and spastic paraparesis. Advances and diagnosis 35 years after its Discovery / Infecção pelo vírus linfotrópico humano de células T tipo 1 (HTLV-1) e paraparesia espástica. Avanços e diagnóstico depois de 35 anos do seu descobrimento

RESUMEN El virus linfotrópico humano tipo 1 (HTLV-1) genera trastornos como la mielopatía inflamatoria crónica y progresiva conocida como mielopatía asociada al HTLV-1 (MAH), caracterizada por un cuadro clínico de paraparesia espástica. Inicialmente, el virus fue reportado en zonas tropicales y actualmente está presente en diferentes regiones del mundo. El HTLV-1 se puede transmitir tanto horizontal como verticalmente y permanecer latente en los pacientes; se calcula que de 1 % a 5 % de los infectados desarrollan leucemia/linfoma de células T en el adulto (LTA) y de 3 % a 5 %, MAH. Esta revisión, por medio de la búsqueda sistemática en bases de datos, es una compilación de la información más sobresaliente acerca de este retrovirus y la paraparesia espástica, aporta al conocimiento básico de la enfermedad, difunde un problema de salud poco conocido y genera la necesidad de hacer un diagnóstico temprano a fin de intervenir en la cadena de transmisión del virus y evitar su propagación silenciosa en la población.

SUMMARY Human T-lymphotropic virus type 1 (HTLV-1) causes disorders such as chronic inflammatory progressive myelopathy, which is known as HTLV-1associated myelopathy (MAH), characterized by spastic paraparesis symptoms. Originally, the virus was reported in tropical zones and is currently distributed in different regions of the world. HTLV-1 can be transmitted both horizontally and vertically, and remains latent in patients; between 1 % and 5 % of those infected develop adult T cell leukemia/lymphoma (LTA) and 3 % to 5 %, MAH. This review, carried out through systematic search of databases, compiles the most outstanding information about this retrovirus and the spastic paraparesis, provides basic knowledge on the disease, illustrates on an unknown health problem and creates the need for early diagnosis in order to stop the chain of viral infection and prevent its silent propagation among the population.

RESUMO O vírus linfotrópico humano tipo 1 (HTLV-1) gera transtornos como a mielopatia inflamatória crônica e progressiva conhecida como mielopatia associada ao HTLV-1 (MAH), caracterizada por um quadro clínico de paraparesia espástica. Inicialmente, o vírus foi reportado em zonas tropicais e atualmente está presente em diferentes regiões do mundo. O HTLV-1 se pode transmitir tanto horizontal como verticalmente e permanecer latente nos pacientes; calculase que de 1% a 5% dos infectados desenvolvem leucemia/linfoma de células T no adulto (LTA) e de 3% a 5%, MAH. Esta revisão, por meio da pesquisa sistemática em bases de dados, é uma compilação da informação mais sobressalente sobre este retrovírus e a paraparesia espástica, aporta ao conhecimento básico da doença, difunde um problema de saúde pouco conhecido e gera a necessidade de fazer um diagnóstico precoce com o fim de intervir na cadeia de transmissão do vírus e evitar a sua propagação silenciosa na população.

Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon

ABSTRACT Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical-spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females, median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males, median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6 years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts, protein and glucose were measured, the Osame’s motor-disability-score/OMDS was determined, and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain-MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8: 9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers (4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min. 2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin measurement as a potential biomarker of disease activity.

Seroprevalencia del virus linfotrópico humano de tipos I y II en donantes del Banco de Sangre de la Fundación Valle del Lili, Cali, Colombia, 2008-2014 / Seroprevalence of human T-lymphotropic virus in blood bank donors at Fundación Valle del Lili, Cali, Colombia, 2008-2014

Introducción. El virus linfotrópico humano (HTLV) de tipos I y II es un retrovirus prevalente en la Costa Pacífica colombiana que puede transmitirse por transfusiones de sangre. En el 2014 se reglamentó la tamización para bancos de sangre con el fin de reducir la transmisión por medio de la donación. La información sobre la seroprevalencia del virus en el suroccidente colombiano es limitada. Objetivo. Determinar la seroprevalencia, el comportamiento a lo largo del tiempo de los resultados reactivos antes y después de la introducción del inmunoensayo Western blot y la concomitancia del HTLV con otros marcadores de infección en donantes de un banco de sangre de Cali, Colombia. Materiales y métodos. Se hizo un estudio trasversal de 77.117 donantes del Banco de Sangre de la Fundación Valle del Lili mediante el análisis de los registros de donantes con prueba reactiva para anticuerpos IgG anti HTLV I-II entre enero de 2008 y diciembre de 2014. Resultados. La seroprevalencia acumulada fue de 0,24 %. Los resultados reactivos fueron más frecuentes en mujeres (61 %) y la mediana de edad fue de 37 años. La seroprevalencia en los años previos a la introducción del Western blot fue de 0,13, 0,19, 0,31 y 0,32 % (2008-2012), y posteriormente fue de 0,18, 0,08 y 0,07 % (2012-2014). La reacción positiva concomitante con otros marcadores de infección fue de 11 %: sífilis (57 %), HIV (19 %), hepatitis B (14 %) y hepatitis C (9 %). La mayor seroprevalencia (0,38 %) se registró en el 2012. Conclusión. Se encontró una alta prevalencia de pruebas reactivas para el HTLV I-II en comparación con otros estudios. Los resultados de este estudio son un punto de partida para el desarrollo de estudios poblacionales.

Introduction: Human lymphotropic virus (HTLV I/II) is a retrovirus that is prevalent across the Colombian Pacific coast, and is potentially transmissible by transfusion. Blood bank screening has been regulated since 2004, in order to reduce transmission of HTLV I/II through donation. Information on the seroprevalence of the virus in southwestern Colombia is limited. Objective: To determine the seroprevalence and the behavior of reactivity to HTLV I/II before and after the introduction of Western blot, and the comorbidity of HTLV and other infectious markers in donors from a blood bank in Cali, Colombia. Materials and methods: We conducted a cross-sectional study of 77,117 blood bank donors from the Fundación Valle del Lili by analyzing records of donors who had been tested with the reactive test for anti-HTLV I-II antibodies (IgG) between January, 2008, and December, 2014. Results: The cumulative seroprevalence during the study period was 0.24% (186/77,119). Reactivity was more common in women (61%), and the median age was 37 years (IQR: 24-48). The seroprevalence in the years before the introduction of Western blot was 0.13%, 0.19%, 0.31%, 0.32% and 0.18% (2008-2012), and thereafter it was 0.08% and 0.07% (2012-2014). Concomitant reactivity with other infectious markers was 11%: syphilis (57%), followed by HIV (19%), hepatitis B (14%) and hepatitis C (9%). The highest seroprevalence (0.38%) was reported in 2012. Conclusion: We found a high prevalence of reactivity to HTLV I-II compared to that reported in other studies. The results of this study are a starting point for the development of population studies.

Prevalencia de enteroparasitos en individuos seropositivos y seronegativos a los virus HTLV-I/II

Para determinar la prevalencia de enteroparásitos en individuos seropositivos a los virus HTLV-I/II, se seleccionaron aleatoriamente 75 donantes que asistieron a los Bancos de Sangre de dos instituciones sanitarias del municipio Maracaibo, Venezuela. Se contactaron personalmente 50 individuos seropositivos a virus HTLV-I/II (grupo muestra) y 25 seronegativos (grupo control), quienes aportaron una muestra fecal para diagnóstico parasitológico. Estas fueron sometidas al examen al fresco con solución salina fisiológica (SSF) al 0,85%, tinción temporal de Lugol y técnica de concentración con formol-éter (Ritchie). Además se realizó cultivo en Agar Nutritivo (método de Arakaki) para investigar la presencia de larvas de Strongyloides stercoralis. Se determinó una prevalencia general de enteroparásitos en el grupo muestra de 54% y 44% en el grupo control. Predominó el monoparasitismo entre todos los individuos estudiados. Las especies identificadas fueron: Blastocystis spp. 47,3% y 15,4%, Entamoeba coli 21% y 15,4%, Endolimax nana 13% y 53,8%, Complejo Entamoeba 10,5% y 15,4%, Giardia intestinalis 5,2% y 0%, y Entamoeba hartmanni 2,6% y 0% en el grupo muestra y grupo control, respectivamente. No se detectó Strongyloides stercoralis ni otros helmintos intestinales, en los individuos estudiados. Blastocystis spp. fue el más frecuente en los pacientes seropositivos (diferencia estadísticamente significativa) que en el grupo control, lo que pudiese relacionarse con una mayor persistencia de este cromista en pacientes coinfectados con HTLV-I/II. Se puede concluir que el estatus serológico del individuo HTLV-I/II positivo parece no influir en la presencia o adquisición de parásitos intestinales.

Prevalence of intestinal parasites in seropositive and seronegative to HTLV I/II viruses

The prevalence of intestinal parasites in individuals seropositive for the HTLV-I/II virus was studied. A total of 75 donors who attended the blood banks of two health institutions in Maracaibo, Venezuela were randomly selected: 50 patients seropositive for HTLV-I/II (study group) and 25 seronegative individuals (control group). The participants in the study were all contacted personally, after which they provided a fecal sample for parasitological diagnosis. The fresh samples were examined using 0.85% physiological saline solution (PSS), Lugol’s solution for temporary staining and the formalin-ether concentration technique (Ritchie). In addition, samples were cultured on nutrient agar (Arakaki method) to determine the presence of Strongyloides stercoralis larvae. Overall prevalences of 54% intestinal parasites in the study group and 44% in the control group were found. Monoparasitism prevailed among all the individuals studied. The species identified in the study and control groups were: Blastocystis spp. 47.3% and 15.4%, Entamoeba coli 21% and 15.4%, Endolimax nana 13.0% and 53.8%, Entamoeba complex 10.5% and 15.4%, Giardia intestinalis 5.2% and 0%, and Entamoeba hartmanni 2.6% and 0 %, respectively. Strongyloides stercoralis and other intestinal helminths were not detected in the individuals studied. Blastocystis spp. was significantly more common in seropositive patients than in the control group, which could be associated with a greater persistence of this chromista in patients co-infected with HTLV-I / II.It can be concluded that the positive serological status of HTLV-I / II infected individuals does not seem to influence either the presence or acquisition of intestinal parasites.

Evaluación del desempeño del sistema inmunoenzimático de diagnóstico DAVIH-HTLV-I, para la detección de anticuerpos contra el Virus Linfotrópico de células T humanas tipo 1 (HTLV-I) / Evaluation of the performance of the immunoenzymatic diagnostic system DAVIH-HTLV-I for detection of antibodies against the human T-cell lymphotropic virus type 1 (HTLV-I)

Introducción: el virus linfotrópico de las células T humanas tipo I (HTLV-I), es el agente causal de la leucemia /linfoma de células T del adulto (LLTA). Resultados hallados en estudios de pesquisa para el HTLV-I en nuestro país demuestran sin lugar a dudas la presencia del mismo en nuestra población. El DAVIH-HTLV-I es un sistema microelisa para la detección de anticuerpos contra el HTLV-I en suero o plasma humano, producido por Laboratorios DAVIH. El objetivo de este trabajo fue evaluar el desempeño del sistema DAVIH-HTLV-I con vistas a su inscripción en el Registro de Diagnosticadores, del Centro para el Control Estatal de la Calidad de los Medicamentos (CECMED), exigencia indispensable para su uso en nuestro país. Métodos: se emplearon cuatro paneles de muestras en los estudios de: especificidad, sensibilidad, eficacia, concordancia con el sistema de referencia Vironostika HTLV-I/II (Biomeriéux), precisión a dos niveles: repetibilidad (intraensayos) y precisión intermedia (inter ensayos), y robustez. Resultados: la evaluación mostró los siguientes resultados: especificidad 99,84 por ciento; sensibilidad 96,49 por ciento; concordancia 96,55 por ciento, límite de detección correspondiente a una dilución de 1/256; elevada precisión intra e interensayos (CV menores que el 15 por ciento y el 20 por ciento respectivamente); sistema robusto frente a los cambios de temperatura entre 36 y 38 °C. Conclusiones: los resultados obtenidos demostraron que el sistema DAVIH-HTLV-I se puede emplear en el pesquisaje de anticuerpos contra el HTLV-I en la población cubana, por lo que se recomendó su registro en el CECMED(AU)

Introduction: The human T-cell lymphotropic virus type 1 (HTLV-I) is the causal agent of adult T-cell leukemia / lymphoma (ATLL). Screening for HTLV-I in our country has revealed its unquestionable presence in the population. DAVIH-HTLV-I is a micro-ELISA system produced by DAVIH Laboratories for detection of antibodies against HTLV-I in human serum or plasma. Objective: Evaluate the performance of the DAVIH-HTLV-I system with a view to registration in the Registry of Diagnostic Media Products of the Center for State Control of the Quality of Drugs (CECMED), an indispensable requirement for its use in our country. Methods: Four sample panels were used to study the following variables: specificity, sensitivity, efficacy, concordance with the reference system Vironostika HTLV-I/II (Biomeriéux), accuracy on two levels: repeatability (intra-assay) and intermediate accuracy (inter-assay), and robustness. Results: The following results were obtained: specificity 99.84 percent; sensitivity 96.49 percent concordance 96.55 percent; detection limit for a 1/256 dilution; high intra- and inter-assay accuracy (CV below 15 percent and 20 percent, respectively); a robust system when faced with temperature changes between 36°C and 38°C. Conclusions: Results show that the DAVIH-HTLV-I system may be used for the screening of antibodies against HTLV-I in the Cuban population. It was therefore recommended for registration with CECMED(AU)

Concentrações plasmáticas de citocinas e quimiocinas na infecção pelo HTLV-1 / Plasma concentrations of cytokines and chemokines in HTLV-1

INTRODUÇÃO: O vírus linfotrópico das células T humano tipo 1 (HTLV-1) é endêmico na Bahia e está associado com doenças graves, como a Paraparesia Espástica Tropical/Mielopatia associada ao HTLV-1 (HAM/TSP) e a Dermatite Infecciosa associada ao HTLV-1 (DIH). Escassos trabalhos tem sido reportados com a avaliação de citocinas e quimiocinas em indivíduos jovens infectados pelo HTLV-1 e não existem dados sobre a manifestação simultânea DIH e HAM/TSP na faixa infanto-juvenil. OBJETIVO: Avaliar as concentrações plasmáticas de citocinas e quimiocinas na infecção pelo HTLV-1 em indivíduos infanto-juvenis. MÉTODO: Foram incluídos 61 indivíduos portadores do HTLV-1 distribuídos nos grupos Portadores assintomáticos, pacientes com a DIH, pacientes com DIH/HAM/TSP, pacientes com a HAM/TSP e 20 indivíduos saudáveis sem a infecção pelo HTLV-1, todos na faixa infanto-juvenil. As concentrações plasmáticas foram comparadas através do método de Elisa e de Cytometric Bead Array (CBA)...

INTRODUCTION: The lymphotropic virus of cells T human type 1 (HTLV ) is endemic in Bahia and it is associated with serious diseases such as Tropical Spastic Paraparesis/associated myelopathy with HTLV-1 and Infectious Dermatitis associated with HTLV -1 (IDH). Very little work has been reported with the evaluation of cytokines and chemokines in the IDH and there has been no data on the manifestation simultaneous IDH and HAM/TSP in children and youth range. OBJECTIVE: To evaluate the plasma concentrations of cytokines and chemokines in HTLV-1 infection in children and young individuals. METHOD: We included 61 individuals HTLV-1 spread in groups Asymptomatic Carriers, patients with IDH, patients with IDH/HAM/TSP, patients with HAM/TSP and 20 healthy individuals without HTLV-1, all in children's range. Plasma concentrations were compared using the ELISA method and Cytometric Bead Array (CBA)...

Prevalence of HCV Infection in Hemodialysis Patients of South Khorasan in Comparison With HBV, HDV, HTLV I/II, And HIV Infection.

Background and objective: This study was performed to evaluate the prevalence of Hepatitis C virus (HCV) infection as well as HBV, HDV, HTLV I/II, and HIV infection in hemodialysis patients in our district. Methods: The subjects of this study involved 41 hemodialysis patients admitted to hemodialysis ward, Vali- Asr hospital. HBV, HDV, HIV, and HTLV1/2 infections were evaluated by enzyme-linked immunosorbent assay (ELISA) technique. Serum anti- HCV anti-body was measured using the 3rd generation of ELISA kit. HCV Viremia was evaluated in all patients using RT-PCR technique. Results: HCV infection was not observed in none of patients by ELISA technique; however RT-PCR technique demonstrated HCV viremia in one (2.43%) patient. HBsAg was detected in 4(9.75%) patients, and one (2.43%) was Anti HTLV 1/2 positive; none of patients were HDV or HIV positive. Conclusion: HCV infection is less common than HBV infection in our patients. ELISA technique can not demonstrate all hemodialysis patients with HCV infection, For this reason it is requirement to evaluate this group of patients for HCV infection using RT-PC technique.

Proprioceptive neuromuscular facilitation in HTLV-I-associated myelopathy/tropical spastic paraparesis

Introduction: Human T cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) can impact the independence and motricity of patients. The aims of this study were to estimate the effects of physiotherapy on the functionality of patients with HAM/TSP during the stable phase of the disease using proprioceptive neuromuscular facilitation (PNF) and to compare two methods of treatment delivery. Methods: Fourteen patients with human T cell lymphotropic virus type I (HTLV-I) were randomly allocated into two groups. In group I (seven patients), PNF was applied by the therapist, facilitating the functional activities of rolling, sitting and standing, walking and climbing and descending stairs. In group II (seven patients), PNF was self-administered using an elastic tube, and the same activities were facilitated. Experiments were conducted for 1h twice per week for 12 weeks. Low-back pain, a modified Ashworth scale, the functional independence measure (FIM) and the timed up and go test (TUG) were assessed before and after the interventions. Results: In the within-group evaluation, low-back pain was significantly reduced in both groups, the FIM improved in group II, and the results of the TUG improved in group I. In the inter-group analysis, only the tone was lower in group II than in group I. Conclusions: Both PNF protocols were effective in treating patients with HAM/TSP. .

Efeito inibitório de quinolinas e fisalina f em células de indivíduos infectados pelo HTLV-1 / Inhibitory effect of quinolones and physalin f in cells from individuals infected with HTLV-1

A proliferação espontânea de linfócitos é um marcador da infecção pelo Vírus Linfotrópico de Célula T Humana do tipo 1 (HTL V -l)o Esta é mais elevada em pacientes com paraparesia espástica tropical/mielopatia associada ao HTL V (HAMJTSP) que em indivíduos assintomáticos. Embora o seu papel na patogênese da HAM/TSP ainda seja desconhecido, a identificação de drogas capazes de modular a proliferação espontânea pode ser relevante para o tratamento da HAM/TSP. Neste estudo nós avaliamos os efeitos dos derivados quinoIínicos BS373, Ql e Q2 e da fisalina F em culturas de células mononucleares do sangue periférico (PBMC) de indivíduos infectados pelo HTL V com HAM/TSP. Estes compostos inibiram, ex vivo, a proliferação espontânea em culturas de PBMC, conforme avaliado pela incorporação de 3H-timidina. Além disso, a produção espontânea, ex vivo, de citocinas inflamatórias foi significativamente inibida pelo composto BS373 (25 j.tM) e pela tlsahna F (10 j.tM). A expressão da proteína viral Tax foi reduzida cerca de 80% após incubação de PBMC com BS373 (25 uM). BS373 e fisalina F induziram um aumento na porcentagem de células em apoptose, como demonstrado por análise da marcação do PBMC com anexina V por citometri~ de fluxo. A análise ultraestrutural de células cultivadas na presença destes compostos mostrou vacúolos apresentando membranas de mielina, que se assemelham a compartimentos autofágicos. Em conclusão, as quinolinas e a fisalina F foram capaz de inibir a proliferação espontânea de células de indivíduos infectados pelo HTL V-I. Outros estudos são necessários para compreendermos os mecanismos pelos quais estes compostos agem no PBMC de indivíduos infectados pelo HTL V-I.

Spontaneous lymphocyte proliferation, a hallmark ofHuman- T Lymphocyte Virus Type 1 (HTL V -1) infection, is particular1y high in HTL V -associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients compared to asymptomatic carriers. Although its role in the pathogenesis of HAM/TSP is stiH unknown, the identification of drugs capable of modulating the spontaneous proliferation may be reievant for the treatment ofHAM/TSP. Here we evaluated the effects ofthe quinoline derivative BS373, Q1 and Q2 and physalin F in cultures of peripheral blood mononuclear ceHs (PBMC) obtained from HTL V-infected subjects with HAM/TSP. Compounds inhibited of spontaneous proliferation in PBMC cultures, as assessed by 3H-thymidine incorporation. Additionally, the spontaneous production of inflammatory cytokines by PBMC was significantly inhibited by BS373 (25 flM) and physalin F (10 flM). The expression of the viral transcription factor Tax was reduced about 80% after incubation of PBMC with 8S373 (25 I-tM). BS373 and physalin F induced an increase in the percentage of apoptotic cells, as shown by flow cytometry analysis of annexin V-stained PBMC. Ultrastructural analysis of cultured cells in the presence of compounds showed vacuoles presented with myelin-like membranes, resembling autophagic vacuole-like compartments. In conc1usion, quinolines and physalin F was able to inhibit the spontaneous proliferation of cells from HTL V -l-infected individuaIs. Further studies are required to understand the mechanisms by which the compounds affect HTL V -1 PBMC.

Transmissão do HTLV-1/2 em grupos familiares: possíveis vias de contaminação / HTLV-1/2 transmission in family groups: possible routes of contamination

Introdução: portador assintomático do vírus linfotrópico de células T humanas (HTLV), sem conhecimento de sua positividade, pode transmiti-lo para seus contatos sexuais e familiares. Objetivo: determinar as rotas de transmissão do HTLV dentro dos grupos familiares da coorte Grupo Interdisciplinar de pesquisa em HTLV (GIPH), Belo Horizonte, Brasil. Métodos: a população do estudo foi formada por indivíduos do sexo feminino, que eram ex-doadoras de sangue com sorologia alterada para HTLV tipo 1 ou 2, detectada após doação de sangue em um hemocentro público (Hemominas) e por seus familiares. A partir dos resultados dos testes sorológicos, foram elaborados heredogramas dos grupos familiares. Em seguida, foram inferidas as possíveis rotas de transmissão do vírus dentro de cada grupo familiar. Resultados: foram selecionadas 275 mulheres; 206 tiveram pelo menos um familiar testado para HTLV, formando 95 grupos familiares nos quais foi possível deduzir a rota de contaminação. Em 23 (24,2%) grupos familiares observou-se contaminação por via vertical [IC 95% (20,7-27,7)], em 58 (61,1%) por via sexual [IC 95% (57,1-65,0)] e em 14 (14,7%) observou-se a existência de contaminação via sexual e via vertical [IC de 95% (11,8-17,6)]. Conclusão: os resultados obtidos são compatíveis com os encontrados em alguns países com alta prevalência de HTLV, já que em grandes áreas metropolitanas o vírus é transmitido principalmente por via sexual. É importante reconhecer a endemia do HTLV no Brasil para que sejam elaboradas medidas de prevenção adequadas.

Background: An asymptomatic carrier of HTLV-1/2 who is unaware of their serological status can spread the virus in their family group and to sexual contacts. Aim: To determine patterns of HTLV-1/2 infection and transmission in the GIPH cohort, Brazil. Methods: The population consisted of former female blood donors found positive for HTLV-1/2 after donating at a public blood center (Hemominas) in Brazil, their mothers and offspring, as well as the partners of male donors who came to be tested and their offspring. The possible pathways of HTLV transmission in these groups were analyzed. Pedigrees were prepared for the family groups after the serologic test results for the family members were ready. Results:Of 275 women, 206 had relatives tested for HTLV, comprising 95 family groups. In these family groups it was possible to infer that in 23 (24.2%) the contamination occurred by the vertical route [95% CI (20.7 to 27.7)], in 58 (61.1%) through sexual intercourse [CI 95% (57.1 to 65.0)] and in 14 (14.7%) both by sexual and vertical routes [CI 95% (11.8 -17.6)]. Conclusion: The results we obtained are consistent with those found in some countries with high prevalence of HTLV, since in large metropolitan areas the virus is transmitted primarily through sexual intercourse. The importance of knowing how HTLV is spreading in Brazil is to devise appropriate prevention measures.

Encephalomyelopathy associated with HTLV-I a primary disease or coexisting with multiple sclerosis / Encefalomielopatia associada ao HTLV-I: doença primária ou coexistência com esclerose múltipla

HTLV-I-associated myelopathy (HAM/TSP) is the most common neurological manifestation of HTLV-I, causing progressive weakness, sensory disturbance, and sphincter dysfunction. Although motor disorders have been well described, few studies have associated cognitive disorders and HTLV-I infection. In areas endemic for HTLV-I infection, the differential diagnosis between HAM/TSP and other myelopathy etiologies can be difficult, particularly if the patient has signs and symptoms of brain involvement, since seropositive HTLV-I patients can present other neurological diseases. Here, we report one case initially diagnosed as Multiple Sclerosis (MS) which, upon further investigation, was found to be HTLV-I seropositive.

HTLV-I causando fraqueza progressiva, alterações de sensibilidade e disfunção esfincteriana. As alterações motoras são bem descritas, mas ainda são poucos os estudos que examinam a possibilidade de ocorrência de transtornos cognitivos na infecção pelo HTLV-I. Em áreas endêmicas para o HTLV-I, o diagnóstico diferencial com outras causas de mielopatias pode ser difícil, particularmente se o paciente tem sinais e sintomas de acometimento encefálico, já que a sorologia positiva para o HTLV-I pode ser detectada em pacientes com outras doenças neurológicas. Aqui relata-se o caso de uma paciente inicalmente diagnosticada com Esclerose Múltipla e que, na investigação posterior, foi encontrado soropositividade para HTLV-I.

Quality of life in patients with HTLV-I associated myelopathy/tropical spastic paraparesis / Qualidade de vida em pacientes com mielopatia associada ao HTLV-I/paraparesia espástica tropical

OBJECTIVE: To assess the quality of life (QoL) of patients with HTLV-I-associate myelopathy/tropical spastic paraparesis (HAM/TSP) and to correlate it with specific aspects of the disease. METHODS: Fifty-seven HAM/TSP patients completed the SF-36 QoL questionnaire. They were also asked about common complaints related to the disease, and we looked for associations between QoL and these complaints. RESULTS: Patients with HAM/TSP showed a strong negative association to QoL. Pain was the condition which most affected their QoL. The practice of physical activity is associated with better QoL in five out of eight domains of the scale. CONCLUSION: HAM/TSP leads to a poor QoL, mostly influenced by pain. Physical activity may have a positive association to QoL of these patients.

OBJETIVO: Avaliar a qualidade de vida (QV) em pacientes com mielopatia associada ao HTLV-I/paraparesia espástica tropical (MAH/PET) e correlacioná-la com aspectos específicos da doença. MÉTODOS: Cinquenta e sete pacientes com MAH/PET completaram o questionário de qualidade de vida SF-36. Também foram feitas perguntas sobre queixas comuns relacionadas à doença e investigadas posteriormente associações entre QV e essas queixas. RESULTADOS: Pacientes com MAH/PET apresentaram uma associação negativa com a QV. A dor foi a condição que mais afetou a QV. A prática de atividade física foi associada a uma melhor QV em cinco dos oito domínios da escala. CONCLUSÃO: MAH/PET leva a uma pior QV, principalmente influenciada pela dor. A atividade física pode estar positivamente associada à QV destes pacientes.

Factores asociados a la seropositividad para virus linfotrópico de células T humanas tipo I y II (HTLV I y II) y otros marcadores serológicos en donantes de sangre de un hemocentro en Cartagena-Colombia / Factors associated with seropositivity for human T-cell lymphotropic virus type I and II (HTLV I and II) and other serological markers in blood donors from a blood center in Cartagena-Colombia

Con el fin de poner a prueba la asociación, entre la prevalencia de transfusiones sanguíneas, la práctica de tatuajes o acupuntura, la presencia de otros marcadores (Chagas, HIV, Anti HCV, HBsAg, AntiHBc, Syphilis) y algunas conductas sexuales, con la seropositividad al Virus Linfotrópico de Células T Humanas tipo I y II se desarrolló este estudio epidemiológico analítico de corte transversal, cuya muestra escogida corresponde a la población de Donantes de sangre del Hemocentro Caribe, un total de 3867, los cuales fueron analizados a partir de los datos obtenidos de una Encuesta e historia clínica del donante, logrando los siguientes resultados: Seroprevalencia del (HTLV I y II) (3,1%), (HIV) (1,9%), (Chagas) (4,1), (Anti HCV) (5,4%), (HBsAg) (1,6%), (Anti HBc II) (12,7%), y (Syphilis TP) (3,7%). Se encontró que la mayoría de los marcadores tienen asociación con la presencia de otro marcador especialmente el anticuerpo del núcleo de la Hepatitis B, (HBc II), Así mismo estos muestran asociación marcada con la procedencia de otras regiones diferentes a la Caribe y las relaciones sexuales riesgosas Se concluye que los hallazgos evidencian una seroprevalencia significativa no solo del (HTLV I y II) en la población estudiada, también de los otros marcadores, que merece mucha atención.

To test the association between prevalence of blood transfusions, the practice of tattooing or acupuncture, the presence of other markers (hepatitis B and C, Chagas, Syphilis, HIV, antibody of the Hepatitis B) and some sexual behaviors, with the seropositive for T-cell lymphotropic virus type I and II Human developed analytical epidemiological study of cross sectional, which corresponds to the selected sample population of blood donors at the Blood Center of the Caribbean, a total of 3867 donor, which were analyzed from data obtained from a survey of donor and medical history, achieving the following results: seroprevalence (HTLV I and II) (3.1%), (HIV) (1.9 %), (Chagas) (4.1), (Anti HCV) (5.4%), (HBsAg) (1.6%) (Anti HBc II) (12.7%), and (Syphilis TP) (3.7%). We found that most markers are associated with the presence of another marker especially antibody of the Hepatitis B (HBc II) Also they show strong association with the origin of different regions of the Caribbean and risky sex. We conclude that the findings show a significant seroprevalence of not only (HTLV I and II) in the study population, also of the other markers, which deserves much attention.