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Biomédica (Bogotá) ; 42(1): 31-40, ene.-mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1374505


Introduction: Individuals infected with the human T-lymphotropic virus type 1 (HTLV-1) may present severe and disseminated forms of Strongyloides stercoralis infection with low therapeutic response. Objective: To investigate the S. stercoralis infection and the seroprevalence of IgG anti-S. stercoralis antibodies in individuals infected with HTLV-1 attending the Reference Center for HTLV-1 (CHTLV) in Salvador, Bahia, Brazil. Materials and methods: We conducted a cross-sectional study in 178 HTLV-1-infected individuals treated at the HTLV specialized center between January, 2014, and December, 2018. The parasitological diagnosis of S. stercoralis was performed using the Hoffman, Pons and Janer, agar plate culture, and Baermann-Morais methods. The IgG anti-S. stercoralis detection was performed using an in house enzyme-linked immunosorbent assay (ELISA). The HTLV-1 infection was diagnosed using a commercial ELISA and confirmed by Western blot. Results: The frequency of S. stercoralis infection was 3.4% (6/178). Individuals infected with S . stercoralis from rural areas (50.0%; 3/6) also showed S. stercoralis hyperinfection (>3,000 larvae/gram of feces). The frequency of circulating anti-S. stercoralis IgG antibodies was 20.8% (37/178). Conclusions: HTLV-1-infected people living in precarious sanitary conditions are more prone to develop severe forms of S. stercoralis infection. Considering the high susceptibility and unfavorable outcome of the infection in these individuals, the serological diagnosis for S. stercoralis should be considered when providing treatment.

Introducción. Los individuos infectados por el virus linfotrópico T humano tipo 1 (HTLV-1) pueden presentar formas graves y diseminadas de infestación por Strongyloides stercoralis con poca mejoría terapéutica. Objetivo. Investigar la infestación por S. stercoralis y la seroprevalencia de IgG anti-S. stercoralis en individuos infectados por HTLV-1 atendidos en el Centro de Referencia para HTLV-1 (CHTLV), en Salvador, Bahía, Brasil. Materiales y métodos. Se hizo un estudio transversal con 178 individuos infectados por HTLV-1 atendidos en el centro especializado de HTLV entre enero de 2014 y diciembre de 2018. El diagnóstico parasitológico de S. stercoralis se hizo mediante los métodos de Hoffman, Pons y Janer, cultivo en placa de agar y Baermann-Morais. Para la detección de IgG anti-S. stercoralis, se utilizó una prueba casera de inmunoabsorción ligada a enzimas (ELISA). La infección por HTLV-1 se diagnosticó usando un ELISA comercial y se confirmó mediante Western blot. Resultados. La frecuencia de infestación por S. stercoralis fue del 3,4 % (6/178). Además, los individuos infestados por S. stercoralis provenientes de la zona rural (50,0 %; 3/6) también mostraron hiperinfestación por S. stercoralis (>3.000 larvas/gramo de heces). La frecuencia de anticuerpos IgG anti-S. stercoralis fue del 20,8 % (37/178). Conclusiones. Las personas infectadas por HTLV-1 que viven en condiciones sanitarias precarias son más propensas a desarrollar formas graves de infestación por S. stercoralis. Teniendo en cuenta la gran vulnerabilidad y el resultado desfavorable de la infección en estos individuos, se debe considerar el diagnóstico serológico de S. stercoralis para administrar el tratamiento

Strongyloides stercoralis , Strongyloidiasis , Human T-lymphotropic virus 1 , Coinfection , Helminths
Rev. Soc. Bras. Med. Trop ; 55: e0111, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1387554


ABSTRACT Background: Infection with the human T-lymphotropic virus type 1 (HTLV-1) affects an estimated 10-15 million people worldwide. However, knowledge of the impact of HTLV-1 infection on work ability is lacking. This study aimed to measure the frequency and identify factors associated with poor work ability in patients living with HTLV-1. Methods: This cross-sectional study included 207 individuals infected with HTLV-1 who attended the University Hospital in Salvador, Bahia, Brazil. HTLV-1 antibodies were detected in the participants' blood by enzyme-linked immunosorbent assay (ELISA) and confirmed by western blotting. Participants answered a questionnaire on sociodemographic data, personal habits, clinical data, health-related quality of life, and work ability, evaluated using the work ability index questionnaire. A Poisson regression model with a robust variance estimate was used to identify the factors associated with the prevalence of poor work ability. Results: Patients mean age was 55.2, ranging from 19 to 84 years, 73.0% were females, 100% had monthly family income less than US$ 394, and 33.8% presented HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). No individual was classified as having excellent work ability. Poor work ability prevalence was strongly associated (prevalence ratio; 95% confidence interval [CI]) with sedentarism (1.30; 1.03-1.65), neurological symptoms (1.25; 1.02-1.52), and low physical (0.95; 0.94-0.96) and mental (0.98; 0.97-0.99) component summaries of health-related quality of life. Conclusions: Poor work ability among people living with HTLV-1 is associated with sedentarism, neurologic symptoms, and low health-related quality of life.

Rev. Pesqui. Fisioter ; 11(3): 465-472, ago.2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1293373


| INTRODUÇÃO: O vírus linfotrópico de células T humana tipo 1 (HTLV-1) é classificado como retrovírus e pode estar diretamente associado às doenças neurológicas. Por ser uma doença negligenciada pelas autoridades sanitárias e governamentais num panorama mundial, ainda existe uma carência de evidências científicas que investigam o impacto do HTLV-1 no âmbito da participação social dessa população. OBJETIVO: Analisar o impacto da pandemia da COVID-19 na participação social de indivíduos com HTLV-1. MATERIAL E MÉTODOS: Trata-se de um estudo observacional do tipo transversal realizado com indivíduos com HTLV-1 vinculados à Associação HTLVida. A coleta de dados foi realizada através de entrevistas via videoconferência; a primeira entrevista teve como objetivo explorar as características clínicas e sociodemográficas dos participantes, já a segunda investigou a participação social dos indivíduos comparando dois períodos (antes e durante a pandemia de COVID-19), através da aplicação do Questionário de Integração na Comunidade (QIC). RESULTADOS: Foram entrevistados 11 indivíduos, com predominância do sexo feminino (72,7%), com mediana de idade de 57 (52- 66) anos. No que tange os resultados referentes à participação social avaliada pelo QIC, observou-se a manutenção do escore do domínio de integração no ambiente doméstico, uma diferença de 3.00 pontos no domínio de integração no ambiente social, uma diferença de 2.00 pontos no domínio de integração no ambiente do trabalho e escola, além de uma diferença de 6.00 pontos no escore total do QIC. CONCLUSÃO: Identificou-se uma diminuição da participação social de indivíduos com HTLV-1 durante a pandemia da COVID-19, quando comparado ao período prévio de início da pandemia.

INTRODUCTION: Human T-cell Lymphotropic Virus type 1 (HTLV-1) is classified as a retrovirus and may be directly associated with neurological diseases. As it is a disease neglected by health and governmental authorities in a world panorama, there is still a lack of scientific evidence that investigates the impact of HTLV-1 in the scope of the social participation of this population. OBJECTIVE: To analyze the impact of the COVID-19 pandemic on the social participation of individuals with HTLV-1. MATERIAL AND METHODS: This is a transversal observational study carried out with individuals with HTLV-1, linked to the HTLVida Association. The data collection was carried out through interviews in a videoconference. The first interview aimed to explore the clinical and sociodemographic characteristics of the participants. In contrast, the second one investigated the social participation of individuals comparing two periods (before and during the COVID-19 pandemic) through the application of the Community Integration Questionnaire (CIQ). RESULTS: Eleven individuals were interviewed, predominantly female (72.7%), with a median age of 57 (52-66). About the results regarding social participation evaluated by the CIQ, was observed maintenance of the score in the domain of Integration in the home environment, a difference of 3.00 points in the domain of Integration in the social environment, a difference of 2.00 points in the domain of Integration in the work and school environment, and a difference of 6.00 points in the total CIQ score. CONCLUSION: A decrease in the social participation of individuals with HTLV-1 during the COVID-19 pandemic was compared to the period before the start of the pandemic.

Humans , Male , Female , Middle Aged , Aged , HTLV-I Infections , Quarantine , Social Participation , COVID-19/prevention & control , Cross-Sectional Studies , Surveys and Questionnaires
Infectio ; 25(1): 28-32, ene.-mar. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1154398


Summary The Human T-lymphotropic virus type 1 (HTLV-1), a retrovirus with oncogenic properties, affects around ten to twenty million people worldwide. The most common disorders associated with HTLV-1 infection are T-cell leukemia/lymphoma (ALT) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Studies have reported other clinical manifestations in HTLV-1 seropositive patients, including inflammatory disorders, co-infections with opportunistic agents, and pulmonary diseases. Objective: Here, we aim to describe a cohort of juvenile patients with confirmed HTLV-1 infection that showed clinical manifestations other than neurological symptoms. Methodology and patients: Retrospective analysis of clinical data describing background and clinical findings of 12 juvenile patients with confirmed HTLV-1 infection, attended during January 2018 to February 2020 in a pediatric referral hospital in Cali, Colombia. Results: 11 out 12 patients were from Colombia´s Pacific coast, 10 suffered from significant nutritional deficiencies. Six exhibited dermatological findings, 3 compatible with infective dermatitis. None of the cases exhibited clinical or laboratory findings suggesting ALT or HAM/TPS. Eight patients had structural lung disease assessed by chest Computed Tomography (CT) scans; 4 of them tested positive for galactomannan antigen in bronchoalveolar fluid suggesting pulmonary aspergillosis, and 2 others exhibited a positive PCR testing for tuberculosis. Three patients were diagnosed with autoimmune disorders; 1 patient with Crohn´s Diseases, 1 case of autoimmune thrombocytopenic purpura, and a patient with Vogt-Koyanagi-Harada syndrome (non-granulomatous uveitis). Conclusions: There is a broad range of clinical manifestations in pediatric HTLV-1 patients, and the clinician should consider structural pulmonary disease, opportunistic co-infections and autoimmune disorders in the diagnostic algorithm.

Resumen El Virus Linfotrópico de células T humanas tipo 1 (HTLV-1), retrovirus con propiedades oncogénicas, afecta alrededor de 10-20 millones de personas mundialmente. Las manifestaciónes más comúnmente asociadas a HTLV-1 incluyen leucemia/linfoma de células T (ALT) y mielopatía asociada a HTLV-1/ paraparesia espástica tropical (HAM/TSP). Estudios han reportado otras manifestaciones clínicas en pacientes positivos para HTLV-1, incluyendo enfermedades inflamatorias, coinfecciones con gérmenes oportunistas y enfermedad pulmonar. Objetivo: es describir clínicamente una cohorte de pacientes pediátricos con infección por HTLV-1 confirmada que presentan manifestaciones clínicas diferentes a síntomas neurológicos. Metogolodía y pacientes: Análisis retrospectivo de historia clínica describiendo procedencia y hallazgos clínicos en 12 pacientes con infección por HTLV-1 confirmada, atendidos durante el periodo de Enero de 2018 a Febrero de 2020 en un hospital pediátrico de referencia en Cali, Colombia. Resultados: Once de 12 pacientes procedían de la costa Pacífica Colombiana, 10 con deficiencias nutricionales significativas. Seis mostraron compromiso dermatológico, 3 compatibles con dermatitis infectiva. Ningún paciente presentó hallazgos clínicos o paraclínicos sugestivos de ALT o HAM/TPS. Ocho pacientes presentaron enfermedad pulmonar estructural evidenciada por TAC de tórax; 4 de ellos con antígeno galactomanan positivo en lavado broncoalveolar, sugiriendo aspergilosis pulmonar, y otros 2 resultaron con PCR positiva para tuberculosis. Tres pacientes presentaron enfermedades autoinmunes concomitantes: uno con Enfermedad de Crohn, uno con Púrpura Trombocitopénica Autoinmune, y un paciente con Síndrome de Vogt-Koyanagi-Harada. Conclusiones: Existe un amplio rango de manifestaciones clínicas en pacientes pediátricos con HTLV-1, considerando enfermedad pulmonar estructural, coinfecciones oportunistas y enfermedades autoinmunes dentro del algoritmo diagnóstico.

Humans , Infant , Child, Preschool , Child , Adolescent , Viruses , Human T-lymphotropic virus 1 , Infections , Paraparesis, Tropical Spastic , Leukemia , Crohn Disease , Coasts , Concurrent Symptoms , Uveomeningoencephalitic Syndrome , Purpura, Thrombocytopenic, Idiopathic , Malnutrition , Dermatitis , Pulmonary Aspergillosis , Lung Diseases
Autops. Case Rep ; 11: e2021307, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285426


Adult T- lymphocyte leukemia/ lymphoma (ATLL), described by Uchiyama et al. in 1977, is a distinct neoplasia of peripheral T-lymphocytes caused by human T-cell lymphotropic virus type 1 (HTLV-1). The authors describe the case of a 75-year-old female patient who presented with fever, chills, and altered mental status. The peripheral blood morphology showed large atypical lymphocytes with multilobed nuclei and flow cytometry consistent with ATLL. The authors discuss the pathophysiology, differential diagnosis, and subtypes of ATLL in addition to the diagnostic approach using flow cytometry when bone marrow biopsy is not available and modalities of treatment.

Humans , Female , Aged , Human T-lymphotropic virus 1 , Leukemia-Lymphoma, Adult T-Cell , Diagnosis, Differential , Flow Cytometry
Rev. Soc. Bras. Med. Trop ; 54: e01752021, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250822


Abstract INTRODUCTION We present a data analysis and review of recent studies regarding the laboratory diagnosis of human T-lymphotropic virus 1 and 2 (HTLV-1/2) infections in Brazil. METHODS Target populations, available diagnostic serological assays (screening and complementary tests), molecular assays (in-house), causes of false-positive and false-negative results, and flowcharts were analyzed. RESULTS A table presents the target populations, two diagnostic flowcharts (depending on laboratory infrastructure and study population), and recent research that may improve how HTLV-1/2 is diagnosed in Brazil. CONCLUSIONS: Our results support the implementation of public policies to reduce HTLV-1/2 transmission and its associated diseases.

Humans , Human T-lymphotropic virus 1 , HTLV-I Infections/diagnosis , HTLV-II Infections/diagnosis , Clinical Laboratory Techniques , Software Design , Brazil , Human T-lymphotropic virus 2 , HTLV-II Infections/epidemiology
MSphere ; 5(5): e00923-20, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP, SESSP-IALPROD, SES-SP, SESSP-IALACERVO | ID: biblio-1128430


Provirus mutations of human T-lymphotropic virus 1 (HTLV-1), mostly the lack of the 5= long terminal repeat (LTR) genomic region, have been described and associated with severe adult T cell leukemia/lymphoma (ATLL), non-sense point mutations with low proviral load, and Western blotting indeterminate results. Until now, no information concerning provirus mutations of HTLV-2 and its consequences, as well as those of HTLV-1/2 in HIV-coinfected individuals, had been described. Therefore, we searched for these mutations in provirus samples of 44 HIV/HTLV-1- and 25 HIV/HTLV-2-coinfected individuals. Using protocols well established for amplification and sequencing of segments of the LTR, env, and tax regions, we searched for defective type 1 particles that retain LTRs and lack internal sequences and type 2 particles that lack the 5=LTR region. In addition, using as references the prototypes ATK (HTLV-1) and Mo (HTLV-2), we searched for point mutations in the LTR and synonyms and nonsynonymous mutations and non-sense mutations in env and tax regions. Defective HTLV-1 and HTLV-2 provirus type 1 or 2 was detected in 31.8% of HIV/HTLV-1- and 32.0% of HIV/HTLV-2-coinfected individuals. Synonymous and nonsynonymous mutations were identified mostly in HTLV-2 and associated with lower levels of specific antibodies. No non-sense mutations that resulted in premature termination of Env and Tax proteins were detected. On the contrary, mutation in the stop codon of Tax2a produced a long protein characteristic of the HTLV-2c subtype. The clinical significance of these mutations in coinfected individuals remains to be defined, but they confirmed the lower sensitivity of serological and molecular diagnostic tests in HIV/HTLV-1/2 coinfections. IMPORTANCE HTLV-1 and HTLV-2 are endemic to Brazil, and they have different effects in HIV/AIDS disease progression. HIV/HTLV-1 has been described as accelerating the progression to AIDS and death, while HIV/HTLV-2 slows the progression to AIDS. Provirus mutations of HTLV-1 were implicated in severe leukemia development and in problems in the diagnosis of HTLV-1; in contrast, provirus mutations of HTLV-2 had not been confirmed and associated with problems in HTLV-2 diagnosis or disease outcome. Nevertheless, data obtained here allowed us to recognize and understand the false-negative results in serologic and molecular tests applied for HTLV-1 and HTLV-2 diagnosis. Defective proviruses, as well as synonymous and nonsynonymous mutations, were associated with the diagnosis deficiencies. Additionally, since HIV-1 and HTLV-1 infect the same cells (CD4 positive), the production of HIV-1 pseudotypes with HTLV-1 envelope glycoprotein during HIV/HTLV-1 coinfection cannot be excluded. Defective provirus of HTLV-2 and Tax2c is speculated to influence progression to AIDS. (AU)

Human T-lymphotropic virus 1 , Human T-lymphotropic virus 2 , Acquired Immunodeficiency Syndrome , HIV , Proviruses , Coinfection , Mutation
Fisioter. Bras ; 21(4): 372-379, Ago 08, 2020.
Article in Portuguese | LILACS | ID: biblio-1283306


Objetivo: Avaliar a influência da fisioterapia pélvica na função urinária e sexual de mulheres infectadas com HTLV-1. Métodos: Estudo quasi-experimental, com protocolo de 16 sessões em nove mulheres, que foram categorizadas em grupo sintomático e assintomático. Realizou-se teste de força muscular do assoalho pélvico com esquema PERFECT modificado, aplicou-se os questionários King's Health Questionnaire (KHQ) e Female Sexual Function Index (FSFI). O protocolo de fisioterapia pélvica consistiu em eletroestimulação do nervo tibial, eletroestimulação transvaginal e exercícios de cinesioterapia pélvica. Resultados: No grupo assintomático, segundo esquema PERFECT houve melhora da Endurance e Resistência do assoalho pélvico. No KHQ, verificou-se melhora geral no impacto da incontinência na qualidade de vida. No FSFI, houve aumento significativo no escore geral (p = 0,01), com influência nos domínios Desejo, Excitação, Lubrificação e Orgasmo. No grupo sintomático, o esquema PERFECT obteve melhora significativa em todos os domínios, assim como nos domínios de Limitação física, Sono/Energia e Medidas de Gravidade do KHQ e dos domínios de Desejo, Excitação e o Escore geral (p = 0,01) do FSFI. Conclusão: Sugere-se que o programa de fisioterapia pélvica aplicado melhorou a funcionalidade do assoalho pélvico, a qualidade de vida, reduziu os sintomas urinários e aprimorou a função sexual. (AU)

Objective: To evaluate the influence of pelvic physical therapy on the urinary and sexual function of women infected with HTLV-1. Methods: A quasi-experimental study in 16 sessions with nine women, divided into a symptomatic and asymptomatic group. The muscle strength test was performed with modified PERFECT scheme and were applied the King's Health Questionnaire (KHQ) and the Female Sexual Function Index (FSFI). The protocol of pelvic physical therapy consisted of electrostimulation of the tibial nerve, transvaginal electrostimulation and pelvic kinesiotherapy exercises. Results: In the asymptomatic group, the main results in PERFECT scheme were the improvement of the endurance and pelvic floor strength. In relation to KHQ, we observed a general improvement in the impact of incontinence on quality of life. In the FSFI, there was a significant increase in the Overall Score (p = 0.01), with influence in the domains Desire, Excitation, Lubrication and Orgasm. In the symptomatic group, the PERFECT scheme obtained significant improvement in all domains. As well as in domains Physical Limitation, Sleep/Energy and Severity measures in KHQ and in domains Desire, Excitation and Overall Score (p = 0,01) of FSFI. Conclusion: The pelvic physical therapy protocol improved the pelvic floor functionality, quality of life, reduced urinary symptoms and improved the sexual function. (AU)

Humans , Female , Urinary Incontinence , Human T-lymphotropic virus 1 , Physical Therapy Modalities , Quality of Life , Pelvic Floor
Rev. Soc. Bras. Med. Trop ; 53: e20200388, 2020. tab, graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1143860


Abstract INTRODUCTION: A good rating of the device in people with HTLV-1 in this population is essential for accuracy in prescribing data (walking). Thus, this study aimed to analyze the counterpart assessment methods that are best suited to patients with human T-cell lymphotropic virus (HTLV)-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP). METHODS: This cross-sectional study related stabilometric and kinematic variables of postural oscillations with Berg's balance scale (BBS) and Timed Up and Go (TUG) in subjects with HAM/TSP compared to asymptomatic subjects. To assess the posterior and lateral postural projection, baropodometry and the Footwork® system was used, and the CVMob system was applied to kinematic parameters. The means comparison tests and correlations were applied with an alpha of 5%. RESULTS: Thirty-nine subjects (predominantly female) made up the sample. There was an increase in barodopometric oscillations, in the total oscillation area (p = 0.004), in the anteroposterior oscillation in the left (p = 0.015) and right views (p = 0.036), and in the lateral oscillation (p = 0.039) in the HAM/TSP group. Moderate correlations were found between oscillation baropodometry and the angular variation of the ankle, as well as with the BBS in the three angles and the TUG for lateral oscillation (p = 0.406). CONCLUSIONS: Each method has advantages and disadvantages, including cost accuracy. The best resources available at no additional cost for outpatient to use are the kinematic evaluation using a simple smartphone camera and free analysis software, and the TUG.

Humans , Female , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic , Cross-Sectional Studies
Fisioter. Mov. (Online) ; 33: e003303, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056178


Abstract Introduction: Postural control in individuals with HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP) is usually compromised, which increases the risk of falls, makes it difficult to perform activities of daily living, and impairs the quality of life. The profile of the center of gravity oscillations in this population is unknown and may aid in clinical follow-up and research. Objective: To compare the stabilometric values between HAM/TSP and uninfected individuals and verify the existence of correlations between stabilometric variables and the Berg Balance Scale (BBS). Method: A cross-sectional observational study was performed with infected individuals, classified as defined and likely (WHO criteria), compared to accompanying persons and seronegative relatives. A baropodometry platform (Footwork®) was used to obtain the oscillation values of the body's center of gravity in total oscillation area (TOA), anterior-posterior oscillation (APO) and lateral oscillation (LO). Mean values were correlated with BBS by Spearman's Correlation (5% alpha). Approved by the ethical committee of Escola Bahiana de Medicina e Saúde Pública under Opinion 49634815.2.0000.5628. Results: An asymmetric distribution of all the stabilometric variables analyzed in the HAM/TSP population was found, different from the uninfected group (p < 0.05). It was also possible to verify strong to moderate and inverse correlations between the variables of center of gravity oscillation with the scores obtained in BBS, especially for TOA and LO. Conclusion: People with HAM/TSP presented higher values for the center of gravity oscillations and these were correlated with the BBS in the balance evaluation.

Resumo Introdução: o controle postural em indivíduos com mielopatia associada ao HTLV-1 ou paraparesia espástica tropical (HAM/TSP) é geralmente comprometido, o que aumenta o risco de quedas, dificulta a realização de atividades de vida diária e prejudica a qualidade de vida. O perfil das oscilações do centro de gravidade nesta população é desconhecido e pode auxiliar no acompanhamento clínico e na pesquisa. Objetivo: comparar os valores estabilométricos entre pessoas com HAM/TSP e não infectados, e verificar a existência de correlações entre variáveis estabilométricas e a Escala de Equilíbrio Berg (EEB). Método: foi realizado um estudo observacional transversal com indivíduos infectados, classificados como definidos e prováveis (critérios da OMS), comparados com acompanhantes e familiares soronegativos. Uma plataforma de baropodometria (Footwork®) foi utilizada para obter os valores de oscilação do centro de gravidade do corpo em área de oscilação total (AOT), oscilação anteroposterior (OAP) e oscilação laterolateral (OLL). Os valores médios foram correlacionados com a BBS pela Correlação de Spearman (alfa 5%). Aprovado pelo Comitê de Ética da Escola Bahiana de Medicina e Saúde Pública sob o CAAE 49634815.2.0000.5628. Resultados: encontrou-se distribuição assimétrica de todas as variáveis estabilométricas analisadas na população com HAM/TSP, diferentes do grupo de não infectados (p < 0,05). Também foi possível verificar correlações de forte a moderada e inversas entre as variáveis de oscilação do centro de gravidade com os escores obtidos na EEB, especialmente para AOT e OLL. Conclusão: Pessoas com HAM/TSP apresentaram valores maiores para as oscilações do centro de gravidade e estas foram correlacionadas com a EEB na avaliação do equilíbrio.

Resumen Introducción: El control postural en individuos con mielopatía asociada al HTLV-1 o paraparesia espástica tropical (HAM/TSP) suele estar comprometido, lo que aumenta el riesgo de caídas, les dificulta en las actividades de la vida diaria y perjudica su calidad de vida. Conocer el perfil de las oscilaciones del centro de gravedad en esta población puede ayudar en el seguimiento clínico y la investigación. Objetivo: Comparar los valores estabilométricos entre personas con HAM/TSP y personas no infectadas, y verificar la existencia de correlaciones entre las variables estabilométricas y la Escala de Equilibrio de Berg (BBS). Método: Se realizó un estudio observacional transversal con individuos infectados, clasificados como definidos y probables (criterios de la OMS), comparados a acompañantes y familiares seronegativos. Se utilizó una plataforma de baropodometría (Footwork®) para obtener los valores de oscilación del centro de gravedad del cuerpo en el área de oscilación total (AOT), oscilación antero-posterior (OAP) y oscilación lateral-lateral (OLL). Los valores medios se correlacionaron con la BBS por la correlación de Spearman (alfa 5%). Estudio aprobado por el Comité de Ética de la Escuela Bahiana de Medicina y Salud Pública bajo CAAE 49634815.2.0000.5628. Resultados: Se encontró una distribución asimétrica de todas las variables estabilométricas analizadas en la población HAM/TSP diferente en el grupo no infectado (p <0,05). También fue posible verificar correlaciones de fuertes a moderadas e inversas entre las variables de oscilación del centro de gravedad con las puntuaciones obtenidas en la BBS, especialmente para AOT y OLL. Conclusión: Las personas con HAM/TSP presentaron valores más altos en las oscilaciones del centro de gravedad, las cuales se correlacionaron con la BBS en la evaluación del equilibrio.

Humans , Middle Aged , Spinal Cord Diseases , Human T-lymphotropic virus 1 , Postural Balance , Paraparesis, Tropical Spastic , Automatic Control of Processes , Motor Activity
Rev. baiana enferm ; 34: e37991, 2020. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1137034


Objetivo identificar diagnósticos de enfermagem em pessoas sintomáticas e soropositivas para o vírus linfotrópico T humano. Método pesquisa documental, realizada nos prontuários de pessoas soropositivas para o vírus linfotrópico T humano, cadastradas no Centro de Testagem e Aconselhamento de um município do interior do estado da Bahia. A análise dos registros foi realizada com base na Taxonomia II da NANDA-I 2018-2020. Resultados foram identificados 13 diagnósticos de enfermagem distribuídos em 5 domínios: Conforto; Eliminação e Troca; Atividade e repouso; Autopercepção; Enfrentamento/Tolerância ao estresse. Os diagnósticos mais prevalentes foram: Dor crônica, em 21 (100%) dos soropositivos, Incontinência urinária em nove (43%), e Deambulação prejudicada em 8 (38%). Conclusão a identificação dos diagnósticos em pessoas sintomáticas e soropositivas para o vírus linfotrópico T humano fornece subsídios para a construção de planos de cuidados de enfermagem específicos.

Objetivo identificar los diagnósticos de enfermería en personas sintomáticas y seropositivas para el virus linfotrópico T humano. Método investigación documental, realizada en los registros médicos de personas seropositivas para el virus linfotrópico T humano, registradas en el Centro de Pruebas y Asesoramiento de un municipio en el interior del estado de Bahía. El análisis de los registros se realizó sobre la base de la Taxonomía II de NANDA-I 2018-2020. Resultados se identificaron 13 diagnósticos de enfermería, distribuidos en cinco dominios: Confort; Eliminación e Intercambio; Actividad y descanso; Auto-percepción; Afrontamiento/tolerancia al estrés. Los diagnósticos más frecuentes fueron: Dolor crónico, en 21 (100%) de individuos seropositivos, incontinencia urinaria en nueve (43%) y deterioro de la ambulación en 8 (38%). Conclusión la identificación de diagnósticos en personas sintomáticas y seropositivas para el virus linfotrópico T humano proporciona apoyo para la construcción de planes específicos de cuidados de enfermería.

Objective to identify nursing diagnoses in symptomatic and seropositive people for the human T lymphotropic virus. Method documentary research, carried out with the medical records of people seropositive for the human T lymphotropic virus, registered at the Testing and Counseling Center of a municipality in inland Bahia state. The analysis of the records was performed based on Taxonomy II of NANDA-I 2018-2020. Results 13 nursing diagnoses were identified, distributed in five domains: Comfort; Elimination and Exchange; Activity and rest; Self-perception; Coping/Stress Tolerance. The most prevalent diagnoses were: Chronic Pain, in 21 (100%) of seropositive individuals, urinary incontinence in nine (43%), and Impaired ambulation in 8 (38%). Conclusion the identification of diagnoses in symptomatic and seropositive people for the human T lymphotropic virus provides support for the construction of specific nursing care plans.

Humans , Nursing Diagnosis , HTLV-I Infections , Nursing Care/methods , Nursing Process , Human T-lymphotropic virus 1 , Human T-lymphotropic virus 2
Fisioter. Mov. (Online) ; 33: e003358, 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1133883


Abstract Introduction: The presence of human T-cell lymphotropic virus type 1 (HTLV-1) associated with neuropathy (myelopathy/tropical spastic paraparesis - HAM/TSP), can generate morphological and functional changes in the respiratory system. As a preventive therapeutic possibility for respiratory dysfunctions, it is expected that the already conceptualized inspiratory muscle training, when performed at home, can be a therapeutic resource that favors adherence to treatment. Objective: To evaluate respiratory muscle strength in patients with HTLV-1 after participating in a home respiratory muscle training protocol under indirect supervision. Method: This was a clinical, longitudinal, prospective, quantitative, and single-center trial approved by the Research Ethics Committee of the State University of Pará, opinion no. 2.695.505 and registered in clinical trials NCT03829709. Six HTLV-1 patients participated in a 5-week home respiratory muscle training protocol lasting 30 minutes daily through a linear load inspiratory muscle trainer. For the characterization of the imposed load, they were submitted to manovacuometry during pre (T0), peri (T3), and post (T5) treatment. Results: Six individuals completed the program, of which 83.33% were female and 16.66% male. With the application of respiratory muscle training, it was possible to achieve a significant increase (p < 0.011) of the maximum inspiratory pressure as shown when comparing T0 (66.8±12.58) to T5 (115.08±31.78). Conclusion: This study identified an increase in inspiratory muscle strength after HTLV-1 patients participated in a home muscle training protocol under indirect supervision.

Resumo Introdução: A presença do vírus linfotrópico de células T humana do tipo 1 (HTLV-1) associado à neuropatia (Paraparesia Espástica Tropical/Mielopatia - PET/MAH) pode gerar alterações morfológicas e funcionais no sistema respiratório. Como possibilidade terapêutica preventiva para disfunções respiratórias, vislumbra-se que o treinamento muscular inspiratório já conceituado, possa a nível domiciliar ser uma ferramenta terapêutica que favoreça a adesão ao tratamento. Objetivo: Avaliar a força muscular respiratória diante de um protocolo de treinamento muscular respiratório domiciliar, sob supervisão indireta em portadores do HTLV- 1. Método: Estudo clínico, longitudinal, prospectivo, quantitativo e de centro único, aprovado pelo Comitê de Ética em Pesquisa da Universidade do Estado do Pará, parecer no. 2.695.505 e registrado no Clinical Trials NCT03829709. Seis pacientes com HTLV-1 participaram de um protocolo de treinamento muscular respiratório domiciliar por 5 semanas com duração de 30 minutos diários por meio de um treinador muscular inspiratório de carga linear. Para a caracterização da carga imposta, os mesmos foram submetidos a manovacuometria, pré (T0), peri (T3) e pós (T5) tratamento. Resultados: Seis indivíduos completaram o programa, dos quais 83.33% eram do sexo feminino e 16.66% do sexo masculino. Com a aplicação do treinamento muscular respiratório foi possível obter um aumento significativo (p < 0,011) da pressão inspiratória máxima ao comparar T0 (66.8±12.58) ao T5 (115.08±31.78). Conclusão: Este estudo identificou um aumento na força muscular inspiratória após pacientes com HTLV-1 participarem de um protocolo de treinamento muscular domiciliar sob supervisão indireta.

Arq. neuropsiquiatr ; 77(6): 429-435, June 2019. tab, graf
Article in English | LILACS, SES-SP, SESSP-IIERPROD, SES-SP | ID: biblio-1011356


Background Although classical human T-cell lymphocyte virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis syndrome is the most frequent HTLV-1-associated neurological disorder, some "minor" neurological disorders can be seen in "asymptomatic" carriers. These disorders, including cognitive alterations already described in clinical cases and studies, may constitute an intermediate syndrome (IMS) between the asymptomatic state and myelopathy. The aim of this study was to investigate the presence of cognitive deficits in patients with HTLV-1 virus, who usually are diagnosed as asymptomatic. Methods A total of 54 HTLV-1-infected patients were evaluated, 35 asymptomatic and 19 with minor neurological alterations (evaluated by a neurologist); 25 HTLV-1-seronegative individuals served as controls. The instruments used were: Beck's Depression Inventory, Lawton's Daily Life Activity Scale, and a complete neuropsychological battery. The application of these evaluation instruments was performed blindly, with the evaluator neuropsychologist not knowing the clinical condition of the patient. Results Most of the participants in this cohort, including seronegative controls, were female (n = 57, 72.21%), their mean age was 52.34 years (SD = 14.29) and their average schooling was 9.70 years (SD = 4.11). Discussion Participants classified with IMS had lower gross scores when compared with both the patients classified as asymptomatic and with the control group, and when tested for auditory episodic memory of immediate (p < 0.01), and late (p = 0.01), recall. Conclusion Patients with IMS presented with memory impairment when compared with asymptomatic patients and seronegative individuals; this is one of the symptoms that aids in the classification of the syndrome.

RESUMO Apesar da síndrome de HAM / TSP clássica ser a perturbação neurológica mais atribuída, alguns distúrbios neurológicos denominados "menores" são vistos em portadores "assintomáticos" de HTLV-1. Esses distúrbios, incluindo alterações cognitivas já observadas em descrições de casos clínicos e estudos, podendo constituir uma verdadeira síndrome clínica intermediária (SI) entre o estado assintomático e mielopatia. O objetivo deste estudo foi investigar a presença de déficits cognitivos em pacientes portadores do vírus HTLV-1 diagnosticados classicamente como assintomáticos. Métodos Foram avaliadas 54 pessoas, sendo 35 assintomáticos, 19 com alterações neurológicas menores (avaliados por um neurologista) e 25 HTLV-1 negativo. Os instrumentos utilizados foram: Inventário Beck de Depressão, Escala de Atividades de Vida Diária de Lawton e uma completa bateria neuropsicológica. A aplicação destes instrumentos de avaliação foi realizada de forma cega, ou seja, a avaliadora não sabia a condição clinica do paciente. Resultados A maioria dos participantes era do sexo feminino (n = 57, 72,21%), com idade média de 52.34 anos (DP = 14,29) e escolaridade média de 9.70 anos (DP = 4,11). Discussão Avaliando o desempenho cognitivo nos três grupos, foi possível observar que os participantes classificados com SI, apresentaram menores escores brutos, quando comparados, com os pacientes com classificação assintomática e grupo controle e, em relação à memória episódica auditiva de evocação imediata (p < 0,01) (p = 0,01) e tardia. Conclusão Diante dos resultados foi possível concluir que os pacientes com SI apresentam comprometimento de memória quando comparado com os outros grupos, sendo possível, ser este um dos sintomas para auxiliar na classificação da síndrome.

Humans , Male , Female , Adult , Middle Aged , Aged , HTLV-I Infections/psychology , Cognitive Dysfunction/virology , Memory Disorders/virology , Reference Values , HTLV-I Infections/physiopathology , Case-Control Studies , Cross-Sectional Studies , Surveys and Questionnaires , Analysis of Variance , Statistics, Nonparametric , Educational Status , Cognitive Dysfunction/physiopathology , Memory Disorders/physiopathology , Neuropsychological Tests
Chinese Journal of Pathology ; (12): 11-16, 2019.
Article in Chinese | WPRIM | ID: wpr-810358


Objective@#To investigate the clinical presentation, clinicopathologic features, diagnosis and differential diagnosis of adult T cell leukemia/lymphoma (ATLL).@*Methods@#Four cases of ATLL from Fujian Cancer Hospital between October 2017 and May 2018 were analyzed using hematoxylin-eosin and immunohistochemical stains and polymerase chain reaction (PCR) for HTLV-1 provirus genes. The relevant literature was reviewed.@*Results@#There were two males and two females, age range 38-80 years. All patients were from coastal cities of Fujian province. Clinical presentations including lymphadenopathy, hepatomegaly and splenomegaly were detected in most patients; skin lesion, hypercalcemia and lymphocytosis were also commonly detected.Histologically, there was diffuse effacement of the normal architecture by tumor cells infiltration. The inflammatory background is usually sparse, with scanty eosinophils. The atypical lymphoid cells were typically medium to large sized with pronounced nuclear pleomorphism, irregular nuclei, chromatin clumping and prominent nucleoli. Blast-like cells with transformed nuclei were present in variable proportions. Giant cells with convoluted or cerebriform nuclear contours may be present. Rare cases may be composed predominantly of anaplastic tumor cells. Characteristic "flower cells" with large multi-lobated nuclei can be seen. The tumor cells were strongly positive for CD2, CD3, CD5, CD4 and CD25, but negative for CD7, CD8 and cytotoxic molecules (including TIA-1, Granzyme B and perforin). In three cases, the large transformed cells were positive for CD30. In one case, the anaplastic large cells were diffusely and strongly positive for CD30. All cases were negative for EBER, but positive for HTLV-1 provirus.@*Conclusions@#ATLL is a rare type of T cell lymphoma with unique clinical and pathological features, and should be distinguished from peripheral T cell lymphoma, NOS, ALK negative anaplastic large cell lymphoma and mycosis fungoides. Hypercalcemia, systemic disease, characteristic "flower cells" and specific immunophenotypic profile of CD3+, CD4+, CD25+, and CD7- are highly suggestive. However, ATLL can only be confirmed if the presence of HTLV-1 provirus.

Rev. Soc. Bras. Med. Trop ; 52: e20180486, 2019. tab
Article in English | LILACS | ID: biblio-1057240


Abstract INTRODUCTION: Bowel dysfunction is frequent in patients with spinal cord diseases, but little is known about the prevalence of bowel symptoms in human T-lymphotropic virus-(HTLV-1) infected individuals. The purpose of this study is to determine the frequency of bowel symptoms in HTLV-1 infected individuals and their correlation with the degree of neurologic disease. METHODS: This is a cross-sectional study comparing the frequency of bowel symptoms in HTLV-1-infected individuals* and seronegative donors (controls). Patients answered a questionnaire, the Rome III Criteria was applied, and stool consistency was evaluated by the Bristol Stool Form Scale. The individuals were classified as HTLV-1 carriers, probable HTLV-1 myelopathy and definitive HTLV-1 associated myelopathy or tropical spastic paraparesis (definitive HAM / TSP)**. RESULTS: We studied 72 HTLV-1 infected individuals and 72 controls with equal age and gender distribution. Constipation was the most frequent complaint, occurring in 38 % of HTLV-1 individuals and in 15 % of the controls. In comparison to the seronegative controls, the probability of constipation occurrence was approximately 18 times higher in definitive HAM / TSP patients. Straining, lumpy or hard stools, sensation of anorectal obstruction/blockage, fewer than 3 defecations per week, flatulence, soiling, evacuation pain, and bleeding were also more frequent in the HTLV-1 patients than in the controls. Moreover, bowel symptoms were more frequent in patients with definitive or probable HAM / TSP than in carriers. CONCLUSIONS: Bowel symptoms were more frequent in HTLV-1-infected patients than in seronegative controls and the frequency of bowel symptoms correlated with the severity of neurologic disease.

Humans , Male , Female , Adult , HTLV-I Infections/physiopathology , Intestines/physiopathology , Socioeconomic Factors , Severity of Illness Index , Case-Control Studies , Prevalence , Cross-Sectional Studies , Middle Aged
Rev. Pesqui. Fisioter ; 8(4): 558-563, nov., 2018. ilus
Article in English, Portuguese | LILACS | ID: biblio-968834


Introdução: A função sensorial é reconhecida como precursora da recuperação do movimento, sendo assim, os sintomas apresentados por pessoas com HTLV-1 podem trazer prejuízo na realização de atividades funcionais Objetivo: Sistematizar o conhecimento sobre alterações sensoriais em pacientes com HTLV-1. Metodologia: Trata-se de uma revisão sistemática, com a busca primária dos artigos realizada nas bases de dados Medline, via biblioteca virtual Pubmed, sendo incluídos estudos observacionais que abordaram a alteração sensorial em indivíduos com HTLV-1. A estratégia de busca foi conduzida de forma independente por dois pesquisadores e as divergências resolvidas por consenso. Resultados: Foram encontrados 44 estudos na busca primária, e destes foram incluídos quatro estudos que abordaram a alteração sensorial em indivíduos com HTLV-1, com um total de 240 participantes. Todos os artigos foram classificados como baixo risco de viés no que diz respeito à descrição da questão do estudo, resultados e discussão. Conclusão: identificou-se uma alta prevalência de dor e alteração na sensibilidade vibratória em relação às outras disfunções sensoriais, no entanto, a escassez de trabalhos publicados acerca deste tema sugere que novas abordagens sejam feitas mostrando uma grande lacuna de conhecimento a ser explorada. [AU]

Background: Sensory function is recognized as a precursor of the movement recovery. Therefore, the symptoms presented by people with HTLV-1 can result in impairment in the performance of functional activities. Aim: To systematize knowledge about sensory alterations in patients with HTLV-1. Methods: This is a systematic review, with the primary search of the articles carried out in the Medline databases, via the Pubmed virtual library, including observational studies that addressed the sensory alteration in individuals with HTLV-1. The search strategy was conducted independently by two researchers and the divergences resolved by consensus. Results: A total of 44 studies were found in the primary search, including four studies addressing sensory impairment in individuals with HTLV-1, with a total of 240 participants. All articles were classified as low risk of bias regarding the description of the study question, results and discussion. Conclusion: We identified a high prevalence of pain and altered vibratory sensitivity in relation to other sensory disorders, however, shortage of published works on this topic suggests new approaches are made showing a large knowledge gap to be explored. [AU]

Viruses , Paraparesis , Sensation
Rev. Soc. Bras. Clín. Méd ; 16(1): 70-73, 20180000.
Article in Portuguese | LILACS | ID: biblio-885012


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)

Humans , Male , Female , HTLV-I Infections/drug therapy , Human T-lymphotropic virus 1 , Paraparesis, Tropical Spastic , Strongyloides stercoralis/parasitology , Strongyloidiasis/parasitology
Rev. gastroenterol. Perú ; 38(1): 85-88, jan.-mar. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-1014064


La falla hepática aguda es el desarrollo de injuria hepática severa con deterioro de la función de síntesis y encefalopatía. Dentro de la variedad de causas, las infiltraciones neoplásicas representan menos del 0,5%. Presentamos el caso de un paciente varón HTLV1 positivo que debuta con una clínica de hepatitis aguda, siendo posteriormente diagnosticado con diseminación de linfoma/leucemia de células T del adulto. Desafortunadamente el paciente presentó deterioro rápido y progresivo de la función hepática, falleciendo a los pocos días de la hospitalización

Acute liver failure is the development of severe hepatic injury with deterioration of liver synthesis function and encephalopathy. Among all the variety of causes, neoplastic infiltration represents less than 0.5%. We present the case of a male patient with a past medical history of HTLV-1 infection, who reports symptoms of acute hepatitis, being diagnosed with Adult T-cell leukemia/ lymphoma. Unfortunately, the patient had a rapid deterioration and passed away a few days after admission

Humans , Male , Middle Aged , HTLV-I Infections/complications , Leukemia-Lymphoma, Adult T-Cell/diagnosis , Liver Failure, Acute/etiology , Leukemia-Lymphoma, Adult T-Cell/complications , Leukemia-Lymphoma, Adult T-Cell/virology , Fatal Outcome
Biomédica (Bogotá) ; 38(1): 37-41, ene.-mar. 2018.
Article in Spanish | LILACS | ID: biblio-888545


Resumen Introducción . El virus linfotrópico humano de células T (HTLV) es un retrovirus del cual se conocen varios tipos, entre ellos el HTLV-I y el HTLV-II, los cuales son de importancia clínica por ser los causantes de diferentes enfermedades, como la leucemia y el linfoma de células T del adulto, la paraparesia espástica tropical y la mielopatía asociada al HTLV. Objetivo . Obtener la prevalencia de las reacciones presuntiva y confirmatoria de los virus HTLV-I y HTLV-II en los donantes del Banco de Sangre del Hospital Pablo Tobón Uribe de Medellín, entre el 2014 y el 2015. Materiales y métodos . La información se obtuvo de la base de datos del Banco de Sangre del Hospital Pablo Tobón Uribe. Se analizaron la edad, el sexo y el lugar de procedencia y de residencia de los donantes, así como la reacción en la prueba de tamización (ELISA) y en la prueba confirmatoria (inmunoblot). Resultados . La población de donantes estudiados incluyó a 6.275 hombres y 8.148 mujeres, para un total de 14.423 donantes reclutados entre el 1° de marzo de 2014 y el 30 de junio de 2015. De ellos, 25 resultaron positivos para HTLV-I o HTLV-II en la prueba de tamización (ELISA). En la prueba confirmatoria (inmunoblot), nueve (36 %) pacientes fueron positivos para el HTLV-I o HTLV-II , y de ellos ocho (32 %) lo fueron para el HTLV-I y uno (4 %) para el HTLV-II; la seroprevalencia global fue de 0,06 % (IC95% 0,10-0,25). Conclusiones . Los hallazgos del estudio concordaron con los de estudios similares en áreas no endémicas del país y con los de los estudios consultados a nivel internacional.

Abstract Introduction: The human-T cell lymphotropic virus is a retrovirus with various types known so far. HTLV-I and HTLV-II are of clinically importance as they cause different diseases such as adult T-cell leukemia/lymphoma, tropical spastic paraparesis, and human T-lymphotropic virus type I-associated myelopathy (HAM). Objective: To estimate the prevalence of presumptive and confirmatory reactivity to HTLV-I/II in blood donors of Hospital Pablo Tobón Uribe Blood Bank between 2014 and 2015. Materials and methods: The information was obtained from the Hospital Pablo Tobón Uribe Blood Bank database. We analyzed age, sex, place of origin, and place of residence of donors, and the reactivity using the screening test (ELISA) as well as the confirmatory test (immunoblot). Results: The donor population studied included 6,275 men and 8,148 women, for a total of 14,423 donors recruited between March 1, 2014, and June 30, 2015. Of all tested donors, 25 were positive for HTLV-I/II by the screening test (ELISA). After performing the confirmatory test (immunoblot), only nine patients were positive for HTLV-I/II (36%), of whom eight were reactive to HTLV-I (32%) and one to HTLV-II (4%), for a global seroprevalence of 0.06% (CI 95%: 0.10-0.25). Conclusions: Our findings were consistent with those found in similar studies in non-endemic areas of the country and with those from studies at international level reported in the literature.

Adult , Female , Humans , Male , Blood Donors/statistics & numerical data , Human T-lymphotropic virus 1/immunology , Human T-lymphotropic virus 2/immunology , Blood Banks , Enzyme-Linked Immunosorbent Assay , Seroepidemiologic Studies , Prevalence
Rev. peru. med. exp. salud publica ; 34(3): 459-465, jul.-sep. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-902950


RESUMEN El objetivo del estudio fue determinar el rendimiento diagnóstico de la prueba de inmunofluorescencia indirecta (IFI) para la detección de anticuerpos contra HTLV-1. Se realizó un estudio de evaluación de prueba diagnóstica. Se usaron cultivos celulares MT2 infectados con HTLV-1 y K-562 sin infección, luego fueron sembrados, fijados en láminas para inmunofluorescencia y enfrentados a sueros. Se usaron 155 sueros (80 positivos para HTLV-1 y 75 positivos para otras enfermedades) procedentes de la seroteca del Instituto Nacional de Salud del Perú. Adicionalmente, se evaluó la repetibilidad (en el laboratorio) y reproducibilidad (en laboratorios de costa, sierra y selva) de la prueba. La prueba IFI para la detección de anticuerpos contra HTLV-1 tuvo una sensibilidad de 98,75% (IC 95%: 95,69-100%), una especificidad de 98,67% (IC 95%: 95,40-100%) y el índice de kappa de 0,975. No hubo falsos positivos ni falsos negativos; sin embargo, sí se obtuvo un resultado indeterminado y uno inespecífico. La prueba mostró 100% de concordancia en la repetibilidad y reproductibilidad. Concluimos que los resultados obtenidos son comparables a la prueba de referencia. La prueba de IFI presenta un buen rendimiento diagnóstico y sería de utilidad para la confirmación de HTLV-1.

ABSTRACT The objective of the study was to determine the diagnostic yield of the indirect immunofluorescence (IFI) test for the detection of antibodies against HTLV-1. A diagnostic test evaluation study was performed. HTLV-1-infected MT2 cells and HTLV-1-uninfected K-562 cells were cultured; then these cells were impregnated and fixed in sheets for immunofluorescence and faced to Peruvian sera. A total of 155 sera (80 HTLV-1-positive sera and 75 sera positive for other diseases) from the Peruvian Instituto Nacional de Salud were used. In addition, the parameters of repeatability (intra-laboratory) and reproducibility (in laboratories of the Peruvian coast, mountains and jungle) of the test were evaluated. The IFI test detected the presence of antibodies against HTLV-1 reaching a sensitivity of 98.75% (95% CI: 95.69 - 100.00%), a specificity of 98.67% (95% CI: 95.40 - 100.00%) and the Kappa index was 0.975. There were no false positives or false negatives; however, one undetermined result and one non-specific result were obtained. The test showed 100% qualitative agreement when performing the repeatability and reproducibility. The results obtained are comparable to the reference test. Therefore, the IFI test had a good diagnostic performance and would be useful for the confirmation of HTLV-1.

Humans , Human T-lymphotropic virus 1/immunology , HTLV-I Infections/diagnosis , Fluorescent Antibody Technique, Indirect , Antibodies, Viral/analysis , Prospective Studies , Reproducibility of Results