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Rev. Soc. Bras. Med. Trop ; 54: e0759-2020, 2021. tab
Article in English | LILACS | ID: biblio-1155599


Abstract INTRODUCTION: Human immunodeficiency virus (HIV) and human T-cell leukemia virus-1 (HTLV-1) viruses are associated with a high global burden of disease, and coinfection is a frequently reported event. We aimed to compare the functioning and health-related quality of life (HRQoL) of patients infected with HTLV-1, HIV, and HIV-HTLV-1. METHODS: We conducted a cross-sectional study of patients older than 18 years who had an HTLV-1 infection (Group A), HIV infection (Group B), or HIV-HTLV-1 coinfection (Group C). The functioning profiles were evaluated using handgrip strength, Berg balance scale (BBS), timed "up and go" (TUG) test, and 5-m walk test (m/s). We used the World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire to measure disability. The HRQoL was evaluated using a 36-item short-form health survey. For data with parametric and non-parametric distribution, we used analysis of variance with Bonferroni correction and the Kruskal-Wallis test, followed by Dunn's pairwise tests with Bonferroni correction. RESULTS: We enrolled 68 patients in Group A, 39 in Group B, and 29 in Group C. The scores for handgrip strength, BBS, TUG test, all the WHODAS domains, and HRQoL were poorer for Groups A and C than for Group B. CONCLUSIONS: Compared to patients with HIV infection, those with HIV-HTLV-1 coinfection and HTLV-1 infection had poor functioning and HRQoL scores. HTLV-1 infection was associated with reduced functioning and HRQoL in patients with a single HTLV-1 infection and HIV-HTLV-1 coinfection.

Humans , Human T-lymphotropic virus 1 , HTLV-I Infections/complications , HIV Infections/complications , Coinfection , Quality of Life , Cross-Sectional Studies , Hand Strength
Article in English | WPRIM | ID: wpr-880336


BACKGROUND@#Human T-cell leukemia virus type 1 (HTLV-1) activates inflammatory cascades by activating the NF-κB pathway. The minor allele of single nucleotide polymorphism (SNP) in breast cancer suppressor BRCA1-associated protein (BRAP), which has a common etiology with HTLV-1 infection, has been reported to be positively associated with carotid atherosclerosis, but inversely associated with hypertension. Therefore, HTLV-1 infection may be inversely associated with hypertension by activating endothelial maintenance, including atherosclerosis. To clarify these associations, a cross-sectional study was conducted using 2989 Japanese individuals aged 60-99 years participating in a general health check-up.@*METHODS@#Logistic regression models were used to clarify the association between HTLV-1 and hypertension. Platelet levels stratified analyses were also performed since platelet production, which plays a crucial role in endothelium maintenance, can be stimulated by activating the NF-κB pathway.@*RESULTS@#HTLV-1 infection was found to be significantly inversely associated with hypertension, particularly in subjects with high platelet levels (≥ second tertiles of platelet levels); the fully adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 0.75 (0.62, 0.92) for total and 0.64 (0.50, 0.82) for high platelet levels, respectively. Further analysis of the non-hypertensive subjects demonstrated that HTLV-1 infection was significantly positively associated with atherosclerosis in subjects with the highest tertile of platelet levels (2.11 [1.15, 3.86]) but not in subjects with low platelet levels (first and second tertiles of platelet level) (0.89 [0.57, 1.39]).@*CONCLUSION@#Asymptomatic HTLV-1 infection is inversely associated with hypertension, possibly by activating endothelial maintenance, including atherosclerosis progression.

Aged , Aged, 80 and over , Carotid Artery Diseases/virology , Cross-Sectional Studies , Female , HTLV-I Infections/complications , Human T-lymphotropic virus 1/physiology , Humans , Hypertension/virology , Japan/epidemiology , Male , Middle Aged
Rev. bras. neurol ; 55(2): 5-10, abr.-jun. 2019. tab
Article in English | LILACS | ID: biblio-1009994


The human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus that infects about 20 million people worldwide and causes immune-mediated diseases of the nervous system. The classical neurological presentation of HTLV-1 infection is the so-called HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). However, HAM/ TSP is not the only neurological outcome that can result from HTLV-1 infection. In this Review it is made an update on the many aspects of this important neurological condition, the HTLV-1 neurological complex.

O vírus linfotrópico de células T humanas tipo 1 (HTLV-1) é um retrovírus que infecta cerca de 20 milhões de pessoas em todo o mundo e causa doenças imunomediadas do sistema nervoso. A apresentação neurológica clássica da infecção pelo HTLV-1 é a chamada paraparesia espástica tropical / mielopatia associada ao HTLV-1 (HAM/TSP). HAM / TSP,no entanto, não é o único desfecho neurológico que pode resultar da infecção pelo HTLV-1. Nesta revisão, é feita uma atualização sobre vários aspectos desta importante condição neurológica, o complexo neurológico do HTLV-1.

Humans , HTLV-I Infections/complications , HTLV-I Infections/diagnosis , Paraparesis, Tropical Spastic/etiology , Nervous System Diseases/diagnosis , Corticosterone/therapeutic use , HTLV-I Infections/drug therapy , Disease Progression , Diagnosis, Differential , Amyotrophic Lateral Sclerosis
Medicina (B.Aires) ; 79(2): 147-149, abr. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1002621


La estrongiloidiasis es una afección desatendida causada por el parásito Strongyloides stercoralis. En los individuos inmunosuprimidos, fundamentalmente en los que tienen depresión de la inmunidad celular, puede desarrollarse el síndrome de hiperinfección por Strongyloides. La coinfección con virus linfotrópico de células T humanas (HTLV) es un factor de riesgo para el desarrollo de formas graves de estrongiloidiasis. Presentamos el caso de un hombre de 50 años con hiperinfección por Strongyloides y coinfección con HTLV. Se demoró el diagnóstico debido a su epidemiología inusual y a la sospecha inicial de enfermedad inflamatoria intestinal. El diagnóstico se confirmó mediante la identificación del parásito en muestras de lavado bronquio-alveolar y biopsias de mucosa duodenal y colónica. Se utilizó ivermectina subcutánea como tratamiento antihelmíntico con adecuada respuesta terapéutica.

Strongylodiasis is an unattended condition caused by the parasite Strongyloides stercoralis. The Strongyloides hyperinfection syndrome can develop in immunosuppressed hosts, mainly in those with depression of cellular immunity. Co-infection with human T-cell lymphotropic virus (HTLV) is a risk factor for the development of severe forms of strongyloidiasis. We present the case of a 50-year-old man with Strongyloides hyperinfection and coinfection with HTLV. The diagnosis was delayed owing to its unusual epidemiology and an initial suspicion of inflammatory bowel disease. Identification of the parasite in bronchioalveolar lavage and duodenal and colonic mucosa biopsies confirmed the diagnosis. Subcutaneous ivermectin was used as an anthelmintic treatment with an adequate therapeutic response.

Humans , Animals , Male , Middle Aged , Strongyloidiasis/virology , HTLV-I Infections/complications , Coinfection/complications , Argentina , Strongyloidiasis/pathology , Strongyloidiasis/drug therapy , Syndrome , Severity of Illness Index , Strongyloides stercoralis/pathogenicity , Coinfection/pathology , Coinfection/drug therapy , Immunocompetence
Rev. Soc. Bras. Med. Trop ; 52: e20180481, 2019. tab
Article in English | LILACS | ID: biblio-1041511


Abstract INTRODUCTION Human T-cell lymphotropic virus type 1 (HTLV-1)-associated inflammatory diseases are not well understood; however, their clinical manifestations may be influenced by the host genetic background. METHODS We genotyped 298 individuals with HTLV-1 and 380 controls for interleukin-10 (IL10) gene variants-rs3024496, rs1800871, rs1800896-and used logistic regression analysis to determine their association with clinical phenotypes. RESULTS No association with HTLV-1 infection was observed. However, allele A of rs1800896 (1082bp upstream) was associated with protection against neurological impairment, specifically overactive bladder (OR=0.447, 95% CI 0.28-0.70, p=0.001). CONCLUSIONS Our data suggests that IL10 regulation ameliorates neurological damage in HTLV-1 infections.

Humans , Male , Female , Adolescent , Adult , Young Adult , HTLV-I Infections/genetics , Interleukin-10/genetics , Polymorphism, Single Nucleotide/genetics , Urinary Bladder, Overactive/genetics , Phenotype , Human T-lymphotropic virus 1 , HTLV-I Infections/complications , Case-Control Studies , Urinary Bladder, Overactive/etiology , Genotype , Middle Aged
Rev. Soc. Bras. Med. Trop ; 52: e20180244, 2019. tab
Article in English | LILACS | ID: biblio-1041529


Abstract INTRODUCTION: Apart from masking the diagnosis of AIDS in patients with HIV/AIDS, human T-cell lymphotropic virus (HTLV), when present, also increases the risk of myelopathies and neurological disease in these patients. METHODS: Disease prevalence was estimated by ELISA and confirmed by Western blot. RESULTS: The coinfection rate was 1.5% (11/720); 10 of 11 patients had HTLV-1, and the remaining one had HTLV-2. The majority were male, over 40 years old, and of pardo color (ethnicity). CONCLUSIONS: There was no association between the risk factors examined and HTLV/HIV coinfection. This is the first study to report the occurrence of HTLV-2 in Pernambuco.

Humans , Male , Female , Adolescent , Adult , Young Adult , HTLV-I Infections/complications , HTLV-II Infections/complications , HIV Infections/complications , Coinfection , Socioeconomic Factors , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Human T-lymphotropic virus 1 , HTLV-I Infections/epidemiology , Human T-lymphotropic virus 2 , HTLV-II Infections/epidemiology , HIV Infections/epidemiology , Blotting, Western , Prevalence , Risk Factors , Middle Aged
Rev. Soc. Bras. Med. Trop ; 51(3): 357-360, Apr.-June 2018. tab
Article in English | LILACS | ID: biblio-1041469


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.

Humans , Male , Female , Adult , Anxiety Disorders/etiology , HTLV-I Infections/complications , Depressive Disorder/etiology , Anxiety Disorders/psychology , HTLV-I Infections/psychology , Case-Control Studies , Cross-Sectional Studies , Surveys and Questionnaires , Depressive Disorder/psychology , Educational Status
Rev. Soc. Bras. Med. Trop ; 51(2): 207-211, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-1041456


Abstract INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1)induces exaggerated Th1 responses, whereas atopy is associated with exacerbated Th2 responses. METHODS: Here, a cross-sectional study compared the prevalence of atopy in HTLV-1 carriers and HAM/TSP patients. It also compared the spontaneous cytokine production in HTLV-1-infected individuals. A retrospective cohort study evaluated the development of neurological manifestations in atopic and non-atopic carriers. RESULTS: Atopic HAM/TSP patients with high IFN-γ production exhibited higher IL-5 levels than non-atopic patients. Allergic rhinitis accelerated the development of Babinski signals and overactive bladders. CONCLUSIONS: Abnormal Th1 and Th2 responses coexist in HTLV-1-infected individuals and allergic diseases may worsen the clinical course of HTLV-1 infections.

Humans , Male , Female , HTLV-I Infections/complications , Hypersensitivity, Immediate/epidemiology , Nervous System Diseases/virology , HTLV-I Infections/immunology , HTLV-I Infections/pathology , Paraparesis, Tropical Spastic/complications , Paraparesis, Tropical Spastic/immunology , Paraparesis, Tropical Spastic/pathology , Cross-Sectional Studies , Retrospective Studies , Cohort Studies , Cytokines/biosynthesis , Hypersensitivity, Immediate/immunology , Hypersensitivity, Immediate/blood , Middle Aged , Nervous System Diseases/immunology
Braz. j. infect. dis ; 22(2): 79-84, Mar.-Apr. 2018. tab, graf
Article in English | LILACS | ID: biblio-951636


ABSTRACT Aim: To evaluate the efficacy of the onabotulinum toxin type A in the treatment of HTLV-1 associated overactive bladder and its impact on quality of life (QoL). Methods: Case series with 10 patients with overactive bladder refractory to conservative treatment with anticholinergic or physical therapy. They received 200Ui of onabotulinumtoxin type A intravesically and were evaluated by overactive bladder symptoms score (OABSS) and King's Health Questionnaire. Results: The mean (SD) of the age was 52 + 14.5 years and 60% were female. All of them had confirmed detrusor overactivity on urodynamic study. Seven patients had HAM/TSP. The median and range of the OABSS was 13 (12-15) before therapy and decreased to 1.0 (0-12) on day 30 and to 03 (0-14) on day 90 (p < 0.0001). There was a significant improvement in 8 of the 9 domains of the King's Health Questionnaire after the intervention. Hematuria, urinary retention and urinary infection were the complications observed in 3 out of 10 patients. The mean time to request retreatment was 465 days. Conclusion: Onabotulinum toxin type A intravesically reduced the OABSS with last long effect and improved the quality of life of HTLV-1 infected patients with severe overactive bladder.

Humans , Male , Female , Adult , Aged , Quality of Life , HTLV-I Infections/complications , Botulinum Toxins, Type A/therapeutic use , Urinary Bladder, Overactive/drug therapy , Acetylcholine Release Inhibitors/therapeutic use , Neuromuscular Agents/therapeutic use , Urodynamics , Human T-lymphotropic virus 1/isolation & purification , Treatment Outcome , Urinary Bladder, Overactive/physiopathology , Urinary Bladder, Overactive/virology , Symptom Assessment
Arq. bras. oftalmol ; 80(6): 369-372, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-888157


ABSTRACT Purpose: To evaluate the accuracy of lacrimal film tests and propose an algorithm for the diagnosis of dry eye disease in individuals infected with human T-cell lymphotropic virus type 1. Methods: Ninety-six patients infected with human T-cell lymphotropic virus type 1 were enrolled in the study. To assess clinical complaints, patients completed the Ocular Surface Disease Index questionnaire. To evaluate lacrimal film quality, patients underwent the tear breakup time test, Schirmer I test, and Rose Bengal staining. Dry eye disease was diagnosed when at least two of the three test results were abnormal. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of the questionnaire as well as of each test alone and combined in parallel and in series were determined. Results: The most sensitive test was the tear breakup time test (98%), whereas the most specific was the Schirmer I test (100%). Rose Bengal staining had the highest overall accuracy (88.64%), whereas the Ocular Surface Disease Index had the lowest overall accuracy (62.65%). The tear breakup time test, Schirmer I test, and Ocular Surface Disease Index combined in parallel showed increased sensitivity and decreased specificity for all tests. In contrast, when combined in series, these tests demonstrated increased specificity and decreased sensitivity. Conclusion: This study shows the need to use multiple tests to evaluate tear film quality and include a symptom questionnaire as part of the diagnostic algorithm for dry eye disease.

RESUMO Objetivo: Avaliar a precisão da propedêutica do filme lacrimal e propor um algoritmo para o diagnóstico da doença do olho seco em indivíduos infectados com Vírus linfotrópico de células-T humanas tipo 1. Métodos: Noventa e seis pacientes infectados com o vírus linfotrópico de células T humana tipo 1 foram incluídos no estudo. Para avaliar sintomatologia, os pacientes responderam o questionário Índice para Doenças da Superfície Ocular. A fim de avaliar a qualidade do filme lacrimal, os pacientes foram submetidos ao teste de ruptura do filme lacrimal, teste de Schirmer I e coloração com Rosa Bengala. A doença do olho seco foi diagnosticada quando, pelo menos, dois dos testes ruptura do filme lacrimal, teste de Schirmer I e coloração com Rosa Bengala) eram anormais. Foram determinados sensibilidade, especificidade, valor preditivo positivo e negativo e acurácia do questionário e de cada teste sozinho e combinados em paralelo e em série. Resultados: O teste de ruptura do filme lacrimal foi o mais sensível (98%) e o teste de Schirmer I foi o mais específico (100%). A maior acurácia foi encontrada no teste de coloração com Rosa Bengala (88,64%), enquanto sintomas avaliados usando o questionário Índice para Doenças da Superfície Ocular teve a menor acurácia geral (62,65%). O teste de ruptura do filme lacrimal, teste de Schirmer I e Questionário de Doença da Superfície Ocular quando combinados em paralelo mostraram um aumento da sensibilidade e uma diminuição na especificidade de todos os testes. Por outro lado, combinados em série, teste de ruptura do filme lacrimal, Schirmer I e questionário Índice para Doenças da Superfície Ocular tiveram um aumento na especificidade e sensibilidade diminuída. Conclusão: Este estudo apontou a necessidade de utilizar mais do que um teste para avaliar a qualidade do filme lacrimal, bem como utilizar um questionário de sintomas como parte do algoritmo de diagnóstico para doença do olho seco.

Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Algorithms , Dry Eye Syndromes/diagnosis , Human T-lymphotropic virus 1 , HTLV-I Infections/complications , Dry Eye Syndromes/virology , Sensitivity and Specificity
An. bras. dermatol ; 92(4): 573-574, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-886987


Abstract: Infective dermatitis associated with HTLV-1 (IDH) is the main cutaneous marker of HTLV-1 infection. This disease occurs primarily in children and should be differentiated from other eczemas, especially from atopic dermatitis. The largest series of IDH are from Jamaica and Brazil. There are an estimated 15 to 20 million infected people in the world, and Brazil is one of the endemic regions. Studies suggest that IDH in children may be a marker for the development of T-cell leukemia/lymphoma (ATL) or myelopathy associated with HTLV-1/tropical spastic paraparesis (HAM / TSP) in adulthood.

Humans , Female , Young Adult , HTLV-I Infections/diagnosis , Skin Diseases, Viral/diagnosis , Dermatitis/diagnosis , HTLV-I Infections/complications , Leukemia-Lymphoma, Adult T-Cell/diagnosis , Skin Diseases, Viral/complications , Dermatitis/virology , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/virology , Diagnosis, Differential , Eczema/diagnosis , Eczema/virology
Braz. j. infect. dis ; 21(3): 297-305, May-June 2017. tab
Article in English | LILACS | ID: biblio-839207


ABSTRACT The present study evaluated several techniques currently available (commercial kits and in-house assays) for diagnosing human T lymphotropic viruses types 1 and 2 in two groups of patients enrolled at HIV/AIDS specialized care services in São Paulo: Group 1 (G1), n = 1608, 1237 male/371 female, median age 44.3 years old, majority using highly active antiretroviral therapy (HAART); G2, n = 1383, 930 male/453 female, median age of 35.6 years old, majority HAART naïve. Enzyme immunoassays [(EIA) Murex and Gold ELISA] were employed for human T lymphotropic viruses types 1 and 2 screening; Western blotting (WB), INNO-LIA (LIA), real-time PCR pol (qPCR), and nested-PCR-RFLP (tax) were used to confirm infection. Samples were considered human T lymphotropic viruses types 1 and 2 positive when there was reactivity using at least one of the four confirmatory assays. By serological screening, 127/2991 samples were positive or borderline, and human T lymphotropic virus infection was confirmed in 108 samples (three EIA-borderline): 56 human T lymphotropic virus type 1 [G1 (27) + G2 (29)]; 45 human T lymphotropic virus type 2 [G1 (21) + G2 (24)]; one human T lymphotropic virus type 1 + human T lymphotropic virus type 2 (G2); six human T lymphotropic virus [G1 (2) + G2 (4)]. Although there were differences in group characteristics, human T lymphotropic viruses types 1 and 2 prevalence was similar [3.1% (G1) and 4.2% (G2), p = 0.113]. The overall sensitivities of LIA, WB, qPCR, and PCR-RFLP were 97.2%, 82.4%, 68.9%, and 68.4%, respectively, with some differences among groups, likely due to the stage of human T lymphotropic virus infection and/or HAART duration. Indeterminate immunoblotting results were detected in G2, possibly due to the seroconversion period. Negative results in molecular assays could be explained by the use of HAART, the occurrence of defective provirus and/or the low circulating proviral load. In conclusion, when determining the human T lymphotropic virus infection, the findings highlight that there is a need to consider the blood samples with borderline results in screening assays. Of all the tested assays, LIA was the assay of choice for detecting human T lymphotropic virus type 1 and human T lymphotropic virus type 2 in human immunodeficiency virus type 1-infected patients.

Humans , Male , Female , Adult , HTLV-I Infections/diagnosis , HTLV-II Infections/diagnosis , HIV Infections/complications , DNA, Viral/genetics , Enzyme-Linked Immunosorbent Assay , HTLV-I Antibodies/blood , HTLV-I Infections/complications , HTLV-II Antibodies/blood , HTLV-II Infections/complications , Blotting, Western , Sensitivity and Specificity , Real-Time Polymerase Chain Reaction
Braz. j. infect. dis ; 21(2): 133-139, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-839193


Abstract Introduction Despite the high prevalence of chronic pain in individuals infected with HTLV-1, predictive and protective factors for its development are still unclear. Objective To identify factors associated with chronic pain in individuals with HTLV-1. Methods This cross-sectional study was conducted in a reference center for treatment of patients infected with HTLV-1 in Salvador, Bahia, Brazil. The study included individuals infected with HTLV-1, over 18 years, and excluded those with difficulty to respond the pain protocol. Data on sociodemographic, health behavior, and clinical characteristics were collected in a standardized way. The prevalence ratio (PR) of pain is described, as well as the factors independently associated with the presence of pain, which were assessed by multiple logistic regression. Results A total of 142 individuals were included in the study, mostly female (62.7%), aged 20–64 years (73.2%), married (61.3%), with less than eight years of education (54.2%), and with a steady income (79.6%). Multivariate analysis showed that being symptomatic for HTLV-1 – sensory manifestations, erectile dysfunction, overactive bladder, and/or HAM/TSP (PR = 1.21, 95% CI: 1.05 to 1.38), self-medication (PR = 1.29, 95% CI: 1.08–1.53), physiotherapy (PR = 1.15, 95% CI: 1.02–1.28), and depression (PR = 1.14, 95% CI: 1.01–1.29) were associated with an increased likelihood of presenting pain. On the other hand, physical activity (PR = 0.79, 95% CI: 0.67–0.93) and religious practice (PR = 0.83, 95% CI: 0.72–0.95) were associated with a decreased likelihood of having pain. Conclusion The use of self-medication, physiotherapy and the presence of depression are independently associated with neurological symptoms in HTLV-1 infected patients. Religious practice and physical activity are both protective for the development of pain.

Humans , Male , Female , Adult , Middle Aged , Young Adult , Pain/etiology , Human T-lymphotropic virus 1 , HTLV-I Infections/complications , Pain/prevention & control , Pain/epidemiology , Religion , Socioeconomic Factors , Exercise , Chronic Disease , Prevalence , Cross-Sectional Studies , Risk Factors
Braz. j. infect. dis ; 20(6): 592-598, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-828167


ABSTRACT Objective: To describe the pain in patients infected with human T-cell lymphotropic virus type 1, clinically and epidemiologically. Methods: This systematic review was based on The PRISMA Statement. Four reviewers searched PUBMED, SciELO, LILACS and BIREME for data from observational studies and clinical trials (n ≥ 30) regarding pain prevalence, characteristics, and associated factors in patients with human T-cell lymphotropic virus type 1. No limits on publication date or language were established. Studies that did not have pain as an outcome measure or not involving human T-cell lymphotropic virus type 1 infected patients were excluded. Results: A total of 3013 articles (including duplicates) were found of which seven met the predetermined criteria. The most common pain region was the lower back (53.0%). Non-neuropathic type (ranging from 52.6% to 86.8%) was more frequent in human T-cell lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis participants, and neuropathic pain was more common in human T-cell lymphotropic virus type 1 carriers (53.1%). The pain was mostly reported as moderate or severe. One study showed that chronic pain was negatively associated with quality of life. Discussion: Pain is a common complaint in human T-cell lymphotropic virus type 1 infected patients, with lower back pain as the most frequent site. Pain can either be nociceptive, neuropathic, or both, is frequently severe, and negatively affects quality of life. Only studies of two countries were included in this review, limiting the external validity of the conclusions. The heterogeneity of variables prevented us from implementing a meta-analysis. Further research should better characterize the pain and explore its impact on quality of life, especially using longitudinal study design.

Humans , Pain/etiology , HTLV-I Infections/complications , Pain/epidemiology , Prevalence , Risk Factors
Braz. j. infect. dis ; 19(5): 486-491, tab
Article in English | LILACS | ID: lil-764498


ABSTRACTBACKGROUND: While 20-40% of patients with hepatitis C virus (HCV) monoinfection will spontaneously clear the virus, less is known regarding clearance with coinfections. HCV, human immunodeficiency virus (HIV), and human T-cell lymphotrophic virus 1 and 2 (HTLV-1/2) coinfection occurs due to shared routes of transmission and is prevalent in Brazil.OBJECTIVES:To compare the proportion of patients who have spontaneously cleared HCV in patients with HCV monoinfection to patients coinfected by HCV/HIV, or HCV/HIV/HTLV-1.METHODS:Using medical records from two clinics in Salvador, Brazil, including demographic data and serological markers of HCV, HIV and HTLV-I/II, cross-sectional data was obtained from 197 patients. Patients who were anti-HCV positive and HCV RNA negative, and who did not receive HCV treatment were defined as having cleared infection.RESULTS:Nineteen patients (9.5%) showed evidence of spontaneous HCV clearance; with clearance in 9 of 108 (8.3%) patients in the HCV monoinfected group, 5 of 68 (7.4%) patients with HCV/HIV, and 5 of 21 (23.8%) patients with HCV/HIV/HTLV. Demographic data were not associated with HCV clearance status. Patients coinfected with both HIV and HTLV-1 had increased odds (5.50; 95% CI 1.00, 30.17) of spontaneous clearance of HCV compared with patients who were HIV negative or of unknown HIV status.CONCLUSION:Our study found that patients coinfected with HIV and HTLV-1 were more likely to spontaneously clear hepatitis C virus than patients with HIV/HCV or HCV alone. The effects of HTLV coinfection on the immune response of such patients may be associated with these findings.

Adult , Female , Humans , Male , Middle Aged , Coinfection/virology , HIV Infections/complications , HTLV-I Infections/complications , Hepatitis C/complications , Virus Shedding , Brazil , Cross-Sectional Studies , Hepatitis C/virology , Prevalence , RNA, Viral
An. bras. dermatol ; 90(3,supl.1): 55-58, May-June 2015. tab, ilus
Article in English | LILACS | ID: lil-755780



Human T cell lymphotropic virus type 1 (HTLV-1)-associated infective dermatitis (ID) is a chronic, severe and recurrent eczema occurring during childhood in patients vertically infected with HTLV-1. HTLV-1-associated myelopathy/tropical spastic paraparesia (HAM/ TSP) is slow and progressive. We report the case of an adolescent female from a non-endemic area for HTLV-1 who presents ID and, most likely, associated HAM/TSP.


Adolescent , Female , Humans , Dermatitis/virology , HTLV-I Infections/complications , Paraparesis, Tropical Spastic/virology , Skin Diseases, Viral/virology , Disease Progression , Dermatitis/pathology , HTLV-I Infections/pathology , Immunohistochemistry , Paraparesis, Tropical Spastic/pathology , Scalp Dermatoses/pathology , Scalp Dermatoses/virology , Skin Diseases, Viral/pathology
Rev. méd. Chile ; 142(7): 859-866, jul. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-726177


Background: Most human T cell lymphotropic virus type 1 (HTLV-1) infected individuals are asymptomatic, but they commonly present cutaneous lesions that could be considered warning signs of the disease. Aim: To identify the main cutaneous manifestations present in HTLV-1 infected blood donors and compare them with healthy donors. Materials and Methods: Two blood donor groups from the blood bank of an emergency hospital were matched according to gender and age. One group was formed by HTLV-1 (+) (cases) and the other by HTLV-1 (-) donors (controls). A blind examiner to the serologic condition, evaluated their cutaneous manifestations. Results: Twenty five cases and 25 controls aged 18 to 60 years (24 females) were evaluated. One or more cutaneous manifestations were found in 24 (96%) cases and in 15 (60%) controls (p < 0.01). Inflammatory cutaneous diseases were found in 19 (76%) cases and in 9 (36%) controls (p < 0.01). Dermatophytosis was found in 18 (72%) cases and in 12 (48%) controls (NS). Conclusions: HTLV-1 infected Chilean subjects have a higher frequency of dermatoses than their healthy counterparts.

Adult , Female , Humans , Male , Middle Aged , Young Adult , Blood Donors/statistics & numerical data , HTLV-I Infections/complications , Human T-lymphotropic virus 1 , Skin Diseases/virology , Case-Control Studies , Chile , Dermatomycoses/diagnosis , Dermatomycoses/microbiology , Skin Diseases/diagnosis
Int. braz. j. urol ; 39(6): 861-866, Nov-Dec/2013. tab
Article in English | LILACS | ID: lil-699119


Objective To investigate the relationship between urinary symptoms and quality of life of patients infected with HTLV-1. Materials and Methods This is a cross-sectional study that enrolled individuals with HTLV-1 positive serology from February 2010 to March 2011. Participants were HTLV-1 infected subjects followed in the HTLV-1 clinic of the University Hospital in Salvador, Bahia, Brazil. Patients with HTLV-1 associated myelopathy / tropical spastic paraparesis (HAM/TSP), who had evidence of other neurological diseases, diabetes mellitus or were pregnant were excluded from the study. The questionnaire SF-36 was used to evaluate quality of life and the questionnaire OAB-V8 was used to evaluate urinary symptoms. Results From the 118 individuals evaluated, 50 (42.4%) complained of urinary symptoms and 68 (57.6%) did not. Most participants were females. There was no difference between the groups regarding demographic variables. The group with symptoms showed significantly lower scores in all domains of the SF-36 questionnaire. The domains with greatest differences were vitality and general health state. Conclusions Urinary symptoms negatively influence the quality of life of individuals infected with HTLV-1. .

Adult , Female , Humans , Male , Middle Aged , HTLV-I Infections/physiopathology , Lower Urinary Tract Symptoms/physiopathology , Quality of Life , Urinary Bladder, Overactive/physiopathology , Urinary Bladder/physiopathology , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , HTLV-I Infections/complications , Sex Distribution , Socioeconomic Factors , Surveys and Questionnaires , Urinary Bladder, Overactive/etiology
Braz. j. infect. dis ; 17(6): 661-666, Nov.-Dec. 2013. tab
Article in English | LILACS | ID: lil-696967


BACKGROUND: The human retroviruses HIV-1 and HTLV-1 share the routes of infection with hepatitis viruses B and C. Co-infection by these agents are a common event, but we have scarce knowledge on co-infection by two or more of these agents. OBJECTIVE: To evaluate the characteristics and risk factors for co-infections by HBV and HCV in patients infected by HIV-1 or/and HTLV-1, in Salvador, Brazil. METHODS: In a case-control study we evaluated patients followed in the AIDS and HTLV clinics of Federal University of Bahia Hospital. Clinical and epidemiological characteristics were reviewed, and patients were tested for the presence of serological markers of HBV and HCV infections. HCV-infected patients were tested by PCR to evaluate the presence of viremia. RESULTS: A total of 200 HIV-1, 213 HTLV-1-infected, and 38 HIV-HTLV-co-infected individuals were included. HIV-infected patients were more likely to have had more sexual partners in the lifetime than other patients' groups. HIV-HTLV-co-infected subjects were predominantly male. Patients infected by HTLV or co-infected had a significantly higher frequency of previous syphilis or gonorrhea, while HIV infection was mainly associated with HPV infection. Co-infection was significantly associated to intravenous drug use (IVDU). HBV and/or HCV markers were more frequently found among co-infected patients. HBV markers were more frequently detected among HIV-infected patients, while HCV was clearly associated with IVDU across all groups. AgHBs was strongly associated with co-infection by HIV-HTLV (OR = 22.03, 95% CI: 2.69-469.7), as well as confirmed HCV infection (p = 0.001). Concomitant HCV and HBV infection was also associated with retroviral co-infection. Patients infected by HTLV-1 had a lower chance of detectable HCV viremia (OR = 0.04, 95% CI: 0.002-0.85). CONCLUSIONS: Infection by HCV and/or HBV is frequent among patients presenting retroviral infection, but risk factors and prevalence for each infection are distinct for each agent. Retroviral co-infection increases the risk of a positive AgHBs, but HTLV-1 infection seems to increase the likelihood of HCV spontaneous clearance.

Adult , Female , Humans , Male , Middle Aged , Young Adult , Coinfection/epidemiology , HIV Infections/epidemiology , HTLV-I Infections/epidemiology , Hepatitis B/epidemiology , Hepatitis C/epidemiology , Brazil/epidemiology , Case-Control Studies , Coinfection/virology , HIV Infections/complications , HTLV-I Infections/complications , Hepatitis B/complications , Hepatitis C/complications , Prevalence , Risk Factors , Sexual Partners
Rev. Soc. Bras. Med. Trop ; 45(5): 545-552, Sept.-Oct. 2012. ilus, tab
Article in English | LILACS | ID: lil-656206


The human T lymphotropic virus type-1 (HTLV-1) was the first human retrovirus identified. The virus is transmitted through sexual intercourse, blood transfusion, sharing of contaminated needles or syringes and from mother to child, mainly through breastfeeding. In addition to the well-known association between HTLV-1 and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), several diseases and neurologic manifestations have been associated with the virus. This review was conducted through a PubMed search of the terms HTLV-1, immune response and neurological diseases. Emphasis was given to the most recent data regarding pathogenesis and clinical manifestations of HTLV-1 infection. The aim of the review is to analyze the immune response and the variety of neurological manifestations associated to HTLV-1 infection. A total of 102 articles were reviewed. The literature shows that a large percentage of HTLV-1 infected individuals have others neurological symptoms than HAM/TSP. Increased understanding of these numerous others clinical manifestations associated to the virus than adult T cell leukemia/lymphoma (ATLL) and HAM/TSP has challenged the view that HTLV-1 is a low morbidity infection.

O vírus linfotrópico de células T humanas do tipo 1 (HTLV-1) foi o primeiro retrovírus humano identificado. O vírus é transmitido via relação sexual, transfusão de sangue, compartilhamento de agulhas ou seringas contaminadas ou da mãe para o filho, principalmente através da amamentação. Além da conhecida associação entre o HTLV-1 e a mielopatia associada ao HTLV-1 (HAM/TSP), várias doenças e manifestações neurológicas tem sido associadas com o vírus. Esta revisão de literatura foi conduzida através de pesquisa ao banco de dados do PubMed, com os termos HTLV-1, resposta imune e doenças neurológicas. Foram enfatizados os dados mais recentes sobre a patogênese e às manifestações clínicas na infecção pelo HTLV-1. O objetivo dessa revisão é analisar a resposta imune e a variedade de manifestações neurológicas associadas com a infecção pelo HTLV-1. Um total de 102 artigos foi analisado. A literatura mostra que grande porcentagem de indivíduos infectados pelo HTLV-1 apresenta sintomas neurológicos mesmo na ausência de HAM/TSP. Uma maior compreensão das várias manifestações clínicas associadas ao vírus, além da leucemia/linfoma de células T do adulto (ATLL) e HAM/TSP, auxilia a estabelecer que, na realidade, a infecção pelo vírus possui uma morbidade maior do que se pensava.

Humans , HTLV-I Infections/complications , Human T-lymphotropic virus 1/immunology , Paraparesis, Tropical Spastic/immunology , HTLV-I Infections/immunology , Paraparesis, Tropical Spastic/complications