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1.
Int J Dermatol ; 62(4): 547-557, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36738114

ABSTRACT

CONTEXT: The most reported viral co-infections in leprosy are human immunodeficiency virus (HIV), human T-cell lymphotropic virus (HTLV), hepatitis B virus (HBV), hepatitis C virus (HCV), and SARS-CoV-2. In co-infections, the burden of an agent can be increased or decreased by the presence of others. To address this issue, we need to fully understand their prevalence, risk factors, immunology, clinical manifestations, and treatment. The purpose of this scoping review is to describe the clinical and epidemiological characteristics of the most reported viral co-infections in leprosy to inform clinicians and guide future research. METHODS: The authors conducted a literature search of five databases for articles on each of the aforementioned co-infections published prior to October 2022. Two independent reviewers conducted the selection process and identified 53 papers meeting the study inclusion criteria. The data extraction process and evidence synthesis were conducted by one reviewer and double-checked by a second one, consistent with best practice recommendations for scoping reviews. RESULTS: For all assessed viruses, most studies reported prevalence rates in leprosy patients higher than the general population. Studies found that HTLV, HBV, and HCV chronic infections were highest in multibacillary leprosy, whereas HIV was mostly found in paucibacillary leprosy, and SARS-Cov-2 affected leprosy subtypes equally. Overall, co-infections were also associated with higher rates of leprosy reactions, except for COVID-19. Forty-six percent of the studies discussed issues related to treatment, which led to favorable outcomes for the most part. CONCLUSIONS: This review summarizes the existing literature on viral co-infections in leprosy patients, generating valuable insights and recommending areas for future research.


Subject(s)
COVID-19 , Coinfection , HIV Infections , HTLV-I Infections , Hepatitis B , Hepatitis C , Leprosy , Humans , Hepatitis B/epidemiology , HTLV-I Infections/complications , HTLV-I Infections/epidemiology , Coinfection/complications , COVID-19/complications , COVID-19/epidemiology , SARS-CoV-2 , Hepatitis C/epidemiology , Hepacivirus , Hepatitis B virus , Leprosy/complications , Leprosy/epidemiology , HIV Infections/complications , HIV Infections/epidemiology , Prevalence
2.
PLoS Negl Trop Dis ; 6(6): e1705, 2012.
Article in English | MEDLINE | ID: mdl-22720112

ABSTRACT

INTRODUCTION: Human T-cell lymphotropic virus type 1 (HTLV-1) infection is intractable and endemic in many countries. Although a few individuals have severe symptoms, most patients remain asymptomatic throughout their lives and their infections may be unknown to many health professionals. HTLV-1 can be considered a neglected public health problem and there are not many studies specifically on patients' needs and emotional experiences. OBJECTIVE: To better understand how women and men living with HTLV-1 experience the disease and what issues exist in their healthcare processes. METHODS: A qualitative study using participant observation and life story interview methods was conducted with 13 symptomatic and asymptomatic patients, at the outpatient clinic of the Emilio Ribas Infectious Diseases Institute, in Sao Paulo, Brazil. RESULTS AND DISCUSSION: The interviewees stated that HTLV-1 is a largely unknown infection to society and health professionals. Counseling is rare, but when it occurs, focuses on the low probability of developing HTLV-1 related diseases without adequately addressing the risk of infection transmission or reproductive decisions. The diagnosis of HTLV-1 can remain a stigmatized secret as patients deny their situations. As a consequence, the disease remains invisible and there are potentially negative implications for patient self-care and the identification of infected relatives. This perception seems to be shared by some health professionals who do not appear to understand the importance of preventing new infections. CONCLUSIONS: Patients and medical staff referred that the main focus was the illness risk, but not the identification of infected relatives to prevent new infections. This biomedical model of care makes prevention difficult, contributes to the lack of care in public health for HTLV-1, and further perpetuates the infection among populations. Thus, HTLV-1 patients experience an "invisibility" of their complex demands and feel that their rights as citizens are ignored.


Subject(s)
HTLV-I Infections/epidemiology , HTLV-I Infections/psychology , Adult , Asymptomatic Diseases/psychology , Brazil/epidemiology , Female , HTLV-I Infections/transmission , Human T-lymphotropic virus 1/isolation & purification , Humans , Interviews as Topic , Male , Middle Aged , Patient Acceptance of Health Care , Social Stigma
3.
Intervirology ; 50(4): 316-8, 2007.
Article in English | MEDLINE | ID: mdl-17622792

ABSTRACT

Brazil may have the highest absolute number of individuals infected by human T cell lymphotropic virus type 1 (HTLV-1). It has been suggested that the prevalence of HTLV-1 is increased in patients with skin diseases. This study shows a higher prevalence of this infection in 1,229 patients attending a Brazilian dermatology clinic (0.7%) when compared to blood donors (0.22%). Of note, one additional patient tested positive for HTLV-2. The main skin diseases described in HTLV-1 seropositives were vitiligo (2 cases), dermatophytosis (2 cases), and leprosy (2 cases). A 23-year-old woman received a diagnosis of infectious dermatitis.


Subject(s)
HTLV-I Antibodies/blood , HTLV-I Infections/complications , HTLV-I Infections/epidemiology , Human T-lymphotropic virus 1/immunology , Skin Diseases/complications , Skin Diseases/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Ambulatory Care Facilities , Brazil/epidemiology , Child , Child, Preschool , Female , HTLV-I Infections/virology , Human T-lymphotropic virus 1/genetics , Human T-lymphotropic virus 1/isolation & purification , Humans , Male , Middle Aged , Polymerase Chain Reaction , Prevalence
4.
Acta Trop ; 97(1): 88-93, 2006 Jan.
Article in English | MEDLINE | ID: mdl-16263074

ABSTRACT

Leprosy is a disease, which is accompanied by cellular immunity defects, which may increase the susceptibility of patients in developing co-infections. The association of leprosy with hepatitis C virus (HCV) infection, human immunodeficiency virus types 1 and 2 (HIV 1+2) infection and human T-lymphotropic virus types I and II (HTLV I+II) infection have previously been described in different populations. In this study, the prevalence of these infections was determined in 199 Southern Brazilian leprosy patients and in 681 matched controls. Antibodies to HCV were positive in 3.52% of the patients (7/199) and in 0.15% of the controls (1/681; odds ratio (OR)=24.79; 95% CI=3.03-202.74; p=0.0002). An increased risk of HCV infection was observed in institutionalized patients (OR=14.95; 95% CI=1.76-127.03; p=0.004) and in the lepromatous form of the disease (OR=7.67; 95% CI=0.43-136.62; p=ns). Anti-HIV 1+2 antibodies were positive in only one out-patient (1/199; 0.50%) and in none of the controls (0/681; OR=3.43; 95% CI=0.21-55.16; p>0.05). No leprosy patient was positive for anti-HTLV I+II antibodies. These results demonstrate an increased prevalence of HCV infection in leprosy patients from South Brazil and that both institutionalization and lepromatous form of the disease confer higher risk to HCV infection. These data emphasizes the importance of monitoring hepatitis C and leprosy interactions and the need of special care to institutionalized and lepromatous patients in preventing HCV co-infection.


Subject(s)
Hepatitis C/complications , Hepatitis C/epidemiology , Leprosy/complications , Leprosy/epidemiology , Patient Isolation , Adolescent , Adult , Aged , Aged, 80 and over , Brazil/epidemiology , Female , HIV Infections/complications , HIV Infections/epidemiology , HTLV-I Infections/complications , HTLV-I Infections/epidemiology , HTLV-II Infections/complications , HTLV-II Infections/epidemiology , Hepacivirus/immunology , Hepatitis C Antibodies/blood , Humans , Male , Middle Aged , Prevalence
5.
Article in English | MEDLINE | ID: mdl-9525441

ABSTRACT

To determine the association between leprosy and HTLV-I, 450 and 394 leprosy patients in two sanatoriums in Japan (Sanatorium-A in Okayama prefecture and Sanatorium-B in Gunma prefecture) were investigated serologically for antibodies to HTLV-I. Serology was positive for HTLV-I in 38 (8.4%) of 450 leprosy patients in Sanatorium-A and in 34 (8.6%) of 394 patients in Sanatorium-B. Prevalence was much higher than that in the general population of these areas in Japan. A large proportion of HTLV-I-positive patients in both sanatoriums came from HTLV-I nonendemic areas in Japan, suggesting that HTLV-I infection occurred after the patients arrived at the sanatoriums. Infection through sexual contact or reuse of needles for frequent vaccination are possible routes of infection for HTLV-I in these cases.


Subject(s)
HTLV-I Infections/epidemiology , Hospitals, Special , Leprosy/complications , Age Distribution , Aged , Aged, 80 and over , Female , HTLV-I Antibodies/blood , Humans , Japan/epidemiology , Male , Middle Aged , Prevalence , Spouses
6.
J Acquir Immune Defic Syndr Hum Retrovirol ; 15(5): 387-90, 1997 Aug 15.
Article in English | MEDLINE | ID: mdl-9342260

ABSTRACT

In this historical prospective study using sera stored for 22 years, we investigated the effect of HTLV-I infection on survival in a population of leprosy patients in the Democratic Republic of the Congo (formerly Zaire). We also determined the distribution of HTLV-I by subpopulation, age, and gender. Stored sera taken from a population of leprosy patients and controls in 1969 were tested for HTLV-I. Follow-up survival data on these patients were obtained in 1991. The sera collected in 1969 from 520 individuals was used to determine the prevalence of HTLV-I. Included in this number were 328 patients resident in the sanatorium. Survival and other data were available for 327 of these. A multivariate survival analysis using a logistic regression model was performed to evaluate the influence of HTLV-I status, age, type of leprosy, gender, duration of hospitalization, and ethnic group on survival. The overall prevalence of HTLV-I among the 520 individuals in the prevalence study was 34%, with 37.4% in the leprosy group and 25.2% in the control group (p < 0.01). Multivariate analysis using logistic regression showed that females of the Mongo and Ngombe ethnic group taken together were significantly more likely to be infected than the other groups (OR = 3.67, 95% CI: 2.14 to 6.30). A comparison of the death rates directly standardized for age and sex showed that the rate was significantly higher for HTLV-I positive (5.5/100 person-years of observation) compared with HTLV-I negative (3.6/100 person-years of observation). A survival analysis using the Cox model showed a risk ratio of 1.4 (CI: 1.04 to 1.89) for those infected with HTLV-I. An increase in the death rate was associated with HTLV-I infection in leprosy inpatients. The decreased survival associated with HTLV-I infection may result from an increased susceptibility to a variety of diseases.


PIP: Preservation of stored sera collected in 1969 from leprosy patients at a sanatorium in the Democratic Republic of the Congo's Equator Province enabled an analysis of the survival of carriers of human T-cell lymphotropic virus type 1 (HTLV-1). The HTLV-1 prevalence in the sera collected from 377 leprosy patients and 143 controls in 1969 was 34% (37.4% and 25.2%, respectively). Multivariate survival analysis was performed to evaluate the impact of HTLV-1 status, age, type of leprosy, gender, duration of hospitalization, and ethnic group on the survival of leprosy patients. Members of the Mongo ethnic group were more likely than those of the Ngombe ethnic group to be infected. After adjustment for age and sex, mortality was significantly higher among HTLV-1-positive cases (5.5 per 100 person-years of observation) than HTLV-1-negative persons (3.6 per 100 person-years of observation). A survival analysis using the Cox model revealed a mortality risk ratio of 1.4 (95% confidence interval, 1.04-1.89) for HTLV-1-positive individuals. The reduced survival observed in HTLV-1-infected leprosy patients presumably resulted from concomitant increased susceptibility to other diseases.


Subject(s)
Carrier State/epidemiology , HTLV-I Infections/epidemiology , Leprosy/complications , Adolescent , Adult , Age Factors , Cause of Death , Child , Child, Preschool , Democratic Republic of the Congo/epidemiology , Female , HTLV-I Infections/complications , HTLV-I Infections/mortality , Humans , Infant , Infant, Newborn , Leprosy/mortality , Logistic Models , Male , Middle Aged , Multivariate Analysis , Prevalence , Retrospective Studies , Risk Factors , Sex Factors
8.
J Infect Dis ; 170(4): 1007-9, 1994 Oct.
Article in English | MEDLINE | ID: mdl-7930695

ABSTRACT

One-hundred seven consecutive patients attending a New York Hansen's disease clinic from November 1990 through June 1991 were tested for retroviruses. This cohort included 58 patients diagnosed with Hansen's disease after the onset of the AIDS epidemic, 54 of whom immigrated to the United States before diagnosis of Hansen's disease (median, 7 years). The overall rate (1.9%) of human T cell lymphotropic virus (HTLV) type I infection was low. Two (3.6%) of 55 Caribbean-born patients had polymerase chain reaction (PCR)-documented HTLV-I infection, but this incidence was not higher than expected in persons without Hansen's disease. No patient had PCR-documented evidence of either HTLV-II or human immunodeficiency virus (HIV) type 1 infection. The low rate of HIV-1 among those studied was likely related to an absence of classic HIV risk behavior because about half of the cohort could have incubated Mycobacterium leprae for a prolonged period while infected with HIV-1.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , HTLV-I Infections/epidemiology , HTLV-II Infections/epidemiology , Leprosy/complications , Acquired Immunodeficiency Syndrome/complications , Adolescent , Adult , Aged , Asia/ethnology , Caribbean Region/ethnology , Ethiopia/ethnology , Europe/ethnology , Female , HTLV-I Infections/complications , HTLV-II Infections/complications , Humans , Latin America/ethnology , Leprosy/epidemiology , Male , Middle Aged , New York City/epidemiology , Prevalence , South America/ethnology
9.
Am J Trop Med Hyg ; 45(6): 653-9, 1991 Dec.
Article in English | MEDLINE | ID: mdl-1763791

ABSTRACT

A seroepidemiologic survey was conducted to determine the prevalence of human immunodeficiency virus type 1 (HIV-1), HIV-2, human T cell lymphotropic virus type I (HTLV-I), and Treponema pallidum infection among southern Somalis. Sera were collected from 1,269 study subjects in the urban area of the capital city, Mogadishu, and in the rural towns of Merka, Qoryoley, and Kismayo. The subjects included 57 prostitutes, 79 sexually transmitted disease (STD) patients, and 1,133 others, including outpatient and hospitalized patients with leprosy, tuberculosis, other infectious diseases, individuals from rehabilitation camps and secondary schools, and Ethiopian immigrants. Results indicated that none of the sera were positive for HIV-1 and HIV-2 by Western blot, but one was positive for HTLV-I. The prostitutes had a significantly higher prevalence of treponemal antibody (50.8%; P less than 0.0001) than either the STD patients (12.6%) or the other subjects (5.2%). Epidemiologic data indicated that 94% of the males and females were circumcised and only 2.6% of the males used condoms. Overall, the results of this study suggested a very low prevalence of HIV-1, HIV-2, and HTLV-I infections, especially among prostitutes and STD patients, who were considered at greatest risk of contracting these retroviral infections.


Subject(s)
HIV Infections/epidemiology , HIV-1 , HIV-2 , HTLV-I Infections/epidemiology , Adolescent , Adult , Female , HIV Infections/microbiology , Humans , Male , Middle Aged , Prevalence , Seroepidemiologic Studies , Sexually Transmitted Diseases/epidemiology , Somalia/epidemiology
14.
Cancer ; 64(6): 1290-5, 1989 Sep 15.
Article in English | MEDLINE | ID: mdl-2766224

ABSTRACT

In order to clarify the prevalence of human T-cell leukemia virus type I (HTLV-I) infection in the Kagoshima district, Japan, a highly endemic area for HTLV-I, antibodies for HTLV-I (anti-HTLV-I) were examined in the sera of 6167 from healthy residents and patients with various hematologic and nonhematologic diseases. In healthy residents, including blood donors, the prevalence of anti-HTLV-I was 11.9% (562/4741 persons). The prevalence increased with age, and was significantly higher in in females than in males (P less than 0.01). The prevalence of anti-HTLV-I in blood donors was 8.5%. In In hematologic diseases, the prevalence of anti-HTLV-I was 98.3% in ATL, 28.9% in lymphoproliferative disorders except ATL, and 10.6% in myeloproliferative disorders. In nonhematologic diseases, the prevalence of anti-HTLV-I was shown to be 29.5% in pulmonary tuberculosis, 25.8% in leprosy, 33.8% in chronic renal failure (CRF), 21.9% in autoimmune diseases, and 47.8% in strongyloidiasis. The various diseases except myeloproliferative disorders had significantly higher prevalence of anti-HTLV-I than healthy residents (P less than 0.01 or 0.05). For autoimmune diseases, the prevalence of anti-HTLV-I in patients with blood transfusion (55.6%) was higher than in those without blood transfusion (8.7%), and healthy residents. In hemodialysis patients with CRF who had received blood transfusions the prevalence of anti-HTLV-I increased with the number of blood transfusions. Therefore, HTLV-I transmission via blood transfusion would partially explain these high prevalence of anti-HTLV-I. However, the prevalence of anti-HTLV-I in hemodialysis patients with CRF was statistically higher than that in healthy residents, regardless of blood transfusion (P less than 0.01). Furthermore, hemodialysis patients showed significantly higher prevalence of anti-HTLV-I than healthy residents, even at a younger age. Patients with pulmonary tuberculosis and leprosy showed the same results as hemodialysis patients. These results suggest that possibility that HTLV-I infection has some relation not only to ATL but also to other diseases. Therefore, it seems very important to halt the spread of HTLV-I transmission as soon as possible.


Subject(s)
HTLV-I Infections/epidemiology , Leukemia-Lymphoma, Adult T-Cell/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Blood Donors , Blood Transfusion , Female , HTLV-I Infections/complications , Hematologic Diseases/complications , Humans , Japan , Male , Middle Aged , Renal Dialysis , Serologic Tests
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