Can HTLV-1 infection be a potential risk factor for atherosclerosis?

INTRODUCTION: Chronic inflammations including infectious disorders such as HIV infection are now considered as risk factors for atherosclerosis. In this study, conducted for the first time on human subjects, human T-lymphotropic virus type 1 (HTLV-1) infection was examined as a potential risk factor for atherosclerosis. MATERIALS AND METHODS: This is a matched-pair cross-sectional study on 58 HTLV-1-infected cases and 55 healthy control subjects. The subjects did not have any major cerebrovascular risk factors. Carotid intima-media thickness (IMT) was measured for each patient using the standard protocol of the Atherosclerosis Risk in Communities (ARIC) Study. RESULTS: The mean age of the subjects was 42.9 ± 10.52 years, and males made up 33% of the population. The difference between the mean IMT of the infected case group and that of the healthy control group was significant (p < 0.05). DISCUSSION: This study indicated that the HTLV-infected individuals showed a greater carotid IMT than the age- and sex-matched control subjects. Observing no other known risk factor for atherosclerosis, we concluded that this significant difference in IMT might support the hypothesis that HTLV-1 infection is an independent risk factor for atherogenesis.

Human T-lymphotropic virus type I and breastfeeding; systematic review and meta-analysis of the literature.

Background: The human T-cell lymphotropic virus type-I (HTLV-I) is the first identified pathogenic human retrovirus. Breastfeeding has been reported to be the predominant route of vertical transmission of HTLV-I. The objective of this systematic review was to pool and evaluate the data on the transmission of HTLV-I with different infant-feeding practices on children born to HTLV-I-positive mothers. We conducted a systematic review of comparison of HTLV-I transmission risk to breastfed and bottle-fed babies. Methods: We searched the following databases: MEDLINE, SID, Magiran, and Cochrane Library. The search strategy was limited to articles in English. Initial screening identified 254 citations; of these, 96 potentially relevant articles were identified. After reviewing the 96 full-text articles in detail, 7 reports met the inclusion criteria for this review. Results: Pooled odds ratio (OR) and risk difference (RD) of HTLV-I transmission in the breastfed group compared to the bottle-fed infants were [OR = 3.48, 95% confidence interval (CI): 1.58-7.64, P = 0.0020, Cochran's Q = 27.7, P = 0.0010, and I2 = 67.5%] and (RD = 17.1%, 95% CI: 7.5%-26.7%, P < 0.0001, Cochran's Q = 106, P < 0.0001, and I2 = 91.5%). So, we have evidence to support that exclusive breast feeding more than 6 months in comparison to bottle feeding highly increases transmission rate of HTLV-I infection. We have also enough evidence to support that exclusive breast feeding up to 6 months compared to bottle feeding does not increase transmission rate of HTLV-I infection (pooled OR = 0.912, CI: 0.45-1.80; OR: 3.83, CI: 1.80-8.10, respectively). Conclusion: The current meta-analysis showed that short period (less than 6 months) of breastfeeding did not increase risk of HTLV-I infection transmission from mother to child among breastfeeders and more than 6 months of breastfeeding significantly increased the risk of HTLV-I infection. However, our meta-analysis shows that refraining from breastfeeding can decrease the risk of vertical HTLV-I transmission.

Intermittent Diazepam versus Continuous Phenobarbital to Prevent Recurrence of Febrile Seizures: A Randomized Controlled Trial.

OBJECTIVE: Febrile seizure is the most common neurologic problem in children between 3 months to 5 years old. Two to five percent of children aged less than five yr old will experience it at least one time. This type of seizure is age dependent and its recurrence rate is about 33% overalls and 50% in children less than one yr old. The prophylactic treatment is still controversial, so we conducted a randomized controlled clinical trial to find out the effectiveness of continuous phenobarbital versus intermittent diazepam for febrile seizure. MATERIALS & METHODS: This clinical trial was conducted in the Department of Pediatric Neurology, Babol University of Medical Sciences, Babol, Iran between March 2008 and October 2010. All children from 6 month to 5 yr old referred to Amirkola Children's Hospital, Babol, Iran were enrolled in the study. Children with febrile seizure that had indication for prophylaxis but did not receive any prophylaxis previously were enrolled in the study. For prophylactic anti convulsion therapy, patients were divided randomly in two groups. One group received continuous phenobarbital and another treated with intermittent diazepam whenever the children experienced an episode of febrile illness for up to one year after their last convulsion. RESULTS: Of all 145 studied cases, the recurrent rate in children under prophylaxis with diazepam was 11/71 and in phenobarbital group was 17/74. There was no significant difference in the recurrence rate in both groups. CONCLUSION: There was no significant difference in the effectiveness of phenobarbital and diazepam in prevention of recurrent in febrile seizure and we think that in respect of lower complication rate in diazepam administration, it cloud be better choice than phenobarbital.