Isolation of the Arawete and Asurini Indians keeps the tribes free from HTLV infection during 36 years of follow-up.

Arawete and Asurini Indian tribes were revisited after a 36-year follow-up in search of HTLV infections. 46 persons (23 from each tribe) were tested for HTLV-1/2 antibodies and viral DNA. None were positive; this was probably because of their social/cultural isolation from neighboring tribes where HTLV-2c is hyperendemic.

Re-emergence of human T-lymphotropic viruses in West Africa.

Human T-lymphotropic viruses (HTLV) are Deltaretroviruses that infect millions of individuals worldwide via the same transmission routes as HIV. With the aim of exposing the possible re-emergence of HTLV in West Africa since discovery, a systematic review was carried out, focusing on the distribution of the virus types and significance of frequent indeterminate reports, while highlighting the need for mandatory routine blood screening. Capturing relevant data from discovery till date, sources searched were Google Scholar, CrossRef, NCBI (PubMed), MEDLINE, Research Gate, Mendeley, abstracts of Conferences and Proceedings, organization websites and reference lists of selected papers. A total of 2626 references were initially retrieved using search terms: Worldwide prevalence of HTLV, HTLV in Africa, HTLV in West Africa, HTLV subtypes, HTLV 3 and 4 in Africa, HTLV of African origin, HTLV seroindeterminate results, Spread of HTLV. These references were rigorously trimmed down to 76. Although evidence shows that HTLV is still endemic in the region, West Africa lacks recent epidemiological prevalence data. Thorough investigations are needed to ascertain the true cause of indeterminate Western Blot results. It is imperative that routine screening for HTLVs be mandated in West African health care facilities.

Re-emergence of human T-lymphotropic viruses in West Africa

ABSTRACT Human T-lymphotropic viruses (HTLV) are Deltaretroviruses that infect millions of individuals worldwide via the same transmission routes as HIV. With the aim of exposing the possible re-emergence of HTLV in West Africa since discovery, a systematic review was carried out, focusing on the distribution of the virus types and significance of frequent indeterminate reports, while highlighting the need for mandatory routine blood screening. Capturing relevant data from discovery till date, sources searched were Google Scholar, CrossRef, NCBI (PubMed), MEDLINE, Research Gate, Mendeley, abstracts of Conferences and Proceedings, organization websites and reference lists of selected papers. A total of 2626 references were initially retrieved using search terms: Worldwide prevalence of HTLV, HTLV in Africa, HTLV in West Africa, HTLV subtypes, HTLV 3 and 4 in Africa, HTLV of African origin, HTLV seroindeterminate results, Spread of HTLV. These references were rigorously trimmed down to 76. Although evidence shows that HTLV is still endemic in the region, West Africa lacks recent epidemiological prevalence data. Thorough investigations are needed to ascertain the true cause of indeterminate Western Blot results. It is imperative that routine screening for HTLVs be mandated in West African health care facilities.

Dia Mundial do HTLV - 10 de Novembro / World HTLV Day - November 10th

O dia 10 de novembro foi instituído como Dia Mundial do HTLV pela Associação Internacional de Retrovirologia (IRVA – International Retrovirology Association). O objetivo deste ato foi de informar e mobilizar a sociedade e o poder público para o significado da infecção ocasionada pelo primeiro retrovírus humano descrito, o vírus linfotrópico de células T humanas do tipo 1 (HTLV1), as doenças a ele associadas, seu impacto na saúde pública e os meios de contê-lo. Como o Brasil é o país da América Latina com o maior número absoluto de casos desta infecção viral, foi elaborado o presente texto que traz as informações relevantes sobre o HTLV-1 para a comunidade científica.

The November 10th was instituted as the World HTLV Day by the International Retrovirology Association (IRVA), aiming informing and mobilizing the society and the public authorities on the significance of this infection caused by the first known human retrovirus, the human T-cell lymphotropic virus type 1 (HTLV-1). The associated diseases, the impact in the public health, and the means to block its transmission were reviewed. Considering that Brazil, the country in the Latin America, has been presenting the highest number of HTLV-1-infected individuals, this text was written for giving the relevant information concerning the HTLV-1 infection to the scientific community.

Dia Mundial do HTLV - 10 de Novembro / World HTLV Day - November 10th

O dia 10 de novembro foi instituído como Dia Mundial do HTLV pela Associação Internacional de Retrovirologia (IRVA International Retrovirology Association). O objetivo deste ato foi de informar e mobilizar a sociedade e o poder público para o significado da infecção ocasionada pelo primeiro retrovírus humano descrito, o vírus linfotrópico de células T humanas do tipo 1 (HTLV1), as doenças a ele associadas, seu impacto na saúde pública e os meios de contê-lo. Como o Brasil é o país da América Latina com o maior número absoluto de casos desta infecção viral, foi elaborado o presente texto que traz as informações relevantes sobre o HTLV-1 para a comunidade científica.(AU)

The November 10th was instituted as the World HTLV Day by the International Retrovirology Association (IRVA), aiming informing and mobilizing the society and the public authorities on the significance of this infection caused by the first known human retrovirus, the human T-cell lymphotropic virus type 1 (HTLV-1). The associated diseases, the impact in the public health, and the means to block its transmission were reviewed. Considering that Brazil, the country in the Latin America, has been presenting the highest number of HTLV-1-infected individuals, this text was written for giving the relevant information concerning the HTLV-1 infection to the scientific community.(AU)

Familial transmission of human T-cell lymphotrophic virus: silent dissemination of an emerging but neglected infection.

BACKGROUND: HTLV-1 is a retrovirus that causes lymphoproliferative disorders and inflammatory and degenerative diseases of the central nervous system in humans. The prevalence of this infection is high in parts of Brazil and there is a general lack of public health care programs. As a consequence, official data on the transmission routes of this virus are scarce. OBJECTIVE: To demonstrate familial aggregation of HTLV infections in the metropolitan region of Belém, Pará, Brazil. METHOD: A cross-sectional study involving 85 HTLV carriers treated at an outpatient clinic and other family members. The subjects were tested by ELISA and molecular methods between February 2007 and December 2010. RESULTS: The prevalence of HTLV was 43.5% (37/85) for families and 25.6% (58/227) for the family members tested (95% CI: 1.33 to 3.79, P = 0.0033). Sexual and vertical transmission was likely in 38.3% (23/60) and 20.4% (29/142) of pairs, respectively (95% CI: 1.25 to 4.69, P = 0.0130). Positivity was 51.3% (20/39) and 14.3% (3/21) in wives and husbands, respectively (95% CI: 0.04 to 0.63, P = 0.0057). By age group, seropositivity was 8.0% (7/88) in subjects <30 years of age and 36.7% (51/139) in those of over 30 years (95% CI: 0.06 to 0.34, P<0.0001). Positivity was 24.1% (7/29) in the children of patients infected with HTLV-2, as against only 5.8% (4/69) of those infected with HTLV-1 (95% CI: 0.05 to 0.72, P = 0.0143). CONCLUSION: The results of this study indicate the existence of familial aggregations of HTLV characterized by a higher prevalence of infection among wives and subjects older than 30 years. Horizontal transmission between spouses was more frequent than vertical transmission. The higher rate of infection in children of HTLV-2 carriers suggests an increase in the prevalence of this virus type in the metropolitan region of Belém.

Correlação de polimorfismos na região promotora dos genes de IL-6 e IL-10 com o desenvolvimento de doenças em indivíduos infectados pelo HTLV-I e análise da distribuição destes polimorfismos em diferentes grupos populacionais brasileiros / Correlation of polymorphisms in the promoter region of genes of IL-6 and IL-10 with the development of diseases in individuals infected with HTLV-I and analysis of the distribution of these polymorphisms in different population groups Brazilians

Polimorfismos localizados em regiões promotoras ou em outras regiões regulatórias dos genes podem estar relacionados à produção diferenciada de citocinas, podendo, conseqüentemente, alterar a intensidade ou a qualidade da resposta imune. Neste trabalho, investigamos a associação entre polimorfismos nos promotores de IL-6 e IL-IO com o desenvolvimento de TSP/HAM, e com osteopenia, em pacientes infectados pelo HTLV-l de Salvador. Para avaliar a correlação com TSP/HAM, nós analisamos 133 indivíduos infectados pelo HTLV-1 (84 assintomáticos, 26 com TSP/HAM e 23 oligosintomáticos) e 100 soronegativos da população geral de Salvador. Para avaliar a possível correlação com osteopenia, os polimorfismos foram analisados em 43 indivíduos, jovens (20-45 anos), assintomáticos, a fim de identificar fatores de risco que poderiam estar relacionados com alterações no metabolismo ósseo. Vale ressaltar, que a freqüência de SNP e de seus haplótipos podem diferir em populações com diferentes backgrounds genéticos, explicando em parte por que algumas populações são mais susceptíveis a determinadas patologias. Desta forma, inicialmente, analisamos o padrão dos polimorfismos nos promotores de IL-6 e IL-IO na população de Salvador e em duas outras populações brasileiras: 99 ameríndios (tribo Tiriyó) e 94 indivíduos de Joinville (descendentes de alemães). Os polimorfismos foram investigados por RFLP (-634G/C e-592C/A) e por Real Time PCR (-572G/C, -597G/ e -174G/C). A freqüência do SNP -174G/C na região promotora do gene da IL-6 foi altamente heterogênea em todas as populações estudadas, sendo os resultados consistentes com dados de outras populações de mesmo background étnico. Descrevemos pela primeira vez a prevalência do polimorfismo -634C/G nesses grupos étnicos. Observamos uma diferença significante na freqüência alélica do SNP -592C/A IL-10 entre os indivíduos de Tiriyó e as duas outras populações, mas não entre Salvador e Joinville. O alelo A na posição -592A foi significativamente mais prevalente nos Tiriyós, sendo sua freqüência similar àquela relatada em populações da Ásia e Índia. Nos indivíduos infectados, detectamos uma maior freqüência do alelo -634C no grupo TSP/HAM (21.2%), quando comparado aos oligosintomáticos (6.5%; p=0.038) e assintomáticos (9.5%; p=O.025). Similarmente, a freqüência do alelo -174G alelo foi maior em TSP/HAM, quando comparado aos oligosintomáticos (p=O.02). Além disso, a combinação -634GC/-174GG foi mais freqüente nos pacientes com TSP/HAM (38.5%) que nos outros grupos (8.7%; p=O.016 para oligosintomáticos e 15.5%, p=O.012 para assintomáticos), sugerindo que esta combinação poderia estar relacionada ao desenvolvimento de TSP/HAM. Em relação à identificação de possíveis fatores de risco para o desenvolvimento de osteopenia em indivíduos jovens assintomáticos, embora não tenhamos encontrado associação com os polimorfismos em IL-6, todos os indivíduos -174GC apresentaram níveis de osteoclacina menores que os valores normais (3.1mg/dL) (p=O.029) e este polimorfismo foi associado ainda a maior carga proviral (p=O.OO5). Juntos, esses resultados sugerem que polimorfismos em genes de IL-6 podem ser importantes no desenvolvimento de doença em indivíduos infectados pelo HTLV-1 e que o background genético deve ser considerados. Esses estudos podem contribuir para a melhor compreensão da complexa associação entre a variabilidade região promotora da de IL-6 e susceptibilidade à doença, bem como podem ajudar na compreensão da interação: hospedeiro X vírus na patogênese do HTLV-1.

HTLV in the Americas: challenges and perspectives.

The first description of the human T-lymphotropic virus type 1 (HTLV-1) was made in 1980, followed closely by the discovery of HTLV-2, in 1982. Since then, the main characteristics of these viruses, commonly referred to as HTLV-1/2, have been thoroughly studied. Central and South America and the Caribbean are areas of high prevalence of HTLV-1 and HTVL-2 and have clusters of infected people. The major modes of transmission have been through sexual contact, blood, and mother to child via breast-feeding. HTLV-1 is associated with adult T-cell leukemia/lymphoma (ATL), HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and HTLV-associated uveitis as well as infectious dermatitis of children. More clarification is needed in the possible role of HTLV in rheumatologic, psychiatric, and infectious diseases. Since cures for ATL and HAM/TSP are lacking and no vaccine is available to prevent HTLV-1 and HTLV-2 transmission, these illnesses impose enormous social and financial costs on infected individuals, their families, and health care systems. For this reason, public health interventions aimed at counseling and educating high-risk individuals and populations are of vital importance. In the Americas this is especially important in the areas of high prevalence.

HTLV in the Americas: challenges and perspectives / El virus de la leucemia humana de células T (VLHT) en las Américas: retos y perspectivas

La primera descripción del virus de la leucemia humana de células T tipo 1 (VLHT-1) se hizo en 1980, y al poco tiempo, en 1982, se descubrió el VLHT-2. Desde entonces las características principales de estos virus, a los que a menudo se les llama VLHT-1/2, se han estudiado exhaustivamente. Centroamérica, América del Sur y el Caribe son áreas con una alta prevalencia de VLHT-1 y VLHT-2 donde hay conglomerados de personas infectadas. Las principales vías de transmisión han sido el contacto sexual, la sangre y sus derivados, y la de madre a hijo por la leche materna. El VLHT-1 se asocia con la leucemia o el linfoma de células T maduras (LTM), la mielopatía o paraparesia tropical espástica ligada al VLHT (M/PTE), y la uveítis ligada al VLHT, así como con la dermatitis infecciosa de la infancia. Se necesita más información acerca del posible papel que desempeña el VLHT en la aparición de enfermedades reumáticas, psiquiátricas e infecciosas. En vista de que no se dispone de ninguna cura para la LTM ni la M/PTE, como tampoco de ninguna vacuna para prevenir la transmisión del VLHT-1 y VLHT-2, estas enfermedades acarrean enormes costos sociales y económicos para las personas infectadas, sus parientes y los sistemas de salud. Por este motivo, las intervenciones sanitarias orientadas a asesorar e instruir a personas y poblaciones en alto riesgo revisten una importancia crítica. En el continente americano esto cobra aun más importancia en zonas de alta prevalencia.

The first description of the human T-lymphotropic virus type 1 (HTLV-1) was made in 1980, followed closely by the discovery of HTLV-2, in 1982. Since then, the main characteristics of these viruses, commonly referred to as HTLV-1/2, have been thoroughly studied. Central and South America and the Caribbean are areas of high prevalence of HTLV-1 and HTVL-2 and have clusters of infected people. The major modes of transmission have been through sexual contact, blood, and mother to child via breast-feeding. HTLV-1 is associated with adult T-cell leukemia/lymphoma (ATL), HTLV-associated myelopathy/tropical spastic paraparesis (HAM/ TSP), and HTLV-associated uveitis as well as infectious dermatitis of children. More clarification is needed in the possible role of HTLV in rheumatologic, psychiatric, and infectious diseases. Since cures for ATL and HAM/TSP are lacking and no vaccine is available to prevent HTLV-1 and HTLV-2 transmission, these illnesses impose enormous social and financial costs on infected individuals, their families, and health care systems. For this reason, public health interventions aimed at counseling and educating high-risk individuals and populations are of vital importance. In the Americas this is especially important in the areas of high prevalence.

Bloodborne viral infections in patients attending an emergency room in Mexico City: estimate of seroconversion probability in healthcare workers after an occupational exposure.

The frequency of hepatitis C (HCV), hepatitis B (HBV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus (HTLV) I/II was determined in the emergency room of a teaching hospital. Of 909 patients, 19% had at least one infection; 7.8% had HCV, 6.9% HBV, 3.3% HIV, and 2.8% HTLV I/II. The probability that a healthcare worker would have an accident with an infected patient and seroconvert was 4.99 to 24.9 per 100,000 venipunctures for HBV, 5.6 to 8.4 for HCV, and 0.12-0.16 for HIV in our emergency room.

Vertical transmission of HTLV-I/II: a review

A transmissao vertical do virus linfotropico para celulas T humanas tipo I (HTLV) ocorre principalmente atraves da amamentacao. Como um pequeno percentual de filhos de portadoras alimentados artificialmente e soropositivo, devem existir outras vias de transmissao vertical. A taxa de prevalencia de transmissao vertical no Japao varia de 15 por cento a 25 por cento. No Brasil, ainda nao existe nenhuma avaliacao desta forma de transmissao, no entanto, sabe-se que em Salvador-Bahia 0,7 por cento a 0,9 por cento das gestantes de classe socio-economica baixa sao portadoras

Human immunodeficiency virus type 2 infection in children.

Human immunodeficiency virus type 2 infection is rare in children. This virus can be acquired through transfusion and also by the maternofetal route, especially when the mother becomes infected during pregnancy. Diagnosis based on specific serologic tests is simple after the age of 18 months. In the perinatal period, however, viral isolation by culture or polymerase chain reaction DNA amplification or both appears to be less sensitive than in the case of human immunodeficiency virus type 1. Disease progression is far slower than with human immunodeficiency virus type 1, but severe immunodeficiency can occur.

HIV risk perception, risk behaviour, and seroprevalence among female commercial sex workers in Georgetown, Guyana / Percepción del riesgo, comportamiento de riesgo y seroprevalencia de VIH en trabajadoras sexuales de Georgetown, Guyana

A study of 108 female sex workers engaged in prostitution in Georgetown, Guyana, was made in April 1993. Based on interviews and procurement of blood samples, the study investigated relationships between HIV seroprevalences and AIDS knowledge, risk behaviors, client characteristics, and condom use. Street-walkers­as distinct from sex workers in bars, hotels, and Port Georgetown­tended to charge less, be worse off socioeconomically, and have clients who were similarly disadvantaged; they were therefore classified as belonging to a "lower" socioeconomic stratum, while the other workers were classified as belonging to a "higher" stratum. The overall HIV seroprevalence found among the sex workers was 25% (95%CI: 17%­33%). But the 50 subjects in the lower stratum had a relatively high seroprevalence (42%, as compared to 10% among those in the higher stratum), accounting for 21 of the 27 HIV-seropositive subjects. Reported patterns of client origins (Guyanese or foreign), worker willingness to have sex without a condom, and condom use by clients differed by stratum. Participants in the higher stratum were more disposed to having sex without a condom. The workers' knowledge of what causes AIDS and how HIV is transmitted was low in both strata; substantial numbers of workers said they had contracted a sexually transmitted disease within the past two years or were users of illicit drugs. Condom use is reportedly less common among Guyanese than foreign clients, suggesting a greater risk of contracting HIV from Guyanese clients or infecting Guyanese clients with it. The HIV seroprevalence among workers who said they had only Guyanese clients was statistically greater than the rate among those who said they had only foreign clients. The HIV seroprevalence among those reporting more than five clients per week was statistically greater than among those reporting fewer. HIV seropositivity was relatively high among the 12 workers who said they used cocaine. Overall, the findings supported the view that interventions targeted at female sex workers and their clients should be strengthened­more specifically, that concerted efforts should be made to intensify condom promotion, distribution, and social marketing; to improve STD services that provide treatment and counseling for female sex workers; and to increase educational activities among the workers' Guyanese clients.

En abril de 1993 se llevó a cabo un estudio de 108 trabajadoras sexuales que ejercían la prostitución en Georgetown, Guyana. En el estudio se investigaron, mediante entrevistas y exámenes de sangre, las relaciones entre seroprevalencia de VIH y conocimientos sobre el sida, comportamientos riesgosos, características de los clientes y uso de condones. Las trabajadoras sexuales callejeras ­en contraste con las que trabajaban en bares, hoteles y en Port Georgetown­ por lo general cobraban menos, estaban en peor situación económica y tenían clientes en circunstancias similares. Por lo tanto, se clasificaron como pertenecientes a un estrato socioeconómico más "bajo", mientras que las otras trabajadoras se clasificaron como de estrato más "alto". En todo el grupo de trabajadoras sexuales se encontró una seroprevalencia general de 25% (95%IC: 17%­33%). Las 50 mujeres clasificadas como de estrato bajo tenían una seroprevalencia relativamente alta (42%, comparada con 10% en el estrato alto), y a ese subgrupo pertenecían 21 de las 27 seropositivas a VIH. Según la información dada por las participantes, también se relacionaban con esos estratos el origen de los clientes (guyaneses o extranjeros), el consentimiento a tener relaciones sin condón y el uso de condón por los clientes. Las participantes de estrato alto consentían más a menudo a tener sexo sin condón. Las mujeres de ambos estratos tenían pocos conocimientos acerca de la causa del sida y la transmisión de VIH y un número importante de las trabajadoras declaró haber contraído alguna enfermedad de transmisión sexual o consumido drogas ilegales en los 2 años anteriores. Los clientes guyaneses usan condones menos que los extranjeros, lo que sugiere un riesgo más alto de adquirir VIH de esos clientes y también de infectarlos con el virus. La seroprevalencia de VIH fue más alta entre las trabajadoras que dijeron haber tenido clientes guyaneses que entre las que recibían solamente a clientes extranjeros. Fue además estadísticamente mayor entre las que tenían más de cinco clientes a la semana. La seropositividad a VIH fue relativamente alta entre las 12 trabajadoras que declararon haber usado cocaína. En general, los resultados de este trabajo sustentan el principio de que deben fortalecerse las intervenciones dirigidas a las trabajadoras sexuales y sus clientes. En particular, debe hacerse un esfuerzo para intensificar la promoción, distribución y mercadeo social de los condones; mejorar los servicios de enfermedades de transmisión sexual que ofrecen tratamiento y orientación personal a las trabajadoras sexuales y aumentar las actividades educativas dirigidas a los clientes guyaneses.

Ethnic composition, age and sex, together with location and standard of housing as determinants of HTLV-I infection in an urban Trinidadian community

The presence of antibody to human T-cell leukaemia virus (HTLV-I) has been assessed in 2,143 men and women who represent 83 percent of all adults aged 35 to 69 years resident in a defined urban community in Trinidad. Individuals of African descent had a higher sero-positivity rate (7.0 percent) than those originating from India (1.4 percent), Europe (0 percent) or of mixed descent (2.7 percent). Women were infected more frequently than men, and the prevalence of infection increased with age in both sexes. Sero-positivity rates were significantly increased in adults who lived in housing of poor quality (p less than 0.001) or close to water courses (p less than 0.025). These data and others raise the possibility that one route of HTLV-I transmission may be via insect vectors under particular domestic circumstances.(AU)

Seroprevalence of HIV, HTLV-I/II and other perinatally-transmitted pathogens in Salvador, Bahia.

Generation of epidemiological data on perinatally-transmitted infections is a fundamental tool for the formulation of health policies. In Brazil, this information is scarce, particularly in Northeast, the poorest region of the country. In order to gain some insights of the problem we studied the seroprevalence of some perinatally-transmitted infections in 1,024 low income pregnant women in Salvador, Bahia. The prevalences were as follow: HIV-1 (0.10%), HTLV-I/II (0.88%), T.cruzi (2.34%). T.pallidum (3.91%), rubella virus (77.44%). T.gondii IgM (2.87%) and IgG (69.34%), HBs Ag (0.6%) and anti-HBs (7.62%). Rubella virus and T.gondii IgG antibodies were present in more than two thirds of pregnant women but antibodies against other pathogens were present at much lower rates. We found that the prevalence of HTLV-I/II was nine times higher than that found for HIV-1. In some cases such as T.cruzi and hepatitis B infection there was a decrease in the prevalence over the years. On the other hand, there was an increase in the seroprevalence of T.gondii infection. Our data strongly recommend mandatory screening tests for HTLV-I/II, T.gondii (IgM), T.pallidum and rubella virus in prenatal routine for pregnant women in Salvador. Screening test for T.cruzi, hepatitis and HIV-1 is recommended whenever risk factors associated with these infections are suspected. However in areas with high prevalence for these infections, the mandatory screening test in prenatal care should be considered.