Evaluation of the cervicovaginal environment in asymptomatic Human T-cell lymphotropic virus type 1 infected women

Firmino, Alisson de Aquino; Martins, Adenilda Lima Lopes; Gois, Luana Leandro; Paixão, Taiane Silva; Batista, Everton da Silva; Galvão–Castro, Bernardo; Grassi, Maria Fernanda Rios

doi:10.1016/j.bjid.2019.02.001

Cited by 4 publications

(4 citation statements)

References 38 publications

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“…Our work has previously shown that HTLV-1-infected women exhibit an activated immune response in the vaginal mucosa, as reflected by higher concentrations of cytokines, such as IL-2, TNF, IL-10, IL-4, and IL-17, in cervical fluid compared to uninfected women. Cytokine levels in vaginal fluid have not been found to correlate with HTLV-1 PVL in cervicovaginal fluid or peripheral blood mononuclear cells in asymptomatic patients [11]. In addition, cytokine analyses revealed no differences between women with detectable or undetectable PVL (data not shown).…”

Section: Discussionmentioning

confidence: 86%

“…Albumin DNA was used as an endogenous reference. The value of HTLV-1 proviral load was reported as the [(HTLV-1 average copy number)/(albumin average copy number)] × 2 × 10 6 and expressed as the number of HTLV-1 copies per 10 6 cells in both blood and vaginal fluid samples, as previously described [11,17]. Results were analyzed using 7500 v2.0.1 software (Applied Biosystems).…”

Section: Sample Analysismentioning

confidence: 99%

“…We have previously shown higher levels of Th1, Th2, and Th17 inflammatory cytokines in the vaginal fluid from HTLV-1-infected women compared to that of uninfected women [11]. In this study, we aimed to quantify PVL in the vaginal fluid of HTLV-1-infected women and then investigate correlations with PVL in peripheral blood mononuclear cells (PBMC).…”

Section: Introductionmentioning

confidence: 99%

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HTLV-1 Proviral Load in Vaginal Fluid Correlates With Levels in Peripheral Blood Mononuclear Cells

Firmino¹,

Filho²,

Martins³

et al. 2023

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Background: The prevalence of human T-lymphotropic virus type-1 (HTLV-1) infection is higher in women, and sexual intercourse has been described as an important route of male-to-female transmission. The present study aimed to quantify HTLV-1 proviral load (PVL) in vaginal fluid, and to investigate correlations with PVL in peripheral blood mononuclear cells (PBMC). Methods: HTLV-1-infected women were consecutively recruited at a multidisciplinary center for HTLV patients in Salvador-Brazil. All women underwent gynecological examinations to obtain cervicovaginal fluid and venipuncture for blood collection. PVL, as measured by real-time quantitative polymerase chain reaction (RT-qPCR), was expressed as the number of copies of HTLV-1/106 cells in blood and vaginal fluid samples. Light microscopy was used to assess cervicovaginal cytopathology and vaginal microbiota. Results: In the 56 included women (43 asymptomatic carriers and 13 diagnosed with HTLV-associated myelopathy/tropical spastic paraparesis-HAM/TSP), mean age was 35.9 (SD±7.2) years. PVL was higher in PBMCs [median: 23,264 copies/106 cells (IQR: 7,420 - 64,371)] than in vaginal fluid [451.9 copies/106 cells (IQR: 0 - 2,672)] (p<0.0001). PVL in PBMCs was observed to correlate directly with PVL in vaginal fluid (R=0.32, p=0.01). PVL was undetectable in vaginal fluid samples from 20 women (35.7%), most of whom were asymptomatic (19/20). Cytopathologic analyses revealed no differences between women with detectable or undetectable PVL. Conclusion: HTLV-1 proviral load is detectable in vaginal fluid and correlates directly with proviral load in peripheral blood. This finding suggests that sexual transmission of HTLV-1 from female to male may occur and vertical transmission, particularly in the context of vaginal delivery.

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Section: Discussionmentioning

confidence: 86%

Section: Sample Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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HTLV-1 Proviral Load in Vaginal Fluid Correlates With Levels in Peripheral Blood Mononuclear Cells

Firmino¹,

Filho²,

Martins³

et al. 2023

Preprint

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“… 33 HTLV-1 infection induces proinflammatory cytokines in the cervicovaginal fluid of asymptomatic women, even in the presence of a low vaginal HTLV-1 proviral load. 34 This inflammatory response may damage the vaginal fluid–secreting glands, as has been observed in lacrimal and salivary glands. 30 However, this hypothesis has not been investigated.…”

Section: Discussionmentioning

confidence: 96%

Vaginal dryness in women infected by human T-lymphotropic virus type 1: an exploratory study

et al. 2023

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Background Human T-lymphotropic virus type-1 (HTLV-1) causes a variety of sicca symptoms, including xeroderma, xerostomia, and xerophthalmia. Aim We sought to evaluate vaginal dryness via the degree of perceived vaginal lubrication, vaginal hormonal cytology, and direct measurements of vaginal wetting. Methods The research was designed as a cross-sectional study. Vaginal dryness was assessed by scores in the lubrication domain of the Female Sexual Function Index (FSFI) questionnaire and the Vaginal Maturation Index (VMI) determined by vaginal hormonal cytology, as well as the measurement of vaginal lubrication using Schirmer strips placed at the anterior vaginal wall. Medians (25th-75th percentiles) were calculated for each group and compared using a nonparametric Kruskal-Wallis test and the Dunn-Bonferroni post hoc method. Outcomes Outcomes were detection of the presence of vaginal dryness in women who were infected or noninfected with HTLV-1. Results HTLV-1–infected women (n = 72, 57 asymptomatic and 15 with HTLV-1–associated myelopathy/tropical spastic paraparesis [HAM/TSP]) and uninfected women (n = 49) were studied. Women with HAM/TSP had significantly lower FSFI lubrication scores than asymptomatic and uninfected women (P = .032). In addition, women with HAM/TSP had significantly lower VMI compared with the asymptomatic and uninfected groups (P = .027 and P = .039, respectively). Clinical Implications The results of this study show a reduction in vaginal lubrication in HTLV-1-infected women diagnosed with HAM/TSP compared with asymptomatic and uninfected women. Strengths and Limitations The lack of a gold standard test for the diagnosis of vaginal dryness and the fact that no assessment of vaginal pH was performed were limitations of this study. The strength of the study was the comprehensive assessment of vaginal dryness from several perspectives: subjective (perception of vaginal lubrication according to the vaginal lubrication domain of the FSFI), hormonal (vaginal hormonal cytology to assess local hormone status), and the degree of vaginal moisture (direct measurement of vaginal dryness with an instrument, the Schirmer strip, already used to measure the presence of dry eye). Conclusion HTLV-1-infected women with HAM/TSP have decreased vaginal lubrication compared with asymptomatic and uninfected women after adjusting for age.

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Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies

et al. 2021

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Human T-cell lymphotropic viruses 1 and 2 (HTLV-1/2) are relatively common in Brazil but remain silent and neglected infections. HTLV-1 is associated with a range of diseases with high morbidity and mortality. There is no curative treatment for this lifelong infection, so measures to prevent transmission are essential. This narrative review discusses HTLV-1/2 transmission routes and measures to prevent its continuous dissemination. The public health policies that are currently implemented in Brazil to avoid HTLV-1/2 transmission are addressed, and further strategies are proposed.

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Evaluation of the cervicovaginal environment in asymptomatic Human T-cell lymphotropic virus type 1 infected women

Cited by 4 publications

References 38 publications

HTLV-1 Proviral Load in Vaginal Fluid Correlates With Levels in Peripheral Blood Mononuclear Cells

HTLV-1 Proviral Load in Vaginal Fluid Correlates With Levels in Peripheral Blood Mononuclear Cells

Vaginal dryness in women infected by human T-lymphotropic virus type 1: an exploratory study

Blocking HTLV-1/2 silent transmission in Brazil: Current public health policies and proposal for additional strategies

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