HTLV-I associated myelopathy in the northern region of Brazil (Belém-Pará): serological and clinical features of three cases

Abstract

Three patients (males, black, ages 37, 40 and 57) attended a university clinic with a progressive paraparesis of obscure origin. One patient who referred disease duration of more than 16 years, showed diminished deep reflexes, bilateral Babinski's sign, diminished sensation of vibration, abnormal bladder function and back pain. The other two patients (with one and six years of disease duration) complained of weakness in one leg, increased deep reflexes and back pain. Babinski's sign and bladder disturbance were also present in the patient with six years of disease. Blood samples tested by an enzyme immune assay and a discriminatory Western blot were positive for HTLV-I. The familial analysis of one patient showed a possible pattern of sexual and vertical transmission of the virus. To the best of our knowledge, these are the first cases of a proven association between HTLV-I and TSP/HAM in Belem, Para, and emphasize the need to actively look for cases of neurological disease associated to the virus.

Human T-lymphotropic virus 1aA circulation and risk factors for sexually transmitted infections in an Amazon geographic area with lowest human development index (Marajó Island, Northern Brazil)

“…In 2002, our research group described, for the first time, the tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM) among three African-decent males residing in Santa Cruz do Arari county, Marajó Island [19]. Four years later we described the cases of HTLV in Quilombola communities in the Marajó Archipelago and associated the presence of the virus with the ethnic origin of the population [20].…”

Identification of human T-cell lymphotropic virus infection in a semi-isolated Afro-Brazilian quilombo located in the Marajó Island (Pará, Brazil)

“…Furthermore, the presence of HTLV-1 in this geographical area is of paramount importance because of the previous description of a cluster of cases of TSP/HAM in two individuals residing in Cachoeira do Arari county, Marajó Island (Ishak et al 2002). It is necessary to emphasize the need for a close surveillance and to proceed a further active search for cases of neurological diseases associated to HTLV-1, in this particular geographical area of the country, considering the total of 294 semi-isolated Afro-Brazilian communities recently described in the state of Pará (Eltermann 2005).…”

HTLV-1/2 in Indigenous Peoples of the Brazilian Amazon: Seroprevalence, Molecular Characterization and Sociobehavioral Factors Related to Risk of Infection

“…In the current investigation, it was not possible to show serological reactivity by ELISA in the Kararaô group, contrary to what was previously known [ 6 , 12 ]. However, as this fact had already been reported among the Arara do Laranjal [ 32 ] people, WB tests were performed, which identified one sample as HTLV-2, one with an HTLV profile and three samples with inconclusive results. These results would have the following explanations: (i) presence of defective particles that are associated with low levels of antibodies, which are identified in asymptomatic patients and in aggressive forms of ATL [ 33 , 34 ]; (ii) HTLV-2 endogenization hypothesis [ 35 ]; (iii) restriction of the applicability of immunoenzymatic assays to detect antibodies to HTLV-2c, predominantly found among indigenous peoples of the Brazilian Amazon [ 7 , 36 ]; and (iv) possible cross-reaction with other endemic infections in the Amazon, such as malaria [ 37 ].…”