Adult T‐cell leukaemia/lymphoma in Brazil: A rare disease or rarely diagnosed?

Complete remission and proviral load negativization after allogeneic‐SCT in a patient with Adult T‐cell lymphoma: Case report

“…Latin America is an endemic HTLV‐1 area. Taking into account a virus infection of between 800 000 and 2 500 000 patients, the incidence density in Brazil is estimated at between 427 and 1333 cases of ATL per year 8‐10 . A similar incidence was published by Iwanaga et al in Japan 11 …”

Pooling of sera for human T-cell lymphotropic virus (HTLV) screening in a time of increasing health care expenditure and limited resources

“…One of the means to achieve this goal is to know the real prevalence of the infection and associated diseases in the general population and in individuals who could acquire/transmit this infection more easily, such as individuals infected with other microorganisms that share routes of transmission with HTLV-1 8,9,19,20 and HTLV-1-infected mothers who could transmit the virus to their infants during breastfeeding 4,6,7 . In Brazil, the estimated number of HTLV-1-infected individuals, as well as individuals with HTLV-1-associated diseases, is high but misdiagnosed 1,4,5,[21][22][23][24] ; thus, we decided to search for strategies that could reduce the cost of HTLV screening in this country to help the Ministry of Health of Brazil to introduce the serology of HTLV-1/2 in health care programs, especially in the national HTLV antenatal screening program. Using two EIAs commonly employed in screening in public health laboratories in Brazil, we tested the strategy of pooling sera, taking into account previous studies that demonstrated that pooling is feasible and costeffective mostly in populations with low prevalence of HIV and HTLV and/or in countries with limited resources [12][13][14][15] .…”

“…Thus, we could suppose that the present pool of five sera using EIA Murex could also be employed in this population. Indeed, this strategy could be helpful for extending the HTLV diagnosis, since: (i) the number of HAM/TSP and ATL cases due to HTLV-1 mother-to-child transmission in Brazil has been underestimated 21,22 , (ii) the low number of HAM/TSP and ATLL cases described in this country could be due to the lack of or misdiagnosis rather than to the low incidence, (iii) the complexity of clinical manifestation and laboratory diagnosis of both diseases, (iv) the lack of knowledge in HTLV-1 and associated diseases among health professionals, (v) the difficult access to public health care in Brazil, especially in low-income areas, and (vi) the high morbidity/mortality of diseases [21][22][23][24] .…”

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecção pelo vírus linfotrópico de células T humanas (HTLV)

“…93,94 La ATLL es rara en otros países, no llega al 2% de los casos, 95 a pesar de evidencias de falta de diagnóstico. 96,97 Son reconocidas cuatro formas clínicas de la ATLL, 98 que llevan en consideración la presencia y la gravedad de las manifestaciones leucémicas, además de exámenes de laboratorio alterados, como aumento de lactato deshidrogenasa e hipercalcemia. Esa clasificación está descrita en la Figura 1, y los factores que predicen peor pronóstico, incluyendo los arriba mencionados, están en la Figura 2.…”

“…23,197,198 Por lo tanto, la prevención de la transmisión vertical es de extrema importancia para reducir la incidencia de enfermedades asociadas al virus. 23,96,137 Como se sabe que la lactancia materna es la principal vía de transmisión vertical del HTLV-1/2 135,[199][200][201][202][203][204] y aún no existe una vacuna para combatir la infección, Carolina Rosadas y colaboradores ni siquiera un tratamiento curativo, la lactancia materna no está contraindicada en madres infectadas por el virus. Para estas mujeres, se recomienda el uso de inhibidores de la lactancia y el suministro de fórmulas lácteas infantiles.…”