CT Chest and pulmonary functional changes in patients with HTLV-associated myelopathy in the Eastern Brazilian Amazon

Falcão, Luiz Fábio Magno; Falcão, Aline Semblano Carreira; Sousa, Rita Catarina Medeiros; Vieira, Waldonio de Brito; Oliveira, Robson Tadachi Moraes de; Normando, Valéria Marques Ferreira; Dias, George Alberto da Silva; Santos, Márcio Clementino de Souza; Rocha, Rodrigo Santiago Barbosa; Yoshikawa, Gilberto Toshimitsu; Koyama, Roberta Vilela Lopes; Fujihara, Satomi; Corrêa, Victor Augusto Cavaleiro; Fuzii, Hellen Thaís; Quaresma, Juarez Antônio Simões

doi:10.1371/journal.pone.0186055

Cited by 19 publications

(20 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The association between HTLV-1 infection and chronic lung disease is therefore recognised to have implications for staging of ATL [ 71 ]. Similar radiological findings have been reported in Brazil where bronchiectasis and centrilobular nodules were detected by HRCT in 14 of 30 patients with HAM but in only three of 18 asymptomatic controls with HTLV-1 [ 53 ].…”

Section: Clinical Studiessupporting

confidence: 86%

“…Moreover, individuals with HTLV-1 associated bronchiectasis may not have been appropriately diagnosed and referred to the UK cohort at the time of this study because HTLV-1 testing has only recently been included in British national bronchiectasis guidelines [ 52 ]. A Brazilian case control study, which excluded causes of chronic lung disease other than HTLV-1, reported similar findings [ 53 ]. Abnormal results on CT chest were recorded for 22 of 30 patients with HAM, but only four of 18 controls with HTLV-1 who did not have HAM, and bronchiectasis was diagnosed in twelve and two patients with and without HAM, respectively [ 53 ].…”

Section: Epidemiological Studiessupporting

confidence: 53%

“…A Brazilian case control study, which excluded causes of chronic lung disease other than HTLV-1, reported similar findings [ 53 ]. Abnormal results on CT chest were recorded for 22 of 30 patients with HAM, but only four of 18 controls with HTLV-1 who did not have HAM, and bronchiectasis was diagnosed in twelve and two patients with and without HAM, respectively [ 53 ].…”

Section: Epidemiological Studiessupporting

confidence: 53%

See 2 more Smart Citations

Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection

et al. 2021

View full text Add to dashboard Cite

The lung is one of several organs that can be affected by HTLV-1 mediated inflammation. Pulmonary inflammation associated with HTLV-1 infection involves the interstitium, airways and alveoli, resulting in several clinical entities including interstitial pneumonias, bronchiolitis and alveolitis, depending on which structures are most affected. Augmentation of the inflammatory effects of HTLV-1 infected lymphocytes by recruitment of other inflammatory cells in a positive feedback loop is likely to underlie the pathogenesis of HTLV-1 associated pulmonary disease, as has been proposed for HTLV-1 associated myelopathy. In contrast to the conclusions of early case series, HTLV-1 associated pulmonary disease can be associated with significant parenchymal damage, which may progress to bronchiectasis where this involves the airways. Based on our current understanding of HTLV-1 associated pulmonary disease, diagnostic criteria are proposed.

show abstract

Section: Clinical Studiessupporting

confidence: 86%

Section: Epidemiological Studiessupporting

confidence: 53%

Section: Epidemiological Studiessupporting

confidence: 53%

See 1 more Smart Citation

Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Persistent HTLV-1-mediated airways inflammation may therefore lead to progressive bronchial wall dilatation, and bronchiectasis. High rates of bronchiectasis among HTLV-1-infected Japanese adults[ 7 , 8 ], and associations between HAM/TSP and bronchiectasis in UK [ 28 ] and Brazilian cohorts [ 29 ] suggest that HTLV-1-associated bronchiectasis affects individuals of diverse genetic backgrounds infected with HTLV-1 strains other than HTLV-1c. Although HTLV-1 associated pulmonary disease in Japan is thought to be largely sub-clinical[ 14 ], published clinical details are limited and prospective survival studies have not been performed.…”

Section: Discussionmentioning

confidence: 99%

Human T-Lymphotropic Virus type 1c subtype proviral loads, chronic lung disease and survival in a prospective cohort of Indigenous Australians

et al. 2018

View full text Add to dashboard Cite

BackgroundThe Human T-Lymphotropic Virus type 1c subtype (HTLV-1c) is highly endemic to central Australia where the most frequent complication of HTLV-1 infection in Indigenous Australians is bronchiectasis. We carried out a prospective study to quantify the prognosis of HTLV-1c infection and chronic lung disease and the risk of death according to the HTLV-1c proviral load (pVL).Methodology/Principal findings840 Indigenous adults (discharge diagnosis of bronchiectasis, 154) were recruited to a hospital-based prospective cohort. Baseline HTLV-1c pVL were determined and the results of chest computed tomography and clinical details reviewed. The odds of an association between HTLV-1 infection and bronchiectasis or bronchitis/bronchiolitis were calculated, and the impact of HTLV-1c pVL on the risk of death was measured.Radiologically defined bronchiectasis and bronchitis/bronchiolitis were significantly more common among HTLV-1-infected subjects (adjusted odds ratio = 2.9; 95% CI, 2.0, 4.3). Median HTLV-1c pVL for subjects with airways inflammation was 16-fold higher than that of asymptomatic subjects. There were 151 deaths during 2,140 person-years of follow-up (maximum follow-up 8.13 years). Mortality rates were higher among subjects with HTLV-1c pVL ≥1000 copies per 105 peripheral blood leukocytes (log-rank χ2 (2df) = 6.63, p = 0.036) compared to those with lower HTLV-1c pVL or uninfected subjects. Excess mortality was largely due to bronchiectasis-related deaths (adjusted HR 4.31; 95% CI, 1.78, 10.42 versus uninfected).Conclusion/SignificanceHigher HTLV-1c pVL was strongly associated with radiologically defined airways inflammation and with death due to complications of bronchiectasis. An increased risk of death due to an HTLV-1 associated inflammatory disease has not been demonstrated previously. Our findings indicate that mortality associated with HTLV-1c infection may be higher than has been previously appreciated. Further prospective studies are needed to determine whether these results can be generalized to other HTLV-1 endemic areas.

show abstract

“…2020 ), skin ( Bimbi, Brzezinski, and Sokolowska-Wojdylo 2019 ; Schierhout et al. 2020 ), lungs ( Falcão et al. 2017 ; Dias et al.…”

Section: Introductionunclassified

HTLV in South America: Origins of a silent ancient human infection

Ishak

Azevedo

et al. 2020

Virus Evolution

View full text Add to dashboard Cite

The description of the first human retrovirus, Human T-lymphotropic virus 1 (HTLV-1), was soon associated with an aggressive lymphoma and a chronic inflammatory neurodegenerative disease. Later, other associated clinical manifestations were described, affecting diverse target organs in the human body and showing the enormous burden carried by the virus and the associated diseases. The epidemiology of HTLV-1 and HTLV-2 showed that they were largely distributed around the world, although it is possible to locate geographical areas with pockets of low and very high prevalence and incidence. Aboriginal Australians and indigenous peoples of Brazil are examples of the large spread of HTLV-1 and HTLV-2, respectively. The epidemiological link of both situations is their occurrence among isolated, epidemiologically closed or semi-closed communities. The origin of the viruses in South America shows two different branches with distinct timing of entry. HTLV-1 made its probable entrance in a more recent route through the east coast of Brazil at the beginning of the slave trade from the African continent, starting in the 16th century and lasting for more than 350 years. HTLV-2 followed the ancient route of human migration from the Asian continent, crossing the Behring Strait and then splitting in South America as the population became separated by the Andes Mountains. By that time, HTLV-2c probably arose and became isolated among the indigenous populations in the Brazilian Amazon. The study of epidemiologically closed communities of indigenous populations in Brazil allowed tracing the most likely route of entry, the generation of a new molecular subtype (HTLV-2c), the elucidation of the vertical transmission of HTLV-2, the intrafamilial aggregation of cases and the escape and spread of the virus to other areas in Brazil and abroad. Despite the burden and impact of both viruses, they are maintained as silent infections among human populations because (i) health authorities in most South American countries in which national surveillance is poor have little interest in the disease, (ii) the information is commonly lost as indigenous groups do not have specific policies for HTLV and other sexually transmitted infections, and (iii) health access is not feasible or properly delivered.

show abstract

CT Chest and pulmonary functional changes in patients with HTLV-associated myelopathy in the Eastern Brazilian Amazon

Cited by 19 publications

References 18 publications

Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection

Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection

Human T-Lymphotropic Virus type 1c subtype proviral loads, chronic lung disease and survival in a prospective cohort of Indigenous Australians

HTLV in South America: Origins of a silent ancient human infection

Contact Info

Product

Resources

About