High incidence of serious infections requiring hospitalisation in human T-cell leukaemia virus type 1-positive rheumatoid arthritis: A case-controlled observational study

Abstract

Objectives We aimed to assess the clinical features of human T-cell leukaemia virus type 1 (HTLV-1)-positive rheumatoid arthritis (RA) patients. Furthermore, we investigated the impact of HTLV-1 infection on incidences of serious infections requiring hospitalisation (SIH) and malignancies. Methods A total of 150 sex- and age-matched HTLV-1-negative and 50 HTLV-1-positive RA patients were enrolled from the HTLV-1 RA Miyazaki Cohort Study. Clinical and laboratory data were collected from this cohort database. The incidence rate (IR) for SIH and malignancies from 2015 to 2020 was analysed. Results The median age and female ratio in the study population were 70 years old and 80%, respectively. Although no differences were found in inflammatory marker values between the two groups, the patient global assessment and Health Assessment Questionnaire scores were higher in HTLV-1-positive RA patients. In HTLV-1-negative RA patients, the IR for SIH was 6.37/100 person-years (PY) and 1.32/100 PY for malignancies. In HTLV-1-positive RA patients, SIH occurred in 11.1/100 PY and malignancies in 2.46/100 PY. The crude IR ratio comparing SIH between two groups was 1.74 (95% confidence interval, 1.04–2.84), which was a significant increase. Conclusions HTLV-1-positive RA patients may worsen RA symptoms. HTLV-1 may be a risk factor for SIH.

The Association of Increase of Human T-Cell Leukemia Virus Type-1 (HTLV-1) Proviral Load (PVL) With Infection in HTLV-1-Positive Patients With Rheumatoid Arthritis: A Longitudinal Analysis of Changes in HTLV-1 PVLs in a Single Center Cohort Study

“…High incidence of infection in HTLV-1-infected patients was also observed in RA. Hashiba et al reported that the incidence rate of serious infection is higher in HTLV-1-positive RA patients compared to that in HTLV-1 negative RA patients (11.1 per 100 person-year vs 6.37 per 100 person-year, respectively) (24). However, the relation of the change of PVL with the risk of infection was not elucidated by these previous studies.…”

Заболевания, Ассоциированные С Т-Лимфотропным Вирусом Типа 1 Человека (HTLV-1)

“…HTLV-1-инфекция может влиять на клиническое течение ревматических заболеваний [32]. У HTLV-1-позитивных пациентов с РА симптомы основного заболевания могут прогрессировать [33].…”

Effect of HTLV-1 Infection on the Clinical Course of Patients with Rheumatoid Arthritis

“…The levels of C-reactive protein (CRP), which is a marker of RA activity, have been shown to be higher in HTLV-1-positive patients with RA before receiving treatment with biologic DMARDs than the levels of CRP HTLV-1-negative patients [ 67 ]. In addition, a recent cohort study suggested that the patient pain visual analog scale, global assessment, and health assessment questionnaire scores were higher in HTLV-1-positive RA patients than in HTLV-1-negative RA patients, even though there were no differences in inflammatory markers between them [ 68 ]. These results suggest that worse pain and physical disability were commonly observed in HTLV-1-positive RA patients.…”

“…Hashiba et al reported a case of HTLV-1-positive RA patients who developed S. stercoralis colitis after administration of a TNF inhibitor [ 77 ]. Recently, a HTLV-1 RA cohort study found a higher incidence of serious infections requiring hospitalization in HTLV-1-positive RA patients than in HTLV-1-negative RA patients [ 68 ]. In this study, the most frequently observed complications were serious respiratory infections in HTLV-1-positive RA patients.…”

“…Given the rarity of HAM/TSP, conducting large-scale prospective observational studies to clarify this issue has been challenging. Several cohort studies of HTLV-1-positive RA Japanese patients with short observational periods suggest that any new onset of HAM/TSP was not observed during antirheumatic therapies, including biologics [ 29 , 68 , 88 ].…”