Human T-lymphotropic virus 1 and 2 among people who used illicit drugs in the state of Pará, northern Brazil

Filho, Aldemir Branco de Oliveira; Araújo, Ana Paula Serra de; Souza, Andreia Polliana C.; Gomes, C. B.; Silva-Oliveira, Gláucia Caroline; Martins, Luisa Carí­cio; Fischer, Benedikt; Machado, Luiz Fernando Almeida; Vallinoto, Antônio Carlos Rosário; Ishak, Ricardo; Lemos, José Alexandre Rodrigues de; Kupek, Emil

doi:10.1038/s41598-019-51383-7

Cited by 27 publications

(33 citation statements)

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“…Fairly rapid changes in the epidemiology of HTLV-1/2 are occurring in the ARB. A recent and extensive study was performed in the State of Para, which detected an intermediate prevalence of 4.3% with almost the same frequencies of HTLV-1 (n = 25) and HTLV-2 (n = 19) among drug users [55]. Both viruses are widely distributed in the Amazon region of Brazil and particularly among this population, who especially need close attention in terms of the control and prevention of infection as they are key participants in the spread of the virus.…”

Section: Epidemiological Data Of Htlv-1 and Htlv-2 In The Amazon Regimentioning

confidence: 99%

“…In the Amazon region of Brazil, injecting drugs was not an important route for the spread and maintenance of HTLV-1/2 in urban, nonurban, or isolated communities or in co-infection with HIV-1 [50,51] in a clear contrast to what was usually seen in other areas of Brazil, where the use of illicit drugs is a well-known risk factor for both virus infections [52][53][54]. More recently, high prevalence rates and levels of genetic diversity of both HTLV-1 and HTLV-2 were shown among illicit drug users in the State of Para [55], which is a change in the epidemiological pattern of the spread of the two viruses in the region.…”

Section: Introductionmentioning

confidence: 99%

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The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil

Ishak

Vallinoto

2020

Retrovirology

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HTLV-1 was the first described human retrovirus and was soon found to be associated with severe clinical diseases, including a devastating lymphoma/leukemia and other inflammatory diseases. Although HTLV-2 is not usually pathogenic, it is widely distributed among native Indian populations in Brazil, particularly in the Amazon region of the country. Presently, HTLV spreads mainly by the sexual route and from mother to child, and virus persistence is an active biological factor aiding its transmission. Recently, the use of illicit drugs has been shown to be an additional risk factor, showing the influence of new habits on the epidemiology of HTLV in the region. Despite the detection of the virus in several different populations in the Amazon region of Brazil for almost 30 years, the exact prevalence of HTLV-1/2 is not well defined. The original biases in sampling and the selection of epidemiologically unsuitable populations were commonly repeated in most prevalence studies, generating unreliable and conflicting figures that do not represent the actual prevalence of HTLV. The improvements in clinical and laboratory facilities have resulted in the description of several clinical manifestations that were previously unknown in the region. The extent of the spread of the virus must be defined in this region, which is the largest geographical area of the country. As prophylaxis advances toward the use of vaccines against HTLV-1, it is important to determine who is at risk of being infected and developing a disease to successfully implement preventive measures, particularly as proposals are made to eradicate the virus among humans.

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Section: Epidemiological Data Of Htlv-1 and Htlv-2 In The Amazon Regimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil

Ishak

Vallinoto

2020

Retrovirology

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“…The present study observed a higher general seroprevalence of HTLV-1 than those reported in the population of men who have sex with men (0.7%) (Malta et al, 2010); candidates for blood donation in the Northeast of Brazil (1.2%) (Ribeiro et al, 2018), the Brazilian state of Amazonas (0.13%) (Morais et al, 2017) and in non-FSW women who had a similar socioeconomic profile, such as pregnant teenagers (0.6%) (Guerra et al, 2018) and women from Belém, Pará (1.4%) (Silva et al, 2018) and parturients (0.4%) of Salvador, Bahia (Vargas et al, 2020). However, the seroprevalence was much lower than the figure recorded among illicit drug users in the state of Pará (6.4%) (Oliveira-Filho et al, 2019b). It is possible that such a figure is a consequence of the higher level of risky behavior, such as injecting drug use and multiple sexual partners.…”

Section: Discussionmentioning

confidence: 86%

Molecular Epidemiology of HIV-1 and HTLV-1/2 Among Female Sex Workers in Four Cities in the State of Para, Northern Brazil

et al. 2020

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Female sex workers (FSWs) represent a key population for the acquisition of sexually transmitted infections (STI) due to their social vulnerability and the risks associated with their occupation. This study was conducted to describe the sociodemographic characteristics and sexual behavior among FSWs in cities in northern Brazil, to determine the prevalence of human immunodeficiency virus 1 (HIV-1) and human T-cell lymphotropic virus (HTLV-1/2) infections and to identify the circulating subtypes of these agents in this key population. A cross-sectional study using the Time Location Sampling (TLS) method was conducted among 339 FSWs in cities in the state of Pará from 2005 to 2006. Serological and molecular tests were performed to identify infections and viral subtypes, and bivariate and multivariate analyses were conducted to identify risk factors. Most FSWs were young, single, less educated and had at least one child. The prevalence of antibodies against HIV-1 and HTLV-1 was 2.3 and 1.7%, respectively. HIV-1 subtypes B (87.5%) and F1 (12.5%) were identified among FSWs, as were Cosmopolitan subtype (1a) and Transcontinental subgroup (A). Unprotected sex and illicit drug use were associated with HIV-1 and HTLV-1 infections using bivariate and multivariate analyses, and age ≥27 years was associated only with HIV. The important information highlighted here clearly indicates that the lack of actions to control and prevent pathogens in FSWs and the lack of strategies for health promotion in key populations can further aggravate the epidemiological scenario of viral infections in remote areas with low human development indices. Neglecting these facts may be causing the spread of these two viruses and their respective subtypes in the general population of northern Brazil.

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“…In the state of Para, the Japanese subgroup was indeed present among women from the Kyushu region, which comprises the southern part of Honshu Island, Japan ( Vallinoto et al. 2004 ), and was further spread outside the communities among drug users ( Oliveira-Filho et al. 2019 ) along with the Transcontinental subgroup.…”

Section: The Origins Of Htlv-1 and Htlv-2 Infection In South Amerimentioning

confidence: 99%

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

Ishak

Azevedo

et al. 2020

Virus Evolution

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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.

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Human T-lymphotropic virus 1 and 2 among people who used illicit drugs in the state of Pará, northern Brazil

Cited by 27 publications

References 50 publications

The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil

The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil

Molecular Epidemiology of HIV-1 and HTLV-1/2 Among Female Sex Workers in Four Cities in the State of Para, Northern Brazil

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

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