Moderada endemicidade da infecção pelo vírus linfotrópico-T humano na região metropolitana de Belém, Pará, Brasil

Abstract

RESUMO: Introdução: A disseminação da infecção pelo vírus linfotrópico-T humano (HTLV) em famílias da área metropolitana de Belém, Pará, Brasil, e a ausência de estudos na população em geral requisitam investigações que esclareçam melhor a sua prevalência na região. Metodologia: Foi realizada pesquisa de anticorpos anti-HTLV-1/HTLV-2 em indivíduos adultos transeuntes de logradouros públicos de Belém, entre novembro de 2014 e novembro de 2015. A infecção foi confirmada por pesquisa de DNA proviral e foi realizada avaliação clínica e investigação intrafamiliar dos infectados. Resultados: Dos 1.059 indivíduos investigados, 21 (2,0%) apresentaram amostras sororeagentes, 15 (1,4%) confirmados para HTLV-1, 5 (0,5%) para HTLV-2 e o DNA proviral foi indetectável em 1 caso. A média de idade dos infectados (57,2) foi maior que a dos não infectados (46,2) (p = 0,0010). A infecção aumentou com a idade e se destacou nos indivíduos com renda familiar menor ou igual a um salário mínimo. A transmissão intrafamiliar parece ter ocorrido em todas as famílias investigadas. Dentre os portadores de HTLV-1, 30% (3/10) já apresentavam algum sintoma relacionado à infecção. Discussão: O aumento da infecção de acordo com a idade pode ocorrer por soroconversão tardia de infecção pré-adquirida ou pelo risco cumulativo de novas infecções, sobretudo em mulheres. Conclusão: A infecção por HTLV demonstrou moderada prevalência na população estudada, com predomínio do HTLV-1. Essa mostrou-se associada à baixa renda e ao aumento da idade das mulheres. Também apresentou disseminação intrafamiliar e negligência no diagnóstico das doenças associadas.

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

“…The presence of the virus in different areas and populations in the State of Amapa has been investigated a few times, and low prevalence rates of infection (0.71%) have been found among blood donors [100]. The viruses were not found in HIV-1 infected persons [114,118] or in a quilombo (Afro-descendants in isolated communities that were originally founded by escaped slaves); however, HTLV-1 was found to be present (5/30) among individuals seeking a serological diagnosis in a public health laboratory [114].…”

“…This was a rather high figure for urban communities, however there was no confirmation of reactivity by other laboratory methods. The most recent investigation in Belém considered the prevalence of antibodies against HTLV among 1059 inhabitants and showed a 2% positivity for antibodies against both HTLV-1 (n = 15) and HTLV-2 (n = 5) [118]. Two different studies dealt with HTLV/HIV-1 coinfections.…”

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

“…The investigation of HTLV-1/2 infections among FSWs is the first approach in Amazon Region of Brazil, particularly in a highly endemic area of HTLV infection (Ishak et al, 2020). 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).…”

“…In the Pará state, the prevalence of HIV and HTLV infection was 0.3 and 0.6% respectively in pregnant adolescents (Guerra et al, 2018) and the prevalence of HIV in the general population of in Marajoì Island was 0.6% (Vallinoto et al, 2016). In a study carried out in the general population of the city of Belém, capital of the state of Pará, the prevalence of HTLV-1 and HTLV-2 infection was 1.4 and 0.5% respectively (Silva et al, 2018).…”

Prevalence and Molecular Epidemiology of Human T-Lymphotropic Virus (HTLV) Infection in People Living With HIV/AIDS in the Pará State, Amazon Region of Brazil

“…Brazil shows a high prevalence of HTLV infection with high variance in different groups and regions (Romanelli et al, 2013). In the State of Pará, which is in the northern region of Brazil and characterized by large areas of the Amazon rainforest, limited infrastructure, and low human development, the prevalence varies from 0.1 to 1.4%, reaching a peak of 3% among people who used illicit drugs (PWUDs) (de Aguiar et al, 2017;Guerra et al, 2018;Silva et al, 2018;Oliveira-Filho et al, 2019). The prevalence of HTLV-2 is lower than HTLV-1 in most places; however, it particularly affects specific populations, such as native Amerindian groups and PWUDs (Ishak et al, 1995;Catalan-Soares et al, 2005;Murphy et al, 2015;Braço et al, 2019).…”