Asunto(s)
Dermatitis/etiología , Infecciones por HTLV-I/complicaciones , Relación CD4-CD8 , Niño , Preescolar , Dermatitis/inmunología , Estudios de Seguimiento , Antígenos HLA/genética , Infecciones por HTLV-I/inmunología , Haplotipos , Humanos , Inmunoglobulinas/sangre , Masculino , Estudios Prospectivos , Subgrupos de Linfocitos TRESUMEN
Mother-to-child transmission of human T-cell lymphotropic virus type I (HTLV-I) is primarily due to prolonged breast-feeding (>6 months) in the postnatal period. Most infant infections are not identifiable until 12 to 18 months of age by available whole virus Western blot serologic tests because of their inability to distinguish passively transferred maternal antibody from infant antibody. We investigated two methods to assess more accurately the time of infant infection. In prospectively collected serial biospecimens, HTLV-I-specific immunoglobulin (Ig) isotypes of IgM and IgA were determined by Western blot and HTLV-I proviral DNA was detected by polymerase chain reaction (PCR). IgA and IgG reactivity was assessed in periodic serum samples from 16 HTLV-I-seropositive children while IgM reactivity was assessed in 9 of the 16 children. Approximately three to five samples were tested for each child. IgG reactivity was observed in 100% of children at 24 months of age and 73% of children at 6-12 months of age; however, this could represent maternal and not infant antibody. Both IgA and IgM reactivity were insensitive indicators of infection, with only 50% of children showing reactivity at 24 months of age. PCR testing was performed in biospecimens obtained from 11 of these children. An estimated median time of infection of 11.9 months was determined by PCR, which was similar to the median time to infection determined by whole virus Western blot (12.4 months; P = 0.72). PCR tests support a median time to infection that is similar to that estimated by whole virus Western blot.
Asunto(s)
Lactancia Materna , Infecciones por HTLV-I/transmisión , Virus Linfotrópico T Tipo 1 Humano/inmunología , Transmisión Vertical de Enfermedad Infecciosa , Adulto , Preescolar , ADN Viral/análisis , Estudios de Evaluación como Asunto , Femenino , Anticuerpos Anti-HTLV-I/sangre , Infecciones por HTLV-I/inmunología , Infecciones por HTLV-I/virología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina M/sangre , Lactante , Recién Nacido , Jamaica , Reacción en Cadena de la Polimerasa/métodos , Estudios Prospectivos , Provirus , Factores de TiempoRESUMEN
To examine risk factors for human T cell lymphotropic virus type II (HTLV-II) infection, a case-control study was conducted among the Guaymi Indians of Panama. In females, HTLV-II seropositivity was associated with early sexual intercourse (15 years; odds ratio [OR], 2.50; 95% confidence interval [CI], 1.11-6.14) and number of lifetime sex partners. One partner increased risk of seropositivity by 30% (OR, 1.30; CI, 1.05-1.64), and risk increased with number of partners. Similar risk was associated with number of long-term sexual relationships. Among males, intercourse with prostitutes was associated with HTLV-II seropositivity (OR, 1.68; CI, 1.04-2.72). These data support a role for sexual transmission in HTLV-II infection. Association of seropositivity with primary residence in a traditional village (OR, 3.75; CI, 1.02-15.38) and lack of formal education (0 vs. >6 years [OR, 3.89; CI, 1.67-9.82]) observed in males may reflect differences in sexual practices associated with acculturation.
Asunto(s)
Infecciones por HTLV-II/epidemiología , Indígenas Centroamericanos , Conducta Sexual , Adolescente , Adulto , Niño , Femenino , Infecciones por HTLV-II/transmisión , Humanos , Masculino , Panamá/epidemiología , Factores de Riesgo , Asunción de Riesgos , Factores Sexuales , Trabajo SexualAsunto(s)
Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/epidemiología , Indígenas Sudamericanos , Adolescente , Adulto , Anciano , Niño , Colombia/epidemiología , Femenino , Infecciones por HTLV-I/complicaciones , Infecciones por HTLV-II/complicaciones , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVES: To define the clinical and laboratory features associated with infective dermatitis (ID) and confirm its association with human T-lymphotrophic virus type I (HTLV-I). DESIGN: A case series of patients with ID were compared with patients with atopic dermatitis (AD), which is an important disease in the differential diagnosis of ID. SETTING: Patients were recruited from dermatology and pediatric clinics at the University Hospital of the West Indies and the Bustamante Children's Hospital, Kingston, Jamaica. MAIN OUTCOME MEASURES: Clinical and laboratory features of patients with AD were compared with those of patients with ID. PATIENTS: Consecutive patients older than 1 1/2 years diagnosed as having ID (n=50) and AD (n=35) were enrolled based on clinical findings. RESULTS: The mean ages of patients with ID and AD were 6.9 and 7.8 years, respectively. Histologically, both diseases were predominantly chronic dermatitis with propensity for skin colonization with Staphylococcus aureus and beta-hemolytic streptococci; however, the distribution of sites of skin involvement differed. Infection with HTLV-I was the most distinguishing feature among patients with ID, with seropositive results in 100%; only 5 (14%) of the 35 patients with AD had results seropositive for HTLV-I. Infective dermatitis was further characterized by dermatopathic lymphadenitis in 16 (67%) of 24 patients with palpable nodes. Anemia, lymphocytosis, and low albumin and elevated serum globulin levels were more prevalent among patients with ID. Significant elevations of IgA, IgD, and IgG levels were observed among patients with ID compared with those with AD. However, both patients with AD and those with ID had levels of IgD and IgE elevated above the normal range. T-cell subsets among patients with ID revealed T-cell activation with a high percentage of HLA-DR antigen positivity, elevated CD4 (2.4 x 10(9)/L) and CD8 (1.4 x 10(9)/L) cell counts, with an increased CD4/CD8 ratio of 1:73. CONCLUSION: Infective dermatitis is a distinct clinical entity associated with HTLV-I, which plays a role in the pathogenesis and immune perturbations observed.
Asunto(s)
Dermatitis/patología , Dermatitis/virología , Infecciones por HTLV-I/inmunología , Infecciones por HTLV-I/patología , Adolescente , Adulto , Linfocitos T CD4-Positivos/patología , Linfocitos T CD8-positivos/patología , Recuento de Células , Niño , Preescolar , Dermatitis/inmunología , Dermatitis Atópica/inmunología , Dermatitis Atópica/microbiología , Dermatitis Atópica/patología , Femenino , Infecciones por HTLV-I/fisiopatología , Humanos , Lactante , Activación de Linfocitos/fisiología , Masculino , Piel/patología , Staphylococcus aureus/aislamiento & purificación , Streptococcus agalactiae/aislamiento & purificaciónRESUMEN
HTLV-I is sexually transmitted more efficiently from men to women than vice versa, and the majority of HTLV-I endemic areas report a female preponderance of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) cases. The objective of this study was to estimate the gender- and age-specific incidence rates of HAM/TSP in the general population as well as in the HTLV-I-infected population in Jamaica and in Trinidad and Tobago. Incidence rates for HAM/TSP were computed based on all reported incident cases in both countries between 1990 and 1994. Population census reports for 1990 were used to calculate the population at risk. The age-standardized HAM/TSP incidence rate (mean +/- standard error of the mean) in Jamaica was 1.8 +/- 0.2/100,000 person years (PY). Among individuals of African descent in Trinidad and Tobago, the rate was 1.7 +/- 0.4/100,000 PY. As in HTLV-I seroprevalence, the incidence rate of HAM/TSP increased with age through the fifth decade of life and was three times as high in women than in men. The HAM/TSP incidence rate, calculated as a function of the number of HTLV-I-infected persons in each age stratum, is higher in women (24.7/100,000 PY) than in men (17.3/100,000 PY). With HTLV-I infection, the lifetime risk of developing HAM/TSP was estimated to be 1.9% overall and is slightly higher in women (1.8%) than in men (1.3%). Thus, the higher prevalence of HTLV-I in women in endemic areas does not fully explain the preponderance of female HAM/TSP, suggesting that other cofactors must be present. The higher incidence rate in women between the ages of 40 and 59 years, as well as the increase in HAM/TSP incidence rates with age, are indicative of the importance of adult-acquired HTLV-I infection, presumably through sexual transmission.
Asunto(s)
Paraparesia Espástica Tropical/epidemiología , Adulto , Factores de Edad , Femenino , Humanos , Incidencia , Jamaica/epidemiología , Masculino , Persona de Mediana Edad , Paraparesia Espástica Tropical/transmisión , Factores Sexuales , Trinidad y Tobago/epidemiologíaAsunto(s)
Transportadoras de Casetes de Unión a ATP/genética , Población Negra/genética , Evolución Molecular , Complejo Mayor de Histocompatibilidad , Miembro 3 de la Subfamilia B de Transportadores de Casetes de Unión a ATP , Alelos , Colombia , Exones/genética , Conversión Génica , Genes , Variación Genética , Haplotipos/genética , Humanos , Desequilibrio de Ligamiento , Polimorfismo Genético , Polimorfismo Conformacional Retorcido-SimpleRESUMEN
Adult T-cell leukemia/lymphoma (ATL) and human T-cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) are associated with differing patterns of immune dysfunction. Biomarkers of immune activation may correlate with perturbations of immune function associated with these diseases. We conducted a pilot cross-sectional study to assess four candidate biomarkers of immune activation. beta 2-microglobulin, neopterin, tryptophan, and kynurenine levels were assayed in stored sera from asymptomatic, human T-cell leukemia virus type I (HTL V-I)-seronegative (HTLV-I-) and HTLV-I-seropositive (HTLV-I+) individuals, and ATL and HAM/TSP patients previously enrolled in seroepidemiological studies in Jamaica. Mean levels of beta 2-microglobulin, neopterin, and kynurenine were significantly elevated among ATL patients compared to the other study groups. Mean tryptophan levels were significantly lower among ATL and HAM/TSP patients than HTLV-I- and HTLV-I+ groups. No significant differences in biomarkers were found between the HTLV-I- and HTLV-I+ groups. Among HAM/TSP patients, a significant association was found between elevated neopterin levels and symptoms of less than 4 years duration. In Cox proportional hazards regression modeling, neopterin and tryptophan were found to be independent predictors of survival among ATL patients. This study demonstrates a differential pattern of biomarkers of immune activation among ATL and HAM/TSP patients compared to HTLV-I- and HTLV-I+ individuals. Neopterin and tryptophan may be useful clinical indicators of disease severity and prognosis among HAM/TSP and ATL patients.
Asunto(s)
Biomarcadores/sangre , Leucemia-Linfoma de Células T del Adulto/inmunología , Paraparesia Espástica Tropical/inmunología , Adulto , Biopterinas/análogos & derivados , Biopterinas/sangre , Estudios Transversales , Femenino , Predicción , Anticuerpos Anti-HTLV-I/sangre , Humanos , Jamaica , Quinurenina/sangre , Leucemia-Linfoma de Células T del Adulto/sangre , Masculino , Persona de Mediana Edad , Neopterin , Paraparesia Espástica Tropical/sangre , Proyectos Piloto , Modelos de Riesgos Proporcionales , Estudios Seroepidemiológicos , Tasa de Supervivencia , Triptófano/sangre , Microglobulina beta-2/análisisRESUMEN
Human T-cell lymphotropic virus type I (HTLV-I) has been etiologically associated with a neurologic syndrome called HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) as well as with adult T-cell leukemia/lymphoma. The authors sought to quantify the risk in Jamaica of HAM/TSP associated with HTLV-I infection and cofactors associated with this disease among infected individuals. Between 1988 and 1989, prevalent and incident HAM/TSP patients and controls with other neurologic diseases were enrolled in a retrospective study. A second control group was composed of HTLV-I-seropositive, asymptomatic carriers in Jamaica, ascertained in a separate study conducted in 1988. Although HTLV-I seropositivity was not a component of the case definition for HAM/TSP, all 43 HAM/TSP patients were HTLV-I seropositive compared with two (4.0%) of the controls with other neurologic diseases. Given HTLV-I seropositivity, one cofactor associated with the risk of HAM/TSP was young age at initial heterosexual confidence interval 1.29-12.46 for individuals aged < or = 15; odds ratio = 4.26, 95% confidence interval 1.41-12.90 for individuals aged 16-17 years at initial intercourse). Among individuals who reported this early age at initial sexual intercourse, an increased risk of HAM/TSP was associated with having reported more than five lifetime sexual partners (odds ratio = 2.88, 95% confidence interval 0.90-8.70). Neither an early age at initial sexual intercourse or the number of lifetime sexual partners was a risk factor for adult T-cell leukemia/lymphoma. These data support the hypothesis that HAM/TSP is associated with sexually acquired HTLV-I infection, whereas adult T-cell leukemia/lymphoma is not.
Asunto(s)
Paraparesia Espástica Tropical/epidemiología , Enfermedades Virales de Transmisión Sexual/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Jamaica/epidemiología , Leucemia-Linfoma de Células T del Adulto/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Paraparesia Espástica Tropical/inmunología , Paraparesia Espástica Tropical/transmisión , Estudios Retrospectivos , Factores de Riesgo , Pruebas Serológicas , Conducta Sexual , Enfermedades Virales de Transmisión Sexual/inmunologíaRESUMEN
Early childhood infection with human T cell lymphotropic virus type I (HTLV-I) has been suggested to be involved in the pathogenesis of infective dermatitis and adult T cell leukemia/lymphoma. Since only a very small percentage of HTLV-I-infected children develop disease later in life, identification of early interim markers for persons at risk for developing disease would enable monitoring and might provide insight into the pathophysiology of the various diseases associated with HTLV-I infection. A cross-sectional study analyzed T cell subsets in 35 HTLV-I-seronegative and 16 HTLV-I-seropositive Jamaican children 11-31 months old. HTLV-I seropositivity was associated with an increase in the mean percentage of CD4 cells expressing HLA-DR, a marker for T cell activation (P = .02). This increase was positively correlated with duration of infection (r = .74, P = .009). These data demonstrate perturbation of regulatory cells of the immune system in HTLV-I-infected children.
Asunto(s)
Anticuerpos Anti-HTLV-I/sangre , Infecciones por HTLV-I/inmunología , Subgrupos de Linfocitos T/inmunología , Lactancia Materna , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Preescolar , Estudios Transversales , Demografía , Femenino , Antígenos HLA-DR/análisis , Antígenos HLA-DR/biosíntesis , Infecciones por HTLV-I/transmisión , Humanos , Lactante , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa , Jamaica , Estudios Longitudinales , Activación de Linfocitos , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/inmunología , Complicaciones Infecciosas del Embarazo/virología , Factores SocioeconómicosRESUMEN
Serological studies on 926 blood samples from 703 Brazilian Kayapo (Cayapo) Indians showed, by conventional definition of HTLV seropositivity, a 28% prevalence of human T lymphotropic virus (HTLV) infection, the highest yet reported. Immunoblot (WB) and SYNTH-EIA patterns indicate that the predominant infecting agent is type II. Of children under 15 years old, 12% were positive, and of persons over 60, more than 60%. Perinatal and heterosexual modes of transmission offer an adequate explanation of this incidence. Infection in infancy may include infection via breast milk from women other than the mother. Evidence of new infection in adults is apparent at an earlier age in women than in men. This pattern of antibody prevalence was not determined by cohort effects, as demonstrated by tests of serial specimens. Enzyme immunosorbent assay (EIA) absorbencies were not stable in the paired specimens: five serum pairs reverted and mean absorbencies declined over some age ranges. Many specimens with relatively high, but less than positive, EIA results were positive by immunoblot (WB). This suggests that the standard EIA end point does not identify all infected persons. If the WB alone indicates positivity, 47% of the whole population, and more than 80% of the older age groups, are infected with HTLV-II.
Asunto(s)
Anticuerpos Anti-HTLV-II/sangre , Infecciones por HTLV-II/epidemiología , Infecciones por HTLV-II/transmisión , Indígenas Sudamericanos , Adolescente , Adulto , Factores de Edad , Brasil/epidemiología , Niño , Preescolar , Demografía , Ensayo de Inmunoadsorción Enzimática , Familia , Femenino , Infecciones por HTLV-II/sangre , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Factores SexualesRESUMEN
Evidence for human T cell lymphotropic viruses (HTLV) was sought in sera and cells collected from adults in 13 isolated South and Central American Indian tribes. Serologic tests identified frequent HTLV-II-like reactivity among the Cayapo and Kraho tribes, who live 330 km apart in Central Brazil. Polymerase chain reaction analyses of viral DNA in cell pellet and plasma fractions confirmed the virus as HTLV-II. Both tribes speak Gé and, at the time of blood collection (1974), subsisted as hunter/gatherers and slash and burn agriculturalists. Further testing of plasma from Cayapo and Kraho of all ages revealed overall HTLV-II prevalence rates of 33.3% and 12.2%, respectively, with increasing prevalence associated with age and female gender. These data reveal for the first time a high prevalence of HTLV-II infection in remote South American Indians with little contact with non-Indians. Thus, HTLV-II is postulated to be an ancient human virus in the New World.
Asunto(s)
ADN Viral/sangre , Anticuerpos Anti-HTLV-II/sangre , Infecciones por HTLV-II/epidemiología , Virus Linfotrópico T Tipo 2 Humano/genética , Indígenas Sudamericanos , Adulto , Factores de Edad , Secuencia de Bases , Brasil/epidemiología , Femenino , Virus Linfotrópico T Tipo 2 Humano/inmunología , Humanos , Immunoblotting , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Sondas de Oligonucleótidos/química , Reacción en Cadena de la Polimerasa , Prevalencia , Factores SexualesRESUMEN
An island-wide cohort of 13,260 Jamaicans who applied for food-handling licenses during 1985 and 1986 were tested for antibodies to human T-cell lymphotropic virus type I (HTLV-I). Demographic and residence history data were linked to geographic and ecologic measures of elevation, rainfall, crop-growing areas, population density, and additional measures of urbanization and correlated with HTLV-I antibody status. By logistic regression analysis (performed separately for men and women), men and women who currently resided at low elevation (less than or equal to 1,000 ft (305 m)) were more likely to be HTLV-I infected than were those residing at high elevation. Men, but not women, who were born in citrus-growing areas were more likely to be HTLV-I infected than were men who were born in other areas. By univariate analysis, there was a significant positive trend of increasing HTLV-I seroprevalence with increasing amount of annual rainfall associated with birthplace and primary residence areas. However, these associations did not remain significant after adjusting for age and sex. These environmental associations raise the possibility of new modes of viral transmission or host response to infection, although they may simply be surrogates for socioeconomic status, breastfeeding habits, or sexual behavior, which are known determinants of HTLV-I zero prevalence.
Asunto(s)
Anticuerpos Anti-HTLV-I/análisis , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Densidad de Población , Adolescente , Adulto , Anciano , Altitud , Niño , Ecología , Femenino , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-I/inmunología , Virus Linfotrópico T Tipo 1 Humano/inmunología , Humanos , Jamaica/epidemiología , Masculino , Persona de Mediana Edad , Lluvia , Análisis de RegresiónRESUMEN
The human T-lymphotropic virus (HTLV) and associated diseases, adult T cell leukemia and spastic paraparesis, appear to be endemic in southwestern Japan and the Caribbean. This cross-sectional population-based study was conducted to describe the seroepidemiology of HTLV in the Republic of Panama. HTLV antibody was measured by first generation and commercial ELISA tests and confirmed by competitive binding ELISA, a radioimmunoassay for anti-p 24, and Western blot. Of 3,231 subjects greater than or equal to 15 years of age, 135 (4.2%) had antibody detected in ELISA screening tests, but because only 20% were confirmed positive, HTLV seroprevalence varied from 0.2-2% throughout the Republic. Infection with HTLV clustered in Guaymi Indians living in Bocas del Toro province (9.9% prevalence rate). With the exception of Guaymi Indians, no major geographic, urban/rural, male/female or racial differences in antibody prevalence were observed; specifically, HTLV infection rates were not elevated in black Panamanians. Clustering of infection in an isolated Amerind population must be further investigated. The small proportion of screen-positive sera which confirmed positive illustrates the importance of strict uniform criteria for seropositivity.
Asunto(s)
Anticuerpos Antideltaretrovirus/análisis , Infecciones por Deltaretrovirus/epidemiología , Deltaretrovirus/inmunología , Unión Competitiva , Western Blotting , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Panamá/epidemiología , RadioinmunoensayoRESUMEN
To evaluate altitude of birthplace and residence as factors associated with geographic clustering of HTLV-I infection in Colombia, we sampled a total of 670 current residents of the South Pacific coastal lowland and of upland regions (Cali and environs) of the Valle and Cauca Provinces, located at an altitude of 3,100 ft. Among the 255 lowland study subjects, 4.3% had antibody against HTLV-I, compared to 0.9% of the 415 upland study subjects. A hypothesis emerging from this study is that the lower socio-economic status of lowland residents and associated diseases, particularly untreated syphilis and other sexually transmitted diseases, may explain the increased HTLV-I seropositivity rates in this population.
Asunto(s)
Anticuerpos Anti-HTLV-I/análisis , Adulto , Factores de Edad , Anciano , Población Negra , Donantes de Sangre , Colombia , Femenino , Infecciones por HTLV-I/etiología , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Enfermedades de Transmisión Sexual/complicaciones , Factores SocioeconómicosRESUMEN
Epidemiologic studies indicate that human T-cell lymphotropic virus type I (HTLV-I), the causative agent of most cases of adult T-cell leukemia/lymphoma (ATLL) in Southeast Japan and the Caribbean islands and the probable cause of a progressive neurological disorder often referred to as tropical spastic paraparesis, occurs with unusual geographic clustering. The current large-scale serosurvey was undertaken to improve our understanding of HTLV-I prevalence in different parts of the world. We analyzed 43,445 serum samples collected from various geographic locales worldwide; 76% of these sera came from clinically healthy donors. Samples were initially screened by an enzyme-linked immunosorbent assay (ELISA) and 4,353 were further evaluated by means of competition assays. In this study, which did not include sera from endemic areas of Japan, a high prevalence of infection was observed in several countries in the Caribbean basin. A significant age-sex difference was observed between populations in the Caribbean and non-endemic regions of Japan. The reason for the male excess in non-endemic areas of Japan will require further study, while the female excess in the Caribbean basin is compatible with the previously described pattern for other HTLV-I-endemic areas. A newly recognized area of possible endemicity was southern Florida, where evidence of infection with HTLV-I or a related virus was found in a group of native Americans whose sera were collected in 1968. In certain parts of the world, particularly sub-Saharan Africa, important problems in determining specificity of reactivity occurred, probably because of cross-reacting antibodies. No pattern was detected that could explain the cross-reactivity solely on the basis of geographic areas, specific patterns of non-viral parasitic infection, or methods of handling the specimens. It is possible that these cross-reactivities are antibodies to proteins from HTLV-I-related retroviruses yet to be discovered.