Asociación entre infección por el virus linfotrópico humano de células T tipo I (HTLV-I) y mortalidad en pacientes hospitalizados con tuberculosis.

Bosteels, Kristien Verdonck; Camacho, César Henriquez; Zárate, Juan Echevarría; Falconi, Leandro Huayanay; Panta, Juan Agapito; Mendez, Rosario Cairampona; Ramos, Carlos Seas; Herencia, Eduardo Gotuzzo

doi:10.20453/rmh.v15i4.773

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…In our country, there is a scarce literature on this topic even though both HTLV-1 and tuberculosis infections are endemic. In an earlier Peruvian study with a population similar to ours, HTLV-1 infection was strongly and independently associated with mortality among inpatients with tuberculosis (OR: 9.43; 95% CI: 2.19-40.6) [30]. Additional Peruvian data also supports the conclusion that HTLV-1 infection can increase an individuals' susceptibility to developing active tuberculosis [31].…”

Section: Discussionsupporting

confidence: 84%

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Amanzo-Vargas,

Arellano-Veintemilla,

González-Lagos

et al. 2023

Pathogens

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Background and aims: In Peru, the estimated prevalence of human immunodeficiency virus (HIV) and human T-lymphotropic virus-1 (HTLV-1) co-infection has been reported to be as high as 18%. Despite the endemicity of HTLV-1 in Peru, few studies have assessed the impact of HIV/HTLV-1 co-infection. Our study compared socio-demographic and clinical characteristics, and mortality rates between HIV-infected and HIV/HTLV-1 co-infected patients. Methods: We reviewed the medical records of patients aged 18 years and older belonging to the HIV and HTLV-1 cohorts in Lima during a 30-year period: 1989–2019. Each HIV/HTLV-1 co-infected patient was randomly matched with two HIV-infected patients with similar characteristics (same sex, age ± 5 years, and same year of HIV diagnosis). Allegedly co-infected patients without a confirmatory diagnosis of HIV and HTLV-1 were excluded. Most of the patients in the HIV-infected group did not have a negative test result for HTLV-1 infection, so we used two probabilistic sensitivity analysis models to correct for potential HTLV-1 exposure misclassification bias in the group of HIV-infected patients. Results: Of 162 patients enrolled, 54 were HIV/HTLV-1 co-infected and 108 were HIV-infected. The median age was 42 years (IQR = 34–51 years) and the majority were male (61.1%), single (44.4%), heterosexual (71%), born in Lima (58%), educated at the secondary school level (55.6%), and receiving antiretroviral treatment (91.4%). HIV/HTLV-1 co-infection was associated with an increased risk of death (HR: 11.8; 95% CI: 1.55–89.00; p = 0.017) while antiretroviral treatment was associated with a decreased risk of death (HR: 0.03; 95% CI: 0.003–0.25; p = 0.001). The overall mortality rate was 13.6 per 100 persons and the survival time for co-infected patients (median = 14.19 years) was significantly shorter than that of HIV-infected patients (median = 23.83 years) (p < 0.001). Conclusions: HIV/HTLV-1 co-infected patients had a significantly shorter survival time compared to HIV-infected patients, suggesting that the immune alterations caused by HTLV-1 in CD4 cell count may have contributed to late initiation of antiretroviral treatment and prophylaxis against opportunistic infections over the decades, and thus reducing their benefits in these patients.

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Section: Discussionsupporting

confidence: 84%

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Amanzo-Vargas,

Arellano-Veintemilla,

González-Lagos

et al. 2023

Pathogens

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“…Según Verdonck et al, la tasa de infección dual (VIH y HTLV-1) es 3,7% en pacientes hospitalizados por TB. Se ha estudiado previamente el impacto que ha tenido el VIH en el incremento de la proporción de personas que desarrollan TB activa (6) ; por lo que también se le considera un mediador importante de la aparición de numerosos casos de TB-MDR.Debido que se trabajó solamente con información laboratorial, no se puede determinar una asociación más precisa entre los factores clínicos y epidemiológicos. Además, debido a la falta de presupuesto no se contó con sueros y reactivos suficientes, lo que limitó considerablemente el tamaño de muestra.…”

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Infección por virus linfotrópico de células T humanas tipo 1 en pacientes con diagnóstico de tuberculosis multidrogorresistente

Cachay

Schwalb

Mora

et al. 2019

Rev Peru Med Exp Salud Publica

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Perú es uno de los países de las Américas que tiene una alta incidencia de tuberculosis (TB) (1) ; además, se estima que tiene una prevalencia de 2,5% de serología positiva 2018]. Disponible en: http://temas.sld.cu/dengue/2017/12/27/ manual-washington-de-especialidades-clinicas-enfermedadesinfecciosas/ 5. Alves A, Moura D, Spolti G. Co-infection with hepatitis A and leptospirosis in the Amazon region: report of two cases. Trop Gastroenterol. 2011;32(3):234-6. 6. Núñez-Garbín A, Espinoza-Figueroa J, Sihuincha-Maldonado M, Suarez-Ognio L. Coinfección por dengue y leptospirosis en una niña de la Amazonía peruana. Rev Peru Med Exp Salud Publica. 2015 ;32(1):179-82. 7. Jaramillo L, Arboleda M, García V, Agudelo-Flórez P. Coinfección brucelosis-leptospirosis, Urabá, Colombia. Reporte de caso. Infectio. 2018;18(2):72-6. Correspondencia: Jorge Luis Fernández Mogollón Dirección: Jr. San José 143 -Lambayeque, Perú. Correo electrónico: jorgeluis_59@yahoo.espara el virus linfotrópico de células T humanas tipo 1 (HTLV-1) (2) . Esta prevalencia se incrementa hasta 5,8% en pacientes con TB, según un estudio realizado en el distrito de San Juan de Lurigancho (SJL) en Lima (1) . El riesgo de desarrollar TB en pacientes portadores del virus es de dos a cuatro veces mayor que en las personas no infectadas (3) .Se ha demostrado que la infección por HTLV-1 disminuye la respuesta inmune tipo 1 al antígeno micobacteriano, por lo que la presencia del virus en pacientes con TB supone un curso de enfermedad más complicado (3) . Por ejemplo, en los casos de coinfección con HTLV-1, se evidencia 3,5 veces más lesiones de destrucción parenquimal que en los casos de TB pulmonar (3) . Por otro lado, la presencia de TB induce una respuesta inflamatoria exagerada que contribuye al desarrollo de la mielopatía asociada a HTLV-1 (4) . Además, debido a que estos pacientes presentan esputo con mayor carga bacilar por mayor tiempo (1) , el pobre control contra el bacilo podría resultar en el desarrollo de cepas de tuberculosis multidrogorresistente (TB-MDR).Considerando el daño resultante a nivel pulmonar, así como su considerable incremento en la infectividad, la asociación entre ambos patógenos amerita estudios más amplios.En nuestro estudio, se analizó retrospectivamente la serología para HTLV-1 en 106 muestras de pacientes provenientes del distrito de SJL, con diagnóstico de TB-MDR (resistente a isoniacida y rifampicina). Las muestras provenían de estudios previos realizados por la Universidad Peruana Cayetano Heredia, los cuales estaban destinados a la formación de un banco de muestras para el desarrollo de pruebas diagnósticas y hallazgos de marcadores asociados a TB. Encontramos que 2,8 % (IC 95%, 0,72-7,5) tuvieron serología positiva para el virus. No hemos encontrados estudios a nivel nacional que midan cuantitativamente la proporción de portadores de HTLV-1 en pacientes con TB-MDR. Esta asociación podría ser un factor que favorece la alta prevalencia de TB en el distrito (5) .En la muestra, también se analizó la frecuencia de infección por el...

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HTLV-1 and Tuberculosis Association: A Review of the Literature

Santos

Lírio

Mascarenhas³

et al. 2014

BJMHH

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Objective: To review and evaluate the scientific evidences on the relationship between tuberculosis (TB) and HTLV-1 infection. Methods: Searches on MEDLINE, LILACS/SciELO and Cochrane Library databases were performed using the following keywords: HTLV-1 Infection, Human T-lymphotropic virus type 1; Paraparesis Tropical Spastic; Tuberculosis. The following data were evaluated: Study design, sample size, number of controls, frequency of HTLV-1 infection in patients with TB and uninfected controls, mortality in HTLV-1/TB coinfected individuals compared with controls group, response in vivo and in vitro to PPD, frequency of individuals with tuberculin skin test (TST) positive or negative. Results: Nineteen articles were selected: twelve investigated prevalence, four mortality, three evaluated both prevalence and mortality and six described immunological findings. The majority of the studies was conducted in South America (Brazil and Peru), and Japan. Seven out of 12 studies found an increased risk of HTLV-1 in patients with TB diagnosis. The prevalence of HTLV-1/TB co-infection ranged from1.49 % in Brazil to 11.4 % in patients in Peru. Two out of five studies found a higher mortality of patients with HTLV-1/TB co-infection compared to patients with TB alone. Three studies conducted in Africa (Guinea Bissau and Senegal) found no increase in the mortality of patients co-infected with TB and HTLV-1. A decreased response to PPD in vitro or in vivo was observed in co-infected individuals compared with patients with TB alone. Conclusion: Patients with TB diagnosis have a higher prevalence of HTLV-1, compared with uninfected controls. Co-infection HTLV-1/TB increases the mortality of TB.

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Asociación entre infección por el virus linfotrópico humano de células T tipo I (HTLV-I) y mortalidad en pacientes hospitalizados con tuberculosis.

Cited by 5 publications

References 7 publications

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Socio-Demographic, Clinical, and Mortality Differences between HIV-Infected and HIV/HTLV-1 Co-Infected Patients in Peru

Infección por virus linfotrópico de células T humanas tipo 1 en pacientes con diagnóstico de tuberculosis multidrogorresistente

HTLV-1 and Tuberculosis Association: A Review of the Literature

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