Susceptibility of Primary HTLV-1 Isolates from Patients with HTLV-1-Associated Myelopathy to Reverse Transcriptase Inhibitors

Macchi, Beatrice; Balestrieri, Emanuela; Ascolani, Arianna; Hilburn, Silva; Martin, Fabiola; Mastino, Antonio; Taylor, Graham P.

doi:10.3390/v3050469

Cited by 41 publications

(39 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, despite in vitro evidence that certain nucleoside/ nucleotide analog reverse transcriptase inhibitors (NRTIs) are active against HTLV-1, in vivo results have been disappointing showing no clinical improvement or reduction of the PVL [37,38]. The same is true for integrase inhibitors such as raltegravir.…”

Section: Management and Treatmentmentioning

confidence: 89%

Update on Neurological Manifestations of HTLV-1 Infection

Araújo

2015

Curr Infect Dis Rep

View full text Add to dashboard Cite

The human T cell lymphotropic virus type 1 (HTLV-1) is a retrovirus that infects 10-20 million persons around the world. Initially associated with the hematological malignancy adult T cell leukemia/lymphoma (ATLL), HTLV-1 is also the cause of a chronic progressive myelopathy named "HTLV-1-associated myelopathy/tropical spastic paraparesis" (HAM/TSP). HAM/TSP arises as the tip of the iceberg of an assortment of neurological syndromes triggered by the virus such as inflammatory myopathies, polyneuropathies, amyotrophic lateral sclerosis (ALS)-like syndromes, dysautonomia, and cognitive impairment. HAM/TSP typifies a chronic progressive spastic paraparesis with neurogenic bladder and minimal sensory signs. The neuropathology of HAM/TSP is concentrated in the thoracic spinal cord and is typically biphasic. Initially, there is a perivascular lymphocytic cuffing and mild parenchymal mononuclear infiltrates. Subsequently, this is replaced by gliosis and scarring. The neuropathogenesis of HTLV-1 is still partially understood. At present, the therapy of HAM/TSP remains basically symptomatic.

show abstract

Section: Management and Treatmentmentioning

confidence: 89%

Update on Neurological Manifestations of HTLV-1 Infection

Araújo

2015

Curr Infect Dis Rep

View full text Add to dashboard Cite

show abstract

“…Two therapies, namely zidovudine (nucleoside analogue reverse transcriptase inhibitor) and raltegravir (integrase inhibitor), have been shown to inhibit HTLV-1 replication both in vitro (70,71,73) and in vivo (68). Both agents are currently licensed for the treatment of HIV-1 infection.…”

Section: Htlv-1 Postexposure Prophylaxismentioning

confidence: 98%

“…We are not aware of any observational ''proof of concept'' studies for postexposure HTLV-1 prophylaxis. The choice of potential antiviral agents in this setting can, however, be guided by animal data (68,69), in vitro data (70,71), and clinical trials in established HTLV-associated diseases (72).…”

Section: Htlv-1 Postexposure Prophylaxismentioning

confidence: 99%

HTLV-1 in Solid-Organ Transplantation

Armstrong¹,

Corbett²,

Rowe³

et al. 2012

Transplantation

View full text Add to dashboard Cite

Human T-cell lymphotrophic virus (HTLV)-1 has been reported after solid-organ transplantation, with a related fatal outcome in less than five cases. The natural history of HTLV-1 transmission from donor to recipient is unknown in this setting, because available screening platforms are suboptimal in low-prevalence areas and there is a lack of long-term follow-up. Minimizing organ wastage due to false-positive screening and avoiding donor-derived HTLV-associated diseases remain the goal. To date, only six HTLV-naive organ recipients from four donors (only one had confirmed HTLV) have developed HTLV-associated disease after transplantation. All of these cases were described in countries or from donors from HTLV-endemic regions. To the best of our knowledge, there have been no reported cases of donor-derived HTLV-1-associated death after organ transplantation in the world. Based on data from low-prevalence countries (Europe and the United States) and the current shortage of donor organs, it appears plausible to authorize the decision to transplant an organ without the prior knowledge of the donor's HTLV-1 status. Currently, it is not possible to exclude such transmission and recipients should be informed of the possible inadvertent transmission of this (and other) infections at the time of consent. In those cases where HTLV-1 transmission does occur, there may be a therapeutic window in which use of antiviral agents (i.e., zidovudine and raltegravir) may be of benefit. The development of national/international registries should allow a greater understanding of the extent and consequences of transmission risk and so allow a more evidence-based approach to management.

show abstract

“…Fárma-cos antirretrovirales como zidovudina, lamivudina y raltegravir no muestran eficacia antiviral en ensayos clínicos; pese a que se observa inhibición de la replicación viral in vitro, los resultados in vivo no muestran mejoría clínica ni reducción de la carga proviral (78)(79)(80). Esto podría explicarse por los escasos ciclos continuos de replicación viral en la mayoría de los portadores, lo que favorecería probablemente el escape del virus del mecanismo de acción de estos fár-macos, el cual utiliza la división de la célula huésped como forma alternativa de replicación (81,82).…”

Section: Tratamientounclassified