Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/46317
ASSOCIATION BETWEEN HIGH PROVIRAL LOAD, COGNITIVE IMPAIRMENT, AND WHITE MATTER BRAIN LESIONS IN HTLV‑1‑INFECTED INDIVIDUALS
Mielopatia
Paraparesia Espástica Tropical ·
Disfunção cognitivo ·
Imagem por Ressonância Magnética
Vírus Linfotrópico T Tipo 1 Humano
HTLV-1-associated myelopathy ·
Tropical spastic paraparesis ·
Cognitive impairment ·
Magnetic resonance imaging
Author
Affilliation
Federal University of Rio de Janeiro. Faculty of Medicine, Postgraduate in Infectious and Parasitic Diseases. Rio de Janeiro, RJ, Brazil / Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Imperial College London. Department of Infectious Disease. London, UK.
Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro. Postgraduate Biological Institute. Rio de Janeiro, RJ, Brazil.
Bahiana School of Medicine. HTLV Integrative and Multidisciplinary Center. Salvador, BA, Brazil.
Bahiana School of Medicine. HTLV Integrative and Multidisciplinary Center. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Bahia, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Bahia, Brasil.
Imperial College London. Department of Infectious Disease. London, UK.
Federal University of Rio de Janeiro. Faculty of Medicine, Postgraduate in Infectious and Parasitic Diseases. Rio de Janeiro, RJ, Brazil / Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil. / Federal University of the State of Rio de Janeiro. School of Medicine and Surgery, Department of General Medicine. Rio de Janeiro,RJ, Brazil.
Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Imperial College London. Department of Infectious Disease. London, UK.
Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil.
Federal University of Rio de Janeiro. Postgraduate Biological Institute. Rio de Janeiro, RJ, Brazil.
Bahiana School of Medicine. HTLV Integrative and Multidisciplinary Center. Salvador, BA, Brazil.
Bahiana School of Medicine. HTLV Integrative and Multidisciplinary Center. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Bahia, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, Bahia, Brasil.
Imperial College London. Department of Infectious Disease. London, UK.
Federal University of Rio de Janeiro. Faculty of Medicine, Postgraduate in Infectious and Parasitic Diseases. Rio de Janeiro, RJ, Brazil / Federal University of the State of Rio de Janeiro. Gaffree and Guinle University Hospital. Neuroinfection Unit Immunology Service. Rio de Janeiro, RJ, Brazil. / Federal University of the State of Rio de Janeiro. School of Medicine and Surgery, Department of General Medicine. Rio de Janeiro,RJ, Brazil.
Abstract
The association between high proviral load (PVL) in peripheral blood mononuclear cells (PBMC), cognitive disturbance and
white matter brain lesions in HTLV-1-infected individuals is still undefined. A cross-sectional study included 62 participants:
22 asymptomatic carriers (mean age 43.4 ± 13.1 years old), 22 patients with HTLV-1-associated myelopathy (HAM/TSP)
(mean age 51.5 ± 8.7 years old), and 18 uninfected controls (mean age 52.3 ± 11.1 years old). All individuals fulfilled the
following criteria: between 18 and 65 years of age, more than 4 years of formal education, and completed neuropsychological
evaluation and HTLV-1 serology. Infected individuals underwent brain conventional magnetic resonance imaging and PVL
quantitative PCR (qPCR). Statistical analysis was adjusted in the models by age and education. Cognitive deficit was observed
in all groups. Patients with HAM/TSP showed higher neurocognitive deviation in attention and motor skills, higher frequency
(84%) of brain white matter lesions, and higher PVL median (range) 8.45 (0.5–71.4) copies/100 PBMC. Brain white matter
lesion was associated with verbal memory deficit in HTLV-1-infected individuals (HAM/TSP and asymptomatic carriers)
(p = 0.026). In addition, there was a correlation between higher PVL and neurocognitive dysfunction score (processing speed
of visuomotor information and visuoconstructive praxis) in HTLV-1-infected patients. The study demonstrates an association
between HTLV-1 infection, neurocognitive disorder, and white matter brain lesions on MRI as well as a correlation with
higher HTLV-1 PVL, suggesting that the central nervous system involvement by HTLV-1 is not restricted to the spinal cord
but involves the whole neuro-axis. HTLV-1-infected individuals should be tested for cognitive impairment.
Keywords in Portuguese
HTLV-1 ·Mielopatia
Paraparesia Espástica Tropical ·
Disfunção cognitivo ·
Imagem por Ressonância Magnética
Vírus Linfotrópico T Tipo 1 Humano
Keywords
HTLV-1 ·HTLV-1-associated myelopathy ·
Tropical spastic paraparesis ·
Cognitive impairment ·
Magnetic resonance imaging
Share