Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study.

Apio Ricardo Nazareth Dias,Karen Margarete Vieira Da Silva Franco,Luiz Fábio Magno Falcão,Valéria Marques Ferreira Normando,Juarez Antônio Simões Quaresma,Aline Semblano Carreira Falcão,Rita Catarina Medeiros De Sousa,Hellen Thais Fuzii,Waldonio De Brito Vieira,Aleksandra Barac

doi:10.1371/journal.pone.0261864

Apio Ricardo Nazareth Dias, Karen Margarete Vieira Da Silva Franco + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0261864

Copy DOI

Abstract

Previous observational studies have demonstrated the development of pulmonary impairments in human T-lymphotropic virus type 1 (HTLV-1) infected individuals. The main observed lesions due to chronic inflammation of viral infection in situ are bronchiectasis and lung-scarring injuries. This lung inflammation may be the causal agent of restrictive and obstructive lung diseases, primarily in tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) patients. We conducted a prospective cohort study to compare spirometry and high-resolution computed tomography (HRCT) findings among 28 HTLV-1-carrier patients over the course of 6 years (2014-2019) (male/female: 7/21; mean age: 54.7 ± 9.5, range: 41-68 years). Chest HRCT exams revealed the development and evolution of lung lesions related to TSP-HAM: including centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. Spirometry exams showed maintenance of respiratory function, with few alterations in parameters suggestive of obstructive and restrictive disorders primarily in individuals with lung lesions and TSP-HAM. The findings of the present study indicate that pulmonary disease related to HTLV-1 is a progressive disease, with development of new lung lesions, mainly in individuals with TSP-HAM. To improve clinical management of these individuals, we recommend that individuals diagnosed with PET-MAH undergo pulmonary evaluation.

Highlights

Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus and has a global infection incidence of ~ 20 million people, with a higher prevalence in Africa, Japan, and Latin America [1]
To the best of our knowledge, our study is the first to compare the findings of chest computed tomography (CT) and spirometry in a cohort of patients infected with HTLV-1 over a 6-year follow-up period; we demonstrate the clinical evolution of these patients and their lung injuries related to HTLV-1
This study aimed to compare the findings of chest computed tomography (CT) and spirometry in a cohort of patients infected with HTLV-1 in a 6-year follow-up period

Summary

Introduction

Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus and has a global infection incidence of ~ 20 million people, with a higher prevalence in Africa, Japan, and Latin America [1]. Brazil has a high prevalence, mainly in Maranhão, Bahia and Para States, and is most common in the Brazilian Amazon rainforest regions [2, 3]. CT Scan demonstrate the evolution of HTLV-1 Lung Injuries

Objectives

Results

Conclusion