Evolution of HTLV-1 proviral load in patients from Salvador, Brazil

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IntroductionVariations in human T cell lymphotropic virus type 1 (HTLV-1) proviral load (PVL) in infected individuals over time are not well understood. ObjectiveTo evaluate the evolution of proviral load in asymptomatic individuals and HAM/TSP patients in order to help determine periodicity for measuring proviral load. MethodsA group of 104 HTLV-1 infected patients, followed at the HTLV reference center in Salvador, Brazil, were included in the study (70 asymptomatic and 34 HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients). HTLV-1 PVL was measured using real-time polymerase chain reaction (PCR) at baseline and again at another point, either ≤ 12 months, between 12-24 months, or ≥ 24 months. ResultsHAM/TSP patients had higher PVL (ranging from 11,041 to 317,009 copies/106 PBMC) when compared to asymptomatic individuals (ranging from 0 to 68,228 copies/106 PBMC). No statistically significant differences were observed in the medians of PVL in HAM/TSP patients or asymptomatic individuals over time. However, in asymptomatic individuals with a PVL below 50,000 copies/106 PBMC, a statistically significant two-fold increase was observed over time. ConclusionHTLV-1-PVL remained stable in both asymptomatic individuals and HAM/TSP patients over time. Frequent monitoring of asymptomatic individuals with low PVLs is recommended and further studies should be conducted to assess the course of PVL in these patients over extended periods of time.