Abstract

BackgroundHuman T-cell lymphotropic virus type 1 (HTLV-1) infection can increase the risk of developing skin disorders. This study evaluated the correlation between HTLV-1 proviral load and CD4+ and CD8+ T cells count among HTLV-1 infected individuals, with or without skin disorders (SD) associated with HTLV-1 infection [SD-HTLV-1: xerosis/ichthyosis, seborrheic dermatitis or infective dermatitis associated to HTLV-1 (IDH)].MethodsA total of 193 HTLV-1-infected subjects underwent an interview, dermatological examination, initial HTLV-1 proviral load assay, CD4+ and CD8+ T cells count, and lymphproliferation assay (LPA).ResultsA total of 147 patients had an abnormal skin condition; 116 (79%) of them also had SD-HTLV-1 and 21% had other dermatological diagnoses. The most prevalent SD-HTLV-1 was xerosis/acquired ichthyosis (48%), followed by seborrheic dermatitis (28%). Patients with SD-HTLV-1 were older (51 vs. 47 years), had a higher prevalence of myelopathy/tropical spastic paraparesis (HAM/TSP) (75%), and had an increased first HTLV-1 proviral load and basal LPA compared with patients without SD-HTLV-1. When excluding HAM/TSP patients, the first HTLV-1 proviral load of SD-HTLV-1 individuals remains higher than no SD-HTLV-1 patients.ConclusionsThere was a high prevalence of skin disorders (76%) among HTLV-1-infected individuals, regardless of clinical status, and 60% of these diseases are considered skin disease associated with HTLV-1 infection.

Highlights

  • Adult T-cell leukemia/lymphoma (ATLL), Human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH) are the main diseases caused by human T-cell lymphotropic virus type 1 (HTLV-1) infection [1,2,3]

  • There is a lack of surrogate markers to assess the infected patients who have a higher risk for HTLV-1 associated skin disorders

  • The dermatological examination revealed a high prevalence of skin disorders among the HTLV-1-infected patients (76%)

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Summary

Introduction

Adult T-cell leukemia/lymphoma (ATLL), HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and infective dermatitis associated with HTLV-1 (IDH) are the main diseases caused by human T-cell lymphotropic virus type 1 (HTLV-1) infection [1,2,3]. There are an estimated 5 to 10 million HTLV-1 infected individuals worldwide and Brazil is considered a highly endemic area for HTLV-1 infection, with the largest absolute number of HTLV-1 infected individuals, with more than one million people living with this virus [7,8,9]. Despite this high prevalence, only a few studies on the dermatological aspects of HTLV-1 infection have been described in this country [10]. This study evaluated the correlation between HTLV-1 proviral load and CD4+ and CD8+ T cells count among HTLV-1 infected individuals, with or without skin disorders (SD) associated with HTLV-1 infection [SD-HTLV-1: xerosis/ichthyosis, seborrheic dermatitis or infective dermatitis associated to HTLV-1 (IDH)]

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