Human T-Lymphotropic Virus-1/2 Infection in Central Brazil Prisons: A Multicenter Study.

Larissa Melo Bandeira,Carolina Amianti,Marco Antonio Moreira Puga,Ana Rita Coimbra Motta-Castro,Grazielli Rocha De Rezende,Maurício Antonio Pompílio,Julio Croda

doi:10.3389/fmicb.2021.740245

Abstract

Human T-lymphotropic virus (HTLV) infection is endemic in some group populations. Prisoners are at high risk of acquiring HTLV infection mainly due to the environment of closed penal institutions, socioeconomic conditions, and risk behaviors. This study aimed to investigate the prevalence, the occurrence of new cases of HTLV infection after a 1-year follow-up, and circulating subtypes of HTLV-1 among prisoners from twelve closed prisons in Mato Grosso do Sul state, Central Brazil. A total of 1,507 prisoners were randomly enrolled in the cross-sectional study. Out of the 1,507 participants, 1,000 prisoners, susceptible to HTLV infection, were included in the prospective cohort study. In the cross-sectional study, serological evidence of HTLV infection was 0.4% (CI 95%: 0.1-0.7), tested for anti-HTLV antibodies by enzyme-linked immunosorbent assay (ELISA). Three samples were positive for HTLV-1, two samples were positive for HTLV-2, and 1 sample was indeterminate by the Western blot method. The presence of HTLV proviral DNA was detected in all positive samples by amplification of the HTLV tax gene through nested-PCR. Phylogenetic analysis showed that HTLV-1 samples belonged to the Cosmopolitan subtype Transcontinental subgroup. From a cohort of 1,000 individuals, no new case of HTLV infection was detected. Although the prevalence rate of HTLV infection found in this study was similar to that observed in the Brazilian general population, the lack of access to preventive interventions and harm reduction measures all contribute to increasing the risk of HTLV transmission and acquisition among this key and vulnerable population.

Highlights

Inmates represent a highly vulnerable population to several infectious diseases compared with the general population, blood, and sexually transmittable infections (STI) (Massoglia and Remster, 2019)
The study population consisted of inmates from 12 of the 21 closed penal institutions of five different cities of Mato Grosso do Sul State, Central Brazil, as follows: Campo Grande, Corumbá, Ponta Porã, Dourados, and Três Lagoas (Figure 1)
Low frequency was found for these variables among the studied population in 1-year-follow-up: tattooing over the last year (13.83%), sharing needle over the last year (1.30%), injecting drug use in prison (0.11%), and history of blood transfusion over the last year (1.41%). This is the first survey on Human T-lymphotropic virus (HTLV)-1/2 infection prevalence carried out among inmates in Central Brazil, involving the five major closed penal institutions of Mato Grosso do Sul State (DEPEN, 2020)

Summary

Introduction

Inmates represent a highly vulnerable population to several infectious diseases compared with the general population, blood, and sexually transmittable infections (STI) (Massoglia and Remster, 2019). Brazil has the third-largest prison population in the world, with approximately 702,000 inmates in 2020 (Puga et al, 2019; DEPEN, 2020). In Brazil, the prevalence of HTLV-1/2 infection varies according to the region and the population group studied. A systematic review study estimated a prevalence of HTLV-1 in Brazilian pregnant women of 0.32%, while HTLV-2 was 0.04% (Vieira et al, 2021). This virus is transmitted via unprotected sexual intercourse, exposure to the infected blood, or from infected mother to child mainly through breastfeeding (Nunes et al, 2017)

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