Human T-Lymphotropic Virus-1-Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-10-11T13:30:57Z No. of bitstreams: 1 Martins AL T- Lymphotropic virus-1...2018.pdf: 280191 bytes, checksum: a36b742c001441efab19f615626e051c (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-10-11T13:43:00Z (GMT) No. of bitstreams: 1 Martins AL T- Lymphotropic virus-1...2018.pdf: 280191 bytes, checksum: a36b742c001441efab19f615626e051c (MD5)Made available in DSpace on 2018-10-11T13:43:00Z (GMT). No. of bitstreams: 1 Martins AL T- Lymphotropic virus-1...2018.pdf: 280191 bytes, checksum: a36b742c001441efab19f615626e051c (MD5) Previous issue date: 2018Universidade Estadual de Feira de Santana. Feira de Santana, BA, Brasil / Escola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório Avançado de Saúde Pública. Salvador, BA, BrasilEscola Bahiana de Medicina e Saúde Pública. Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas. Salvador, BA, BrasilHuman T-lymphotropic virus (HTLV)-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurological disorder that mostly affects women. This disease is characterized by a progressive loss of motor function and disruptions in sensory function in the lower limbs. HTLV-1 is also associated with isolated neurologic dysfunctions, overactive bladder, and erectile dysfunction. The occurrence of sexual dysfunction in HTLV-1-infected women remain unclear. Aim: To investigate associations between HTLV-1 infection and sexual dysfunction in both asymptomatic infected women and those diagnosed with HAM/TSP compared with uninfected women. Methods: HTLV-1einfected and uninfected women were assessed for sexual dysfunction using the Female Sexual Function Index instrument. Sexual dysfunction was considered if global Female Sexual Function Index scores were <26.5. Crude and adjusted prevalence ratios (PR) with 95% CI were calculated to identify associations between sexual dysfunction (outcome) and HTLV infection statuseasymptomatic or HAM/TSP (main exposure), compared with uninfected women, and adjusted by sociodemographic and/or clinical characteristics (covariables). Results: HTLV-1einfected women (n ¼ 72; 57 asymptomatic; 15 HAM/TSP) and HTLV-1 uninfected women (n ¼ 49) were evaluated. The overall sexual dysfunction prevalence was 53.7% (65/121), which was higher in the HAM/TSP group (80.0%; adjusted PR 1.89; 95% CI 1.23e2.90) when compared with non-infected individuals (44.9%). Sexual dysfunction was found in 54.4% of the HTLV-1einfected asymptomatic women (PR 1.21; 95% CI 0.82e1.79). Sexual dysfunction was associated with income lower than 1 minimal wage (wUS $300, October 2017) and number of previous birthday. Conclusion: The obtained results indicate that sexual dysfunction is associated with HAM/TSP in women infected with HTLV-1 of reproductive age

Evaluation of the cervicovaginal environment in asymptomatic Human T-cell lymphotropic virus type 1 infected women

ABSTRACT Introduction: Human T-cell lymphotropic virus type 1 (HTLV-1) is sexually transmitted and causes persistent infection. This virus induces activation of the immune system and production of inflammatory cytokines. This study aimed to assess the cytokine profile and cytopathological findings in the cervicovaginal fluid of asymptomatic HTLV-1-infected women. Methods: HTLV-1-infected and uninfected women were selected at the Centro de Atendimento ao Portador de HTLV in Salvador-Brazil. None of the included HTLV-1-infected women reported any HTLV-1-associated diseases. All volunteers underwent gynecological examination to collect cervicovaginal fluid. Cytokine quantification was performed using the Cytometric Bead Array (CBA) Human Th1/Th2/Th17 kit. Light microscopy was used to evaluate cervicovaginal cytopathology. In addition, proviral load in cervicovaginal fluid and peripheral blood was measured by real-time quantitative polymerase chain reaction. Results: 112 women (63 HTLV-1-infected and 49 uninfected) were evaluated. No differences were found with respect to cytopathological cervicovaginal findings between the groups. IL-2, TNF, IL-4, IL-10, and IL-17 levels were significantly higher in cervicovaginal fluid of the HTLV-1-infected women than in uninfected women (p < 0.05). Conversely, IFN-γ was found to be lower in the HTLV-1-infected women (p < 0.001) compared to uninfected individuals. Cervicovaginal proviral load was detectable in 53% of the HTLV-1-infected women and was found to be consistently lower than the proviral load in peripheral blood. Conclusions: HTLV-1 infection induces immune activation in cervicovaginal environment, characterized by elevated concentrations of Th1, Th2, and IL17 in the cervicovaginal fluid

Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age

Introduction: Human T-lymphotropic virus (HTLV)-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurological disorder that mostly affects women. This disease is characterized by a progressive loss of motor function and disruptions in sensory function in the lower limbs. HTLV-1 is also associated with isolated neurologic dysfunctions, overactive bladder, and erectile dysfunction. The occurrence of sexual dysfunction in HTLV-1–infected women remain unclear. Aim: To investigate associations between HTLV-1 infection and sexual dysfunction in both asymptomatic infected women and those diagnosed with HAM/TSP compared with uninfected women. Methods: HTLV-1–infected and uninfected women were assessed for sexual dysfunction using the Female Sexual Function Index instrument. Sexual dysfunction was considered if global Female Sexual Function Index scores were <26.5. Crude and adjusted prevalence ratios (PR) with 95% CI were calculated to identify associations between sexual dysfunction (outcome) and HTLV infection status–asymptomatic or HAM/TSP (main exposure), compared with uninfected women, and adjusted by sociodemographic and/or clinical characteristics (covariables). Results: HTLV-1–infected women (n = 72; 57 asymptomatic; 15 HAM/TSP) and HTLV-1 uninfected women (n = 49) were evaluated. The overall sexual dysfunction prevalence was 53.7% (65/121), which was higher in the HAM/TSP group (80.0%; adjusted PR 1.89; 95% CI 1.23–2.90) when compared with non-infected individuals (44.9%). Sexual dysfunction was found in 54.4% of the HTLV-1–infected asymptomatic women (PR 1.21; 95% CI 0.82–1.79). Sexual dysfunction was associated with income lower than 1 minimal wage (∼US $300, October 2017) and number of previous birthday. Conclusion: The obtained results indicate that sexual dysfunction is associated with HAM/TSP in women infected with HTLV-1 of reproductive age.Lima Lopes Martins A, Rios Grassi MF, de Aquino Firmino A, et al. Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age. Sex Med 2018;6:324–331. Key Words: Sexual Dysfunction, Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis, Female Sexual Function Index, Human T-Lymphotropic Virus-1, Prevalenc