Development of Tropical Spastic Paraparesis in Human T-Lymphotropic Virus Type 1 Carriers Is Influenced by Interleukin 28B Gene Polymorphisms

Producción CientíficaInterleukin 28B (IL28B) rs12979860 polymorphisms were examined in 41 individuals with human T-lymphotrophic virus type 1 (HTLV-1). The alleles CT/TT were more frequent in 12 individuals with HTLV-1-associated myelopathy/tropical spastic paraparesis than in 29 asymptomatic carriers (80% vs 20%; P = .03), and median HTLV-1 proviral load was greater in CT/TT than CC carriers (P = .01). Thus, IL28B testing and closer follow-up of HTLV-1 asymptomatic CT/TT carriers is warranted.Fundación Investigación y Educación en Sida Grant (IES) FIS (CP05/00300)Red de Investigación en SIDA Grant (RIS, ISCIII-RETIC RD06/006)Proyecto europeo NEAT Grant (LSHP-CT-2006-037570

Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain

Background: although only 8%-10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods: a nationwide HTLV-1 register was created in Spain in 1989. A total of 351 infected persons had been reported by the end of 2017. We examined all new HTLV-1 diagnoses during the last decade and compared their clinical presentation. Results: a total of 247 individuals with HTLV-1 infection had been reported in Spain since year 2008. The incidence has remained stable with 20-25 new diagnoses yearly. Women represented 62%. Only 12% were native Spaniards, most of whom were foreigners from Latin America (72.5%). Up to 57 (23%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (n = 24; 42.1%), T-cell lymphoma (n = 19; 33.3%), or Strongyloides stercoralis infestation (n = 8; 14%). Human T-cell leukemia virus type 1 diagnosis had been made either at blood banks (n = 109; 44%) or at clinics (n = 138; 56%). It is interesting to note that Spaniards and especially Africans were overrepresented among patients presenting with HTLV-1-associated illnesses, suggesting that misdiagnosis and late presentation are more frequent in these populations compared to Latin Americans. Conclusions: given that 23% of new HTLV-1 diagnoses in Spain are symptomatic, underdiagnosis must be common. Although screening in blood banks mostly identifies asymptomatic Latin American carriers, a disproportionately high number of Spaniards and Africans are unveiled too late, that is, they already suffer from classic HTLV-1 illnesses

HTLV infection in HCV-antibody positive patients in Spain.

Since hepatitis C virus (HCV) and human T-lymphotropic virus (HTLV) share transmission routes, dual infection could be frequent. In Spain, HTLV underdiagnosis is highlighted by the high proportion of patients presenting either with tropical spastic paraparesis or adult T cell leukemia at first diagnosis. We examined whether the renewed efforts for expanding HCV testing may provide a sentinel population that might selectively be targeted to unveil asymptomatic HTLV carriers. The presence of anti-HTLV antibodies was examined in 3,838 consecutive individuals with reactive HCV serology attended during the last 3 years at 13 hospitals distributed across the Spanish geography. Overall 71% were male, and the median age was 41 years old. Foreigners represented 9% of the study population. A total of 50 individuals (1.3%) were seroreactive for HTLV, being 30 confirmed as HTLV-2 and 2 as HTLV-1 (0.12%). The remaining 18 had indeterminate Western blot patterns. Most individuals with HTLV-2 and HTLV indeterminate serology were human immunodeficiency virus positive, former injection drug users, and native Spaniards. In contrast, the two HTLV-1 infections were found in men coming from Brazil and the Dominican Republic, respectively. In summary, the overall prevalence of HTLV infection in individuals living in Spain seropositive for HCV is 1.3%, more than 10-fold greater than in general outclinics in Spain. However, immigrants from HTLV-1 endemic regions and former injection drug users with HTLV-2 infection are by far the major contributory groups in HCV patients. Therefore, testing for HTLV in newly diagnosed HCV individuals would not contribute much to improve late HTLV diagnosis in Spain

Análisis de la actividad antimicrobiana de la Gliotoxina en diferentes microorganismos de interés clínico

Trabajo presentado en el XXIV Congreso Nacional de la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), celebrado de manera virtual del 5-11 junio de 2021.[Introducción/Objetivos]: la gliotoxina es una micotoxina producida por Aspergillus fumigatus y otros hongos del género Aspergillus. Es un metabolito secundario perteneciente a la familia de las epipolitiodioxopiperazinas, caracterizada por la presencia de un puente disulfuro interno en un anillo de piperazina, que parece ser necesario para la mayoría de las propiedades biológicas de este compuesto. Se ha demostrado que la gliotoxina es un factor de virulencia durante la aspergilosis invasiva y presenta una toxicidad notable contra las células de mamíferos. Sin embargo, las evidencias científicas sobre su potencial actividad antimicrobiana son escasas. Por lo tanto, este trabajo tiene como objetivo evaluar su eficacia antibiótica contra microorganismos de interés clínico como Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa; y antifúngico contra Candida albicans y Candida glabrata. [Material y métodos]: la sensibilidad a la gliotoxina de diferentes cepas (incluidas las farmacorresistentes) de los microorganismos indicados se analizó por diferentes métodos: métodos de difusión en disco (antibiogramas/antifungigramas), estudio de curvas de tiempo-mortalidad, métodos de microdilución y ensayo MTT. Para los aislados de Candida, los resultados fueron confirmados mediante el análisis de la muerte celular por citometría de flujo. [Resultados]: Los resultados sugieren una potente actividad antimicrobiana de gliotoxina contra Candida albicans y Staphylococcus aureus, incluso en las cepas resistentes a azoles y a meticilina, respectivamente. En el caso de Escherichia coli y Candida glabrata, la gliotoxina ejerce una acción antimicrobiana moderada. Sin embargo, Pseudomonas aeruginosa parece ser resistente a la gliotoxina. [Conclusiones]: Nuestros resultados indican que la gliotoxina es efectiva contra Candida albicans y Staphylococcus aureus por lo que podría usarse como una alternativa para el tratamiento de infecciones causadas por cepas resistentes a antibióticos/antifúngicos. Sin embargo, será necesario aclarar aún más los mecanismos por los cuales la gliotoxina ejerce este efecto y probar en modelos apropiados in vivo la viabilidad de su uso teniendo en cuenta los posibles efectos secundarios debido a su toxicidad. En este sentido, planeamos analizar su eficacia y seguridad en un modelo de infección cutánea causada por Staphylococcus aureus.Peer reviewe

Trends in the prevalence and distribution of HTLV-1 and HTLV-2 infections in Spain

<p>Abstract</p> <p>Background</p> <p>Although most HTLV infections in Spain have been found in native intravenous drug users carrying HTLV-2, the large immigration flows from Latin America and Sub-Saharan Africa in recent years may have changed the prevalence and distribution of HTLV-1 and HTLV-2 infections, and hypothetically open the opportunity for introducing HTLV-3 or HTLV-4 in Spain. To assess the current seroprevalence of HTLV infection in Spain a national multicenter, cross-sectional, study was conducted in June 2009.</p> <p>Results</p> <p>A total of 6,460 consecutive outpatients attending 16 hospitals were examined. Overall, 12% were immigrants, and their main origin was Latin America (4.9%), Africa (3.6%) and other European countries (2.8%). Nine individuals were seroreactive for HTLV antibodies (overall prevalence, 0.14%). Evidence of HTLV-1 infection was confirmed by Western blot in 4 subjects (prevalence 0.06%) while HTLV-2 infection was found in 5 (prevalence 0.08%). Infection with HTLV types 1, 2, 3 and 4 was discarded by Western blot and specific PCR assays in another two specimens initially reactive in the enzyme immunoassay. All but one HTLV-1 cases were Latin-Americans while all persons with HTLV-2 infection were native Spaniards.</p> <p>Conclusions</p> <p>The overall prevalence of HTLV infections in Spain remains low, with no evidence of HTLV-3 or HTLV-4 infections so far.</p

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

HTLV testing of solid organ transplant donors

Carta al edito

Transmisión congénitade Trypanosoma cruzi(enfermedad de Chagas):a propósito de un caso

We report a case of congenital transmission of Trypanosoma cruzifrom a Bolivian mother with asymtomatic Chagas diseaseliving in Spain.The serology to T. cruziwere positive for the mother. Nested PCR and direct examination were positive in theblood of the neonate. Received treatment with benznidazole 10 mg/kg/day for 90 days. Nested PCR, examination direct andserologicol test to T. cruzywere negativeComunicamos un caso de transmisión vertical de Trypanosoma cruzide una madre boliviana que vive en España y afectade enfermedad de Chagas asintomática. La serología a T. cruziera positiva en la madre. La reacción en cadena de lapolimerasa (PCR) y el examen directo del parásito fueron positivos en sangre del recién nacido.Recibió tratamiento conbenznidazole 10 mg/kg/día durante 90 días.La PCR,el examen directo y los test serológicos a T. cruzi se hicieron negativos