Introduction Brazil is endemic for HIV-1, HTLV-1 and HTLV-2, these retrovirus share routes of transmission with HCV and HBV, thus coinfections can occur. Several studies tried to evaluate the impact of human retroviruses on the course of HCV infection, and association of HTLV-1 with spontaneous clearance of HCV, mostly in HIV coinfected patients, and less hepatic injury were detected. In contrast, an increase in HCV viral load in HIV and/or HTLV-2 coinfected individuals was described. Concerning HBV infection, one study showed higher rate of HBV antigenemia in HIV/HTLV-1 coinfected patients. Thus, searches for HTLV infections in HCV and HBV infected patients have prognostic value.
Methods Plasma samples from 1244 individuals sent to Instituto Adolfo Lutz for measuring HCV and HBV viral load: 622 HCV+ (G1=343 male, 279 female), and 622 HBV+ (G2=327 male, 295 female) were evaluated for HTLV-1/–2 infection by enzyme immunoassay (EIA, HTLV-I/II, Gold ELISA, REM), and confirmed by line immunoassay (INNO-LIA HTLV-I/II, Fujirebio). HIV infection was detected by immunochromatographic assay (Rapid Check HIV 1+2, UFES).
Results On screening test 44 plasma samples reacted, and HTLV-1 was confirmed in 25 samples [20(G1), 5(G2)]. HTLV-2 was detected in 16 samples [13(G1), 3(G2)]. Two samples were indeterminate, and one negative (G2). The overall prevalence of HTLV in HCV+ was 5.3% (3.2% HTLV-1% and 2.1% HTLV-2), and HBV +1.3% (0.8% HTLV-1% and 0.5% HTLV-2). No difference in the median age of patients was detected between HCV-infected and HCV/HTLV coinfected (50.7 vs. 50.6 years), also in HBV and HTLV/HBV coinfected (45.8 vs. 53.5 years). In HCV/HTLV coinfected patients 30.3% were HIV+, while in HBV/HTLV coinfected patients, all except one were HIV+.
Conclusion The results emphasise the need for searching HTLV infections mostly in patients with HCV. Thus, we suggest to include the serology for HTLV in the tests battery for following up the hepatitis virus infected patients in Brazil, regardless of your HIV status.
Support: FAPESP AP#2016/03654– 0, CNPq PD#302661/2015 – 8