A Systematical Review on ART Use in HTLV Infection: Clinical, Virological, and Immunological Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Information Sources and Search Strategy
2.2. Eligibility Criteria
2.3. Exclusion Criteria
2.4. Main Outcomes
2.5. Assessment of Risk of Bias in Included Studies
2.6. Selection of Studies
2.7. Data Extraction and Management
3. Results
3.1. Antiretroviral Therapy
3.2. Proviral Load
3.3. Immunological Outcomes
3.4. Clinical Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Database (Company) | Keyword (MeSH) Terms and Text Word Search | |
---|---|---|
1 | Medline (PubMed) | (“Human T-lymphotropic virus 1”[Mesh] OR “HTLV-I Infections”[Mesh] OR “HTLV-II Infections”[Mesh] OR “HTLV-1”[tiab] OR “HTLV-2”[tiab] OR “HTLV-I”[tiab] OR “HTLV-II”[tiab] OR “HTLV”[tiab]) AND (“Anti-Retroviral Agents” OR “dolutegravir” OR “raltegravir” OR “Isentress” OR “elvitegravir” OR “bictegravir” OR “zidovudine” OR “efavirenz”) NOT (“ATL”) |
2 | Cochrane Library | (“HTLV” OR “ Human T-lymphotropic virus 1” OR “HTLV-I Infections” OR “HTLV-II Infections” OR “HTLV-1” OR “HTLV-2” OR “HTLV-I” OR “HTLV-II”) AND (“Anti-HIV Agents” OR ‘HIV Protease inhibitors” OR “HIV Integrase Inhibitors” OR “Anti-Retroviral Agents” OR “HIV/drug effects” OR “”Drug Ressistance”) NOT (“ATL”) |
3 | Scopus (Elsevier) | ((ALL (“HTLV” OR “ Human T-lymphotropic virus 1” OR “HTLV-I Infections” OR “HTLV-II Infections” OR “HTLV-1” OR “HTLV-2” OR “HTLV-I” OR “HTLV-II”)) AND (ALL (“Paraparesis, Tropical Spastic” OR “HAM/TSP” OR “Paraparesis, Tropical Spastic/therapy”) OR TITLE-ABS-KEY (“Paraparesis, Tropical Spastic” OR “HAM/TSP”))) AND (ALL (“Anti-HIV Agents” OR “dolutegravir” OR “raltegravir” OR “Anti-Retroviral Agents” OR “elvitegravir” OR “bictegravir” OR “zidovudine” OR “efavirenz”) NOT ALL(“ATL”)) |
4 | Web of Science (Clarivate Analytics) | ALL = (“HTLV” OR “ Human T-lymphotropic virus 1” OR “HTLV-I Infections” OR “HTLV-II Infections” OR “HTLV-1” OR “HTLV-2” OR “HTLV-I” OR “HTLV-II”) AND ALL = (“Anti-Retroviral Agents” OR “dolutegravir” OR “raltegravir” OR “Isentress” OR “elvitegravir” OR “bictegravir” OR “zidovudine” OR “efavirenz”) NOT ALL = (“ATL”) |
Study | Design, Country | Population Characteristic | Infection | ART Use | Outcomes |
---|---|---|---|---|---|
Taylor et al., 1999 [12] | Cohort, United Kingdom | N = 5; female: 4 (80%); mean age: 46.8 | HTLV-1 with HAM/TSP: 5 (100%) | 3TC (150 mg bid *) (* A patient who had a recent diagnosis of HAM/TSP received AZT (300 mg bid) for 3 months and then switched to 3TC). | HTLV-PVL was reduced in all patients. Clinical improvement was only observed in one patient with recent-onset HAM/TSP during the use of lamivudine, as well as PVL decrease. |
Zehender et al, 2002 [13] | Retrospective cohort, Italy | N = 90; male: 70%; mean age HIV group: 32 (26–50) mean age HIV/HTLV-2 group: 33 (23–55). | HIV/HTLV-2: 30 (33.3%) HIV: 60 (66.6%) | It was not controlled by the study protocol. | There was no difference between the monoinfected and coinfected groups in mortality or CD4+ cell count. HLTV-2 infection was an independent predictor for developing PN. The incidence of PN decreased during ART use. |
Taylor et al., 2006 [14] | RCT, United Kingdom | N = 16, male: 5 (31%); mean age: 57.4 | HTLV-1 with HAM/TSP: 16 (100%) | AZT + 3TC (300 mg + 150 mg bid) | There was a trend of decreasing CD8+ cell count with the use of ART. There was no significant change in PVL nor CD4+ cell count. There were no significant changes in pain score, urinary frequency, or nocturia. |
Beilke et al., 2007 [15] | cross-sectional, USA | N = 72, male: 59 (76%) Age: >45 years (72%) | HIV/HTLV-1: 20 (27.7%) HIV/HTLV-2: 52 (72.3%) | Any triple ART | PVL was higher in HIV/HTLV-1 than in HIV/HTLV-2 and in cases with positive PBMC cultures. |
Macchi et al., 2011 [16] | Cohort, United Kingdom/Italy | N = 6, Female: 4 (67%); mean age: 44.8 (±15) | HTLV-1 with HAM/TSP: 5 (83.3%); 1 patient with encephalitis (16.7%) | TDF (300 mg qd) | There were increases in CD4+ and CD8+ cell count. No significant clinical improvement was seen, except in those who received TDF for a longer period who experienced improvement in pain and gait. There was no significant change in PVL. |
Treviño et al., 2012 [17] | Pilot study, Spain | N = 5; Female: 3 (60%); median age: 52 | HTLV-1 without HAM/TSP: 2 (40%) HTLV-1 with HAM/TSP: 2 (40%) Asymptomatic HIV/HTLV-1 1 (20%) | RAL (400 mg bid) | There was a transient reduction in PVL in the two symptomatic patients. No clinical improvement was observed. |
Abad-Fernandez et al., 2014 [18] | Cohort, Spain | RAL group: N = 4; male: 4 (26.6%); median age: 51 (48–54). Control group: N = 11(73.4), median age: 50 (46–56). | HIV/HTLV-2: 15 (100%) | Intervention: RAL-based ART (400 mg bid) Control: ART without RAL | There was an initial increase followed by a reduction in PVL in the RAL group. This was not observed in the control group. No changes in CD4+ and CD8+ cell count were detected, regardless of group. |
Enose-Akahata et al., 2021 [19] | Clinical trial, USA | RAL group: N = 16 (28.6%); female: 10 (62.5%); mean age: 53.5 Control group: HAM/TSP: N = 13 (23.2%) People without infection: N = 27 (48.2), age and gender not described | HTLV-1 with HAM/TSP:29 (51.8%) People without infection: 27 (48.2%) | Intervention: ART with RAL (400 mg bid) Control group: without ART | There was a subjective improvement in symptoms with the use of RAL, but not in objective clinical measurements. PVL in CSF and PBMC remained stable throughout this study. There were reductions in CD4+ and CD8+ cells in peripheral blood following the use of RAL. |
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Fernandez, T.; Marconi, C.; Montaño-Castellón, I.; Deminco, F.; Brites, C. A Systematical Review on ART Use in HTLV Infection: Clinical, Virological, and Immunological Outcomes. Pathogens 2024, 13, 721. https://doi.org/10.3390/pathogens13090721
Fernandez T, Marconi C, Montaño-Castellón I, Deminco F, Brites C. A Systematical Review on ART Use in HTLV Infection: Clinical, Virological, and Immunological Outcomes. Pathogens. 2024; 13(9):721. https://doi.org/10.3390/pathogens13090721
Chicago/Turabian StyleFernandez, Tatiana, Cleyde Marconi, Iris Montaño-Castellón, Felice Deminco, and Carlos Brites. 2024. "A Systematical Review on ART Use in HTLV Infection: Clinical, Virological, and Immunological Outcomes" Pathogens 13, no. 9: 721. https://doi.org/10.3390/pathogens13090721