RESUMO
A total of 963 HIV-infected patients have been identified or followed up in Martinique since 1985. Medical files were used to retrieve information about age, sex, circumstances of diagnosis, HTLV-I status, and HIV clinical grade at first examination according to CDC criteria from 1987. Complete information was available for 774 patients. At the first clinical examination, the clinical grade of 65 coinfected patients was more severe than that of the monoinfected patients (GIV versus GII, OR = 2.60, p < 0.01), but after adjustment for age and sex, this odds ratio was reduced 1.57. Although this study cannot invalidate the hypothesis of a faster progression toward AIDS of coinfected than of monoinfected patients, it shows that one or several other mechanisms contribute to the different grades of severity at the first clinical examination observed between these two categories of patients. We believe that HTLV-I infection acquired during adulthood is a marker of high-risk behavior and that it might be associated with early or multiple HIV infections.
Assuntos
Infecções por HIV/complicações , HIV-1 , Infecções por HTLV-I/complicações , Vírus Linfotrópico T Tipo 1 Humano , Adulto , Fatores de Confusão Epidemiológicos , Estudos Transversais , Anticorpos Antideltaretrovirus/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Anticorpos Anti-HIV/análise , Infecções por HIV/epidemiologia , Infecções por HIV/patologia , HIV-1/imunologia , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/patologia , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Vírus Linfotrópico T Tipo 2 Humano/imunologia , Humanos , Masculino , Martinica/epidemiologia , Pessoa de Meia-Idade , Razão de ChancesRESUMO
We have investigated HTLV-I and HTLV-II infection in children born to HTLV-I-seropositive or indeterminate Western blot mothers in Martinique by using the polymerase chain reaction (PCR). Only HTLV-I and no HTLV-II-positive samples were found in this study. All the samples from HTLV-I-seropositive children and adults were PCR positive, whereas the four HIV-I-seropositive and Western blot HTLV-I-negative mothers and their eight children were all PCR negative. Therefore, PCR and serology were in complete agreement in these patients. However, two of the six mothers who were first indeterminate by Western blot, and who later became seronegative, were found positive by PCR. Of the 27 children (ages 2-12 years), born to HTLV-I-seropositive and PCR-positive mothers, 2 were seropositive and PCR positive, 5 were seronegative and PCR positive with 2 primer pairs in gag and pol, and 4 were seronegative and PCR positive with only 1 of the primer pairs. In contrast to an initial rate of transmission of 7% estimated by serology we found a rate of transmission of 28 to 41% (whether or not children who were positive with only one of the primer pairs were included). Thus, our study confirms that PCR is useful in detecting HTLV-I infection in children before seroconversion and underlines the potential lack of sensitivity of serology to detect contaminating HTLV-I blood units in endemic areas.
Assuntos
Infecções por HTLV-I/transmissão , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Complicações Infecciosas na Gravidez/microbiologia , Provírus/isolamento & purificação , Sequência de Bases , Western Blotting , Pré-Escolar , DNA Viral/sangue , Anticorpos Antideltaretrovirus/sangue , Feminino , Infecções por HTLV-I/congênito , Infecções por HTLV-I/embriologia , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/imunologia , Infecções por HTLV-I/microbiologia , Vírus Linfotrópico T Tipo 1 Humano/genética , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Vírus Linfotrópico T Tipo 2 Humano/genética , Humanos , Martinica/epidemiologia , Dados de Sequência Molecular , Sondas de Oligonucleotídeos , Reação em Cadeia da Polimerase , Gravidez , Provírus/genética , Viremia/microbiologiaRESUMO
The epidemiologic study of HIV infected patients in Martinique from 1985 to 1992 allowed to point out a stability of new cases by year, and confirm the heterosexual transmission in this area. The sexual comportment of Martinicans seems to be different of the continental French people and different between men and women. This constation is important to know for the preventive strategy of the infection.
Assuntos
Infecções por HIV/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Infecções por HIV/transmissão , Soropositividade para HIV , Humanos , Masculino , Martinica , Pessoa de Meia-Idade , Comportamento SexualRESUMO
A case-control study was performed in Martinique, French West Indies, comparing 66 anti-p24 antibody carriers to 91 seronegative subjects for HTLV-I, matched for age and place of residence. The aim of our study was to identify factors associated with HTLV-I infection and to observe whether clinical examination and biological measurements would reveal any abnormalities among the seropositive subjects. We observed a predominance of females among seropositive subjects (74% compared to 59%, p less than 0.05), and a greater risk due to earlier blood transfusions (p less than 0.001). This survey revealed important differences between cases and controls regarding socioeconomic factors: cases had fewer luxuries or advantages (i.e. bathroom, toilets, refrigerator, telephone, p less than 0.01), were more corpulent (p less than 0.05), and more often widowed, divorced or separated (p less than 0.01) than the controls. Although the differences were not significant, the seropositive donors seemed to be less educated, and were from a lower socioprofessional class than the seronegative donors. With regard to clinical symptoms (infections, adenopathies, splenomegaly, hepatomegaly) and biological parameters (blood count; T-cell subsets, electrophoresis of protids, immunoglobulins, calcemia, antischistosomal antibody), seropositive subjects appeared to be healthy; no parameters, except for alpha 1 globulin (p less than 0.05) and monocytes (p less than 0.05), were found to be correlated with seropositivity; but these two parameters remained within their normal ranges. This study confirms blood transfusion as a risk factor. It underscored the importance of socioeconomic factors for seropositivity.
Assuntos
Infecções por HTLV-I/epidemiologia , Adulto , Transfusão de Sangue , Estudos de Casos e Controles , Feminino , Anticorpos Anti-HTLV-I/análise , Infecções por HTLV-I/diagnóstico , Humanos , Masculino , Martinica/epidemiologia , Análise de Regressão , Proteínas Oncogênicas de Retroviridae/imunologia , Fatores de Risco , Classe Social , Inquéritos e QuestionáriosRESUMO
The fact that only a small percentage of excessive drinkers develop cirrhosis may be due to a genetic susceptibility to the disease. In order to identify possible genetic risk factors for cirrhosis, we studied mixed-race (Negroid-Caucasian) inhabitants of the French West Indies and compared: (1) the frequency of 51 HLA-A, -B, -C and -DR antigens in 41 subjects with alcoholic cirrhosis and in two control groups consisting of 41 excessive drinkers free of liver disease and 51 healthy non-drinkers; and (2) the frequency of Gm and Km haplotypes in the same groups. Analysis of the Gm system also determined the patients' ethnic origins. The frequency of the HLA-A2 antigen was significantly higher in the cirrhotic patients than in the control group of excessive drinkers (chi 2 = 4.47; P less than 0.05), while that of the HLA-B15 antigen was significantly lower (chi 2 = 5.14; P less than 0.05). The frequency of the Cw4 antigen was significantly higher in the cirrhotics than in the non-drinkers (chi 2 = 5.59; P less than 0.05). However, these differences did not persist when the number of comparisons was taken into account. The frequency of Gm and Km haplotypes was not significantly different in the three groups. In conclusion, complementary studies are required to determine the value of the Gm-Km system as a marker of susceptibility to alcoholic cirrhosis. Our results do not identify an association between HLA antigens and cirrhosis specific to a negroid ethnic group and support the notion that such an association is weak.
Assuntos
População Negra/genética , Antígenos HLA/análise , Alótipos Gm de Imunoglobulina/análise , Cadeias kappa de Imunoglobulina/análise , Cirrose Hepática Alcoólica/imunologia , População Branca/genética , Adulto , Idoso , Biomarcadores/sangue , Suscetibilidade a Doenças , Feminino , Antígeno HLA-A2/análise , Antígenos HLA-B/análise , Antígeno HLA-B15 , Antígenos HLA-C/análise , Humanos , Cirrose Hepática Alcoólica/etnologia , Masculino , Pessoa de Meia-Idade , Índias OcidentaisRESUMO
HTLV-1 infection is endemic in Japan, black Africa, the Caribbean and several regions of South America. In these foci, the infections is very heterogeneously distributed (variations from village to village, intrafamilial clustering). The virus is transmitted from mother to child, and breast feedings seems to play a major role. Sexual transmission is usually from man to woman. The frequency of transmission by blood transfusion must not be underestimated. It justifies the systematic detection of HTLV-1 infection in areas where it is economically feasible.
Assuntos
Infecções por HTLV-I/epidemiologia , África Oriental/epidemiologia , Infecções por HTLV-I/transmissão , Humanos , Japão/epidemiologia , Índias Ocidentais/epidemiologiaRESUMO
The prevalence of human T-lymphotropic virus type I (HTLV-I) infection is higher for females than for males. Blood transfusion is a potential confounding factor which might contribute to this high female:male ratio. Two studies were performed in Martinique (French West Indies) to clarify this issue: a case-control survey comparing the experience of previous blood transfusion among 62 HTLV-I-seropositive and 88 HTLV-I-seronegative blood donors, and a retrospective study of the sex of recipients of blood. Blood transfusion was strongly associated with HTLV-I infection (odds ratio = 6.4, p less than 0.001). Females were more often given blood transfusions (57.9 percent, p less than 0.001) and received a higher percentage of blood units (53.5 percent, p less than 0.05) than could be expected from their proportion in the general population (51.6 percent). Thus, the high female:male sex ratio of HTLV-I-infected subjects might be due partially to a sex difference for blood transfusion.
Assuntos
Infecções por HTLV-I/etiologia , Reação Transfusional , Adulto , Estudos de Casos e Controles , Feminino , Infecções por HTLV-I/epidemiologia , Humanos , Masculino , Martinica/etnologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores SexuaisRESUMO
HTLV-I is a type C human retrovirus, endemic in Japan, central Africa, South America and the Caribbean, which causes adult T cell leukemia/lymphoma and chronic progressive paraparesis. Some neurological patients with chronic progressive myelopathies, but seronegative for HTLV-I have been reported in Martinique. We performed polymerase chain reaction (PCR), to look for the presence of HTLV-I genomic sequences in those patients. Two primers were chosen for gag and tax genes. Liquid hybridization was performed on the amplified products using an internal 32p labelled oligonucleotide as a probe. The hybridized material was run on a 6% polyacrylamide gel. Forty-three of forty-four seropositive subjects analysed as "positive controls" were positive for gag, but only 16/29 for tax. Twenty HTLV-I seronegative neurological patients with a symptomatology suggesting HAM/TSP were tested: 18 were found positive for at least one of the 2 oligonucleotide pairs. Two "negative controls": Moya-Moya and vascular brain failure were found negative. 8/9 subjects with uninterpretable WB were also studied by PCR, and 8 were found positive for at least one oligo pair. Our conclusion is that PCR methodology is able to detect genetic information related to HTLV-I in a number of cases where classical serology is negative.
Assuntos
DNA Viral/isolamento & purificação , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Paraparesia Espástica Tropical/diagnóstico , Western Blotting , Criança , Ensaio de Imunoadsorção Enzimática , Humanos , Martinica , Paraparesia Espástica Tropical/sangue , Reação em Cadeia da Polimerase , Testes SorológicosRESUMO
Two alpha-globin structural mutants were mapped to their encoding loci by in vitro translation of hybrid-selected alpha 1- and alpha 2-globin mRNA. The more highly expressed mutant, alpha Spanish Town (alpha 27Val), is encoded at the alpha 2 locus and the less expressed mutant, alpha Fort de France (alpha 45Arg), is encoded at the alpha 1 locus. These results further define the distribution of alpha-globin structural mutations within the alpha-globin gene cluster and substantiate the dominant role of the alpha 2-globin locus in alpha-globin expression.
Assuntos
Genes , Globinas/genética , Mutação , Sequência de Aminoácidos , Arginina/genética , Globinas/biossíntese , Humanos , Biossíntese de Proteínas , RNA Mensageiro/isolamento & purificação , Talassemia/genética , Valina/genética , Índias OcidentaisRESUMO
Sera of supposedly healthy blood donors were screened for the presence of anti HTLV-I p24 antibodies, and HLA typing for A, B, C and DR antigens was performed for 68 seropositive subjects and 92 seronegative controls. HLA phenotypes of the two groups were not significantly different but the level of the antibody response was related to the antigens of the HLA-B (P = 0.02) and -C loci (P = 0.003). Subjects with HLA-B12 or -B21 antigens had lower titres than the others. Subjects with HLA-Cw2 or -Cw7 antigens had higher titres than the others, but only the difference between HLA-B12 positive and negative subjects (P = 0.002) remained significant at the alpha = 0.10 level if the classical, although conservative, Bonferroni procedure was used to correct for the number of comparisons performed.