人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）感染个体的干燥性角膜结膜炎与高水平的 HTLV-1 前病毒载量有关。

Keratoconjunctivitis sicca of human T cell lymphotropic virus type 1 (HTLV-1) infected individuals is associated with high levels of HTLV-1 proviral load.

机构信息

Instituto Brasileiro de Oftalmologia e Prevenção da Cegueira (IBOPC), Salvador, BA, Brazil.

出版信息

J Clin Virol. 2011 Nov;52(3):177-80. doi: 10.1016/j.jcv.2011.07.016. Epub 2011 Aug 24.

DOI:10.1016/j.jcv.2011.07.016

PMID:21868282

Abstract

BACKGROUND

A high HTLV-1 proviral load is found in HTLV-1-associated diseases, mainly HAM/TSP. However, the association between proviral load and keratoconjunctivitis sicca (KCS) has not been well established.

AIM

To verify the association between KCS and HTLV-1 proviral load.

STUDY DESIGN

104 HTLV-1 infected patients (51 asymptomatic and 52 with HAM/TSP) from the HTLV reference center in Salvador, Brazil were followed from June 2008 to May 2010. Evaluation of tear secretion was performed by BUT (break-up time), Rose Bengal and Schirmer I tests. The diagnosis of KCS was based upon the presence of symptoms and when at least two of three tests were positive. HTLV-1 proviral load was determined using real-time PCR.

RESULTS

The prevalence of KCS was 44.2%. KCS was more frequent among HAM/TSP patients (p = 0.022). Patients with KCS had higher proviral load (mean 134,672 ± 150,393copies/10(6) PBMC) than patients without the disease (mean 66,880 ± 109,525copies/10(6) PBMC) (p = 0.001). HTLV-1 proviral load>100,000copies/10(6) PBMC increased significantly the risk of developing KCS (OR = 4.05 and 95% CI = 1.40-11.76). After age>45 years and HAM/TSP status were excluded in stepway reward analysis, the variables PVL>100,000 (OR = 4.77 and 95% CI = 1.83-12.44) still remained statistically significant.

CONCLUSION

HTLV-1 proviral loads are higher in patients with KCS and may represent a relevant biological marker of disease.

摘要

背景

在 HTLV-1 相关疾病中，尤其是 HAM/TSP 中，可检测到较高的 HTLV-1 前病毒载量。然而，前病毒载量与干燥性角膜结膜炎（KCS）之间的关联尚未得到充分证实。

目的

验证 KCS 与 HTLV-1 前病毒载量之间的关联。

研究设计

2008 年 6 月至 2010 年 5 月，巴西萨尔瓦多的 HTLV 参考中心对 104 例 HTLV-1 感染患者（51 例无症状和 52 例 HAM/TSP）进行了随访。通过 BUT（泪膜破裂时间）、Rose Bengal 和 Schirmer I 试验评估泪液分泌。KCS 的诊断基于存在症状和至少两项三项检测阳性。使用实时 PCR 测定 HTLV-1 前病毒载量。

结果

KCS 的患病率为 44.2%。HAM/TSP 患者中 KCS 更为常见（p = 0.022）。患有 KCS 的患者的前病毒载量（平均 134672 ± 150393 拷贝/10（6）PBMC）高于未患病患者（平均 66880 ± 109525 拷贝/10（6）PBMC）（p = 0.001）。前病毒载量>100000 拷贝/10（6）PBMC 显著增加了发生 KCS 的风险（OR = 4.05 和 95%CI = 1.40-11.76）。在逐步奖励分析中排除年龄>45 岁和 HAM/TSP 状态后，PVL>100000（OR = 4.77 和 95%CI = 1.83-12.44）仍然具有统计学意义。