人类 T 细胞白血病病毒 1 型（HTLV-1）前病毒载量（PVL）增加与 HTLV-1 阳性类风湿关节炎患者感染的相关性：单中心队列研究中 HTLV-1 PVL 变化的纵向分析。
The Association of Increase of Human T-Cell Leukemia Virus Type-1 (HTLV-1) Proviral Load (PVL) With Infection in HTLV-1-Positive Patients With Rheumatoid Arthritis: A Longitudinal Analysis of Changes in HTLV-1 PVLs in a Single Center Cohort Study.
机构信息
Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan.
出版信息
Front Immunol. 2022 May 6;13:887783. doi: 10.3389/fimmu.2022.887783. eCollection 2022.
OBJECTIVE
We evaluated changes of HTLV-1 proviral loads (PVLs) during treatment for rheumatoid arthritis (RA) and investigated whether these changes affect the clinical course in HTLV-1-positive RA patients.
METHODS
A total of 41 HTLV-1-positive RA patients were analyzed. Their clinical picture including disease activity [Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR), DAS28-CRP, simplified disease activity index (SDAI), and clinical disease activity index (CDAI)] and comorbidity were evaluated over a 2-year period. PVLs from peripheral blood mononuclear cells were investigated by real-time polymerase chain reaction (PCR). We investigated whether HTLV-1 PVLs is altered, or which clinical characteristics affect changes of HTLV1-PVLs during 2-year treatment.
RESULTS
Clinical disease activity was not changed during the 2-year observational period. The mean HTLV-1 PVL value change from baseline to 2 years was -1.2 copies/1000 PBMCs, which was not statistically significant. No baseline clinical characteristics influenced changes in HTLV-1 PVL. However, a numerical change of HTLV-1 PVLs was increased in 4 patients initiating the new biological/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) at 2-10 months after starting the new b/ts DMARDs (numerical increase was 24.87 copies/1000 PBMCs). Infection occurred in 4 patients, and 3 of those patients showed an increased HTLV-1 PVL. Univariate analysis revealed an association between increase of HTLV-1 PVL and incidence of infection.
CONCLUSIONS
Over 2 years, HTLV-1 PVL did not significantly change in our HTLV-1-positive RA patients. Individual changes in HTLV-1 PVL were correlated with incidence of infection but not disease activity which indicate that we may take precaution toward infection at the uptick of HTLV-1 PVL in HTLV-1-positive RA patients.
目的
我们评估了人类嗜 T 淋巴细胞病毒 1 （HTLV-1）前病毒载量（PVLs）在类风湿关节炎（RA）治疗过程中的变化，并研究这些变化是否会影响 HTLV-1 阳性 RA 患者的临床病程。
方法
共分析了 41 例 HTLV-1 阳性 RA 患者。在 2 年的时间内，通过实时聚合酶链反应（PCR）检测外周血单个核细胞中的 HTLV-1 PVLs，评估他们的临床情况，包括疾病活动度[28 关节红细胞沉降率疾病活动评分（DAS28-ESR）、DAS28-CRP、简化疾病活动指数（SDAI）和临床疾病活动指数（CDAI）]和合并症。我们研究了 HTLV-1 PVLs 是否发生改变，或者哪些临床特征会影响 2 年治疗期间 HTLV1-PVLs 的变化。
结果
在 2 年的观察期内，临床疾病活动度没有变化。从基线到 2 年时，HTLV-1 PVL 值的平均变化为-1.2 拷贝/1000 PBMCs，无统计学意义。基线临床特征没有影响 HTLV-1 PVL 的变化。然而，在开始新的生物/靶向合成疾病修饰抗风湿药物（b/tsDMARDs）后 2-10 个月，4 例患者的 HTLV-1 PVLs 出现数值增加（数值增加 24.87 拷贝/1000 PBMCs）。有 4 例患者发生感染，其中 3 例患者的 HTLV-1 PVL 升高。单因素分析显示，HTLV-1 PVL 升高与感染发生率之间存在关联。
结论
在我们的 HTLV-1 阳性 RA 患者中，超过 2 年的时间里，HTLV-1 PVL 没有明显变化。HTLV-1 PVL 的个体变化与感染发生率相关，但与疾病活动度无关，这表明我们可能需要在 HTLV-1 阳性 RA 患者的 HTLV-1 PVL 升高时警惕感染的发生。
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