Luiz Cláudio Ferreira Romanelli

Fundação Centro Tecnológico de Minas Gerais, Cidade de Minas, Minas Gerais, Brazil

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Publications (5)8.45 Total impact

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    ABSTRACT: The incidence of human T-cell lymphotropic virus type 1 (HLTV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is not well defined in the literature. Several studies have reported different incidence rates, and recent publications suggest a higher incidence and prevalence of HAM/TSP. The interdisciplinary HTLV Research Group (GIPH) is a prospective open cohort study of individuals infected with HTLV-1/2. This study describes the demographic data and HAM/TSP incidence rate observed in 181 HTLV-1-seropositive individuals and compares the results with previous reports in the literature. HAM/TSP was diagnosed on the basis of the World Health Organization diagnostic criteria and Castro-Costa et al., 2006. Seven HAM/TSP incident cases were observed during the follow-up. The HAM/TSP incidence density was 5.3 cases per 1,000 HTLV-1-seropositive cases per year (95% confidence interval: 2.6-10.9), with a mean follow-up of 7 ± 4 years (range: 1 month to 15 years). HAM/TSP was more frequent in women in their 40s and 50s with probable infection via the sexual route. The HAM/TSP incidence density among HTLV-1-seropositive cases observed in the present study is higher than that in previous studies. HAM/TSP may be underdiagnosed in countries like Brazil where HTLV infection is prevalent. Orientation and prevent transmission of HTLV programs are needed. Currently, preventing HTLV-1 transmission is the most effective way to reduce the impact of HAM/TSP on society.
    AIDS research and human retroviruses 04/2013; · 2.18 Impact Factor
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    ABSTRACT: BACKGROUND: HTLV-1 proviral load is a risk marker for HAM/TSP, but it is insufficient to determine the disease outcome. HTLV-1 Tax and HBZ proteins have been implicated in HAM/TSP pathogenesis in inducing cell proliferation and cytotoxic T lymphocytes response. OBJECTIVES: To quantify the expression of tax and HBZ mRNA in asymptomatic carriers (AC) and HAM patients, and to investigate their association with HAM/TSP. STUDY DESIGN: We quantified the expression of HTLV-1 tax and HBZ mRNA in 37 AC and 26 HAM patients classified according to proviral load as low (AC(L) and HAM(L): <1% infected cells) or high (AC(H) and HAM(H): >1%). RESULTS: The AC(L) subgroup showed the lowest frequency of individuals expressing tax mRNA in comparison with AC(H), HAM(L) and HAM(H), and tax mRNA load normalized by proviral load was significantly lower in the AC(L). In turn, normalized HBZ mRNA expression was similar in all subgroups. Both tax and HBZ mRNA expression were moderately correlated with proviral load in AC (r=0.6, p<0.001) and were weaker in HAM (r=0.4, p<0.05). In contrast, the correlation between tax and HBZ mRNA load was moderate in AC (r=0.5, p=0.001) and was much stronger in HAM (r=0.8, p<0.001). In addition, HBZ mRNA load, but not tax, was significantly associated with motor disability in HAM patients (p=0.036). CONCLUSIONS: The expression of tax mRNA seems to be best to estimate the risk of HAM/TSP, whereas HBZ mRNA appears to be a surrogate marker to disease progression, indicating that they have important but distinct roles in HAM/TSP pathogenesis.
    Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 11/2012; · 3.12 Impact Factor
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    ABSTRACT: Human T-lymphotropic virus 1 (HTLV-1) infection is associated with HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP), which affects approximately 5% of carriers. High proviral load is a risk marker for HAM/TSP, although there is an overlap of proviral load levels in peripheral blood between asymptomatic carriers and HAM/TSP patients. In this study, receiver operating characteristic curve analysis was used to define a set point of HTLV-1 proviral load that better indicates an increased risk for HAM/TSP. Proviral load was quantified in 75 asymptomatic carriers and 78 HAM/TSP patients in a Brazilian cohort. The cut-off of proviral load was defined as 114 copies/10(4)  cells, with 78.2% sensitivity to identify true HAM/TSP patients. The mean proviral load levels were not significantly different between males and females with the same clinical status, and there was no significant correlation between proviral load and age at blood sampling, age at the onset of illness, or duration of disease. In HAM/TSP patients, proviral load was significantly higher in wheelchair-bound patients than in individuals able to walk without support and in those with the worst spinal cord injuries. Follow-up of HTLV-1-infected individuals showed that proviral load was more stable in asymptomatic carriers than in HAM/TSP patients. In a cohort study, periodically quantifying proviral load in asymptomatic carriers is necessary to identify those at risk for developing neurological disease, and it is necessary for HAM/TSP patients to monitor spinal injury and progression to walking disability. The measure of proviral load in clinical practice implicates the definition of the cut-off of proviral load and its validation during follow-up.
    Journal of Medical Virology 04/2012; 84(4):664-71. · 2.37 Impact Factor
  • Luiz Cláudio Ferreira Romanelli, Paulo Caramelli, Anna Barbara de Freitas Carneiro Proietti
    Revista Da Associacao Medica Brasileira - REV ASSOC MED BRAS. 01/2010; 56(3).
  • Luiz Cláudio Ferreira Romanelli, Paulo Caramelli, Anna Barbara de Freitas Carneiro Proietti
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    ABSTRACT: Human T-cell lymphotropic virus (HTLV) infections have occurred for thousands of years. However, knowledge about their pathogenesis is recent. The virus is endemic in several regions around the world. In Brazil, it is present in all states at varying prevalence rates and it has been estimated that around 2.5 million Brazilians are infected. Genetic and immunological parameters of the host are the most important determinants of the clinical manifestations associated with infection. These can be divided into three categories: neoplastic, inflammatory and infectious. HTLV-associated myelopathy (HAM/TSP) and adult T-cell leukemia/lymphoma (ATLL) were the first diseases to be related to this retrovirus. More recently, countless other diseases have been correlated with the virus. The objective of this review is to provide an update on epidemiological, pathophysiologic, therapeutic and, primarily, diagnostic knowledge about HTLV, in order to encourage etiologic suspicion of HTLV in all its diverse clinical manifestations, which are currently rarely associated with this agent.
    Revista da Associação Médica Brasileira 56(3):340-7. · 0.77 Impact Factor