Human T-lymphotropic virus (HTLV) research in cervical-vaginal discharge samples from women, in Belém, Pará, Brazil




Women's Health; Sexually Transmitted Viral Diseases; Retrovirus infections; Deltaretrovirus.


Pará is among the Brazilian states with the highest prevalence rates of infection by the human T-lymphotropic virus (HTLV) in populations where this virus has already been investigated. HTLV infection generally has a higher prevalence in women over 40 and in a stable relationship. Furthermore, women are more susceptible to acquiring the virus through sexual intercourse. In this context, this study aimed to detect the HTLV provirus in vaginal-cervical discharge, with subsequent confirmation of the infection in blood samples, thus aiming to propose a new methodology for tracking the infection. A total of 400 women were investigated from November 2015 to December 2019, in Belém, Pará, Brazil. The vaginal-cervical discharge was collected during the Papanicolaou test (Pap test), and the peripheral blood, during posterior contact. After collection, the DNA of the samples was extracted and molecular analysis by Nested-PCR was performed, followed by a enzymatic digestion by Taq I, for detection of the infection by HTLV-1 or HTLV-2. Five (1.25%) of the 400 women tested positive for HTLV in vaginal-cervical discharge, three of them being HTLV-1 and two HTLV-2. Due to inaccessibility, it was only possible to confirm the blood infection in one of these five women. Our findings suggest that it is possible to use cervical-vaginal discharge samples as an alternative screening test for HTLV infection in women.


Bangham, C. R. M. (2018). Human T Cell Leukemia Virus Type 1: Persistence and Pathogenesis. Annual review of Immunology. 36:25–53.

Barbosa, M. M. et al. (2020). Conhecimento de estudantes adolescentes sobre Infecções Sexualmente Transmissíveis. Research, Society and Development, 9(9).

Bélec, L. et al. (1996). Cervicovaginal synthesis of IgG antibodies to the immunodominant 175-199 domain of the surface glycoprotein gp46 of human T-cell leukemia virus type I. Journal of medical virology, 50(1):42-9.

Bell, D. A., et al. (1993). Genetic risk and carcinogen exposure: a common inherited defect of the carcinogen-metabolism gene glutathione S-transferase M1 (GSTM1) that increases susceptibility to bladder cancer. Journal of the National Cancer Institute, 21;85(14):1159-64.

Black, F. L., et al. (1994). Endemic transmission of HTLV type II among Kayapo Indians of Brazil. AIDS Research and Human Retroviruses, 10(9):1165-71.

Bonita, R., et al. (2010). Epidemiologia básica (2a ed.). Santos editora.

Braço, I. L. J., et al. (2019). High prevalence of human T-lymphotropic virus 2 (HTLV-2) infection in villages of the Xikrin tribe (Kayapo), Brazilian Amazon region. BMC Infectious Diseases. 19 (1):459.

Carneiro-Proietti, A. B. F., et al. (2002). Infecção e doença pelos vírus linfotrópicos humanos de células T (HTLV-I/II) no Brasil. Revista da Sociedade Brasileira de Medicina Tropical, 35:499-508.

Catalan-Soares, B., et al. (2005). Heterogeneous geographic distribution of human T-cell lymphotropic viruses I and II (HTLV-I/II): serological screening prevalence rates in blood donors from large urban areas in Brazil. Cadernos de Saúde Pública, 21(3), 926-931.

Coelho, J., et al. (2018). Importância das ações de extensão universitária na prevenção de infecções e doenças associadas ao vírus linfotrópico-T humano. Revista Pan-Amazônica de Saúde, 9(1): 25-31.

Costa, C., et al. (2013). Familial transmission of human T-cell lymphotrophic virus: silent dissemination of an emerging but neglected infection. PLoS Neglected Tropical Diseases, 7(6).

Ferreira, L. et al. (2010). A Soroprevalência do vírus linfotrópico de células T humanas em comunidades ribeirinhas da região nordeste do Estado do Pará, Brasil. Revista Pan-Amazônica de Saúde, 20, 1(3):103-108.

Futsch, N., et al. (2017). HTLV-1, the Other Pathogenic Yet Neglected Human Retrovirus: From Transmission to Therapeutic Treatment. Viruses. 10(1):1.

Gallo, R., et al. (1982). HTLV: the virus of adult T-cell leukaemia in Japan and elsewhere. The Lancet, 20;1(8273):683.

Gessain, A., & Cassar O. (2012). Epidemiological aspects and world distribution of HTLV-1 infection. Frontiers in Microbiology, 3(388): 1-23.

Glória, L. M., et al. (2015). Perfil clínicoepidemiológico de pacientes infectados pelo HTLV-1 em Belém/Pará. Cadernos de Saúde Coletiva, 23(2): 157-62.

Inca. (2021). Ações de controle do câncer do colo do útero.

Ishak, R., et al. (1998). Detection of HTLV-IIa in blood donors in an urban area of the Amazon Region of Brazil (Belém, PA). Revista da Sociedade Brasileira de Medicina Tropical, 31(2): 193-197.

Ishak, R., et al. (2003). Epidemiological aspects of retrovirus (HTLV) infection among Indian populations in the Amazon Region of Brazil. Cadernos de Saúde Pública, 19(4): 901-914.

Ishak, R., et al. (2020). The challenge of describing the epidemiology of HTLV in the Amazon region of Brazil. Retrovirology. 17: 4.

Johnson, L. & Lewis, D. (2008). The effect of genital tract infections on HIV-1 shedding in the genital tract: A systematic review and meta-analysis. Sexually Transmitted Diseases, 35(11): 946-959.

Kajiyama, W., et al. (1986). Intrafamilial transmission of adult T cell leuckemia vírus. The Journal of Infetious Diseases,154(5): 851-7.

Mayer, H., & Venkatesh, K. (2011). Interactions of HIV, Other Sexually Transmitted Diseases, and Genital Tract Inflammation Facilitating Local Pathogen Transmission and Acquisition. American Journal of Reproductive Immunology. 65 (3): 308-16.

Mello, M. A. G., et al. (2014). HTLV-1 in pregnant women from the Southern Bahia, Brazil: a neglected condition despite the high prevalence. Virology Journal, 11:28.

Mome, R. K. B., et al. (2018). Effectiveness of female condom in preventing HIV and sexually transmitted infections: a systematic review protocol. BMJ Open, 8:e023055.

Moriuchi, H., et al. (2013). Mother-to-child transmission of human T-cell lymphotropic virus type 1. The Pediatric Infectious Disease Journal. 32 (2):175–77.

Mylonas, I., et al. (2010). HTLV infection and its implication in gynaecology and obstetrics. Archives of Gynecology and Obstetrics, 282:493-501.

Paiva, A., et al. (2017). High risk of heterosexual transmission of human T-cell lymphotropic virus type 1 infection in Brazil. Journal of Medical Virology. 89 (7):1287–94.

Paiva, A., & Casseb, J. (2014). Sexual transmission of human T-cell lymphotropic virus type 1. Revista da Sociedade Brasileira de Medicina Tropical, 4;47(3).

Pereira, F. M., et al. (2019). Evidence of New Endemic Clusters of Human T-Cell Leukemia Virus (HTLV) Infection in Bahia, Brazil. Frontiers in microbiology. 14.

Pique, C., & Jones, K. S. (2012). Pathways of cell-cell transmission of HTLV-1. Frontiers of Microbiology 3:378.

Poiesz, B. J., et al. (1980). Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proceedings of the National Academy of Sciences of the United States of America, 77(12):7415-9.

Popovic, M., et al. (1982). The virus of Japanese adult T-cell leukaemia is a member of the human T-cell leukaemia virus group. Nature, 300(5887):63-66.

Romanelli, L. C. F., et al. (2010). Vírus linfotrópico de células t humanos tipo 1 (HTLV-1): quando suspeitar da infecção? Revista da Associcação Médica Brasileira, 56(3): 340-7.

Rosadas, C., et al. (2021). Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecção pelo vírus linfotrópico de células T humanas (HTLV). Epidemiologia e Saúde, 30: 171-194.

Roucoux, D. F., & Murphy, E. L. (2004) The epidemiology and disease outcomes of human T-lymphotropic virus type II. AIDS Reviews,6(3):144-54.

Santos, E. L. D., et al. (2009). Caracterização molecular do HTLV-1/2 em doadores de sangue em Belém, Estado do Pará: primeira descrição do subtipo HTLV-2b na região Amazônica. Revista da Sociedade Brasileira de Medicina Tropical. 42:271–6.

Satake, M., et al. (2016). Incidence of human T-lymphotropic virus 1 infection in adolescent and adult blood donors in Japan: a nationwide retrospective cohort analysis. The Lancet. Infectious Diseases.16 (11):1246–54.

Schierhout, G., et al. (2019). Association between HTLV-1 infection and adverse health outcomes: a systematic review and meta-analysis of epidemiological studies. The Lancet Infectious Diseases. 20(1): 133-143.

Silva, I. C., et al. (2018). Moderada endemicidade da infecção pelo vírus linfotrópico-T humano na região metropolitana de Belém, Pará, Brasil. Revista Brasileira de Epidemiologia, 21, 1-14.

Souza, V. G., et al. (2012). High prevalence of HTLV-1 and 2 viruses in pregnant women in São Luis, State of Maranhão, Brazil. Revista da Sociedade Brasileira de Medicina Tropical, 45(2):159-162.

Tezuka, K., et al. (2020). HTLV-1 targets human placental trophoblasts in seropositive pregnant women. The journal of clinical investigation. 130 (11): 6171-86.

World Health Organization (2021). (6a ed.) Geneva: World Health Organization; 6th Edition of the WHO laboratory manual for the examination and processing of human semen.

Zunt, J. R., et al. (2002). Cervical shedding of human T cell lymphotropic virus type I is associated with cervicitis. The Journal of Infetious Diseases, 186:1669-1672.



How to Cite

PEREIRA, C. C. C. .; LA-ROQUE , D. G. de L. .; ALBUQUERQUE, R. dos S. .; SILVA , I. C. .; COVRE, L. de S. C. .; NOBRE, A. F. S. .; REIS, M. de N. L. dos .; ASSIS, I. M. de .; SOUZA, J. D. de .; MORAES , S. S. de .; SANTOS , P. F. S. L. .; SILVA, L. B. L. da .; ALMEIDA, D. de S. .; SOUSA, M. S. de . Human T-lymphotropic virus (HTLV) research in cervical-vaginal discharge samples from women, in Belém, Pará, Brazil. Research, Society and Development, [S. l.], v. 10, n. 4, p. e9410413867, 2021. DOI: 10.33448/rsd-v10i4.13867. Disponível em: Acesso em: 11 apr. 2021.



Health Sciences