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. 2023 Aug 21;20(1):185.
doi: 10.1186/s12985-023-02135-7.

Prevalence and characteristics of HTLV-associated uveitis in patients from Bahia, an endemic area for HTLV - 1 in Brazil

Daniele Piai Ozores  1   2   3 , Regina Rathsam Pinheiro  1   2 , Ney Boa-Sorte  1 , Maurício Campos E Silva Dias  1 , Raianne Silva Lima  3 , Thessika Hialla Almeida Araújo  1 , Bernardo Galvão-Castro  1   4 , Maria Fernanda Rios Grassi  5   6
Affiliations

Prevalence and characteristics of HTLV-associated uveitis in patients from Bahia, an endemic area for HTLV - 1 in Brazil

Daniele Piai Ozores et al. Virol J. .

Abstract

Background: HTLV-1-associated uveitis (HAU) is an inflammatory reaction of the choroid, retina, optic nerve and vitreous that can lead to vision impairment. The worldwide prevalence of HAU varies widely.

Objective: To determine the prevalence of HAU in patients from Salvador, Bahia-Brazil, and describe uveitis type and associated symptoms.

Methods: Cross-sectional analytical study to determine the prevalence of uveitis in HTLV-1-infected patients recruited in Bahia, Brazil, a region considered endemic for HTLV-1. Patients were enrolled at a local reference center for HTLV (infected) and at an outpatient ophthalmology clinic (noninfected group). All patients were examined by the same ophthalmologist following a single protocol. Prevalence ratios (PR) were calculated.

Results: A total of 168 consecutively examined HTLV-1-infected patients and 410 noninfected patients (randomly selected) were included. Females predominated (82.1%) in the HTLV-1-infected group (versus 64.4% in the uninfected group) (p < 0.001). The mean age of infected and uninfected patients was 53.2 and 62.8 years, respectively (p < 0.001). The prevalence of uveitis in HTLV-1+ and HTLV-1- patients was 7.14% and 0.73%, respectively (PR = 9.76; 95CI%:2.79-34.15; p < 0.01). Bilateral intermediate uveitis, associated with symptoms including visual disturbances and floaters, was most commonly identified in the HTLV-1-infected patients, whereas unilateral anterior uveitis, in association with symptoms such as blurring and ocular pain, was more common in the uninfected group.

Conclusion: The prevalence of uveitis in patients with HTLV-1 was markedly higher than in uninfected subjects. HAU patients were mostly asymptomatic and exhibited bilateral presentation, with uveitis more frequently localized in the intermediate chamber.

Keywords: Endemic area; HAU uveitis types; HTLV-1 uveitis (HAU); Prevalence.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Endothelial keratic precipitates (black arrow) and anterior chamber reaction (yellow arrows) and in HTLV-1 patients (anterior slit-lamp biomicroscopic examination). Patients 11 and 1, respectively
Fig. 2
Fig. 2
Anterior slit-lamp biomicroscopic examination (A) and ocular ultrasound (B) showing vitreous cells characteristic of active intermediate uveitis in an HTLV-1 patient (patient 3)
Fig. 3
Fig. 3
Papilledema in an HTLV-1 patient in retinography (A), optical coherence tomography (B) and fluorescein angiography (C). Patient 2
Fig. 4
Fig. 4
Right eye with normal macula (image A) and left eye with abnormal exam (image B). Macular edema (black and white arrow) and epiretinal membrane (red arrow) in an HTLV-1 patient (optical coherence tomography). Patient 4
See this image and copyright information in PMC

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