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. 2025 Aug 20;19(8):e0013409.
doi: 10.1371/journal.pntd.0013409. eCollection 2025 Aug.

Prevalence of human T-cell leukemia virus type 1 associated inflammatory myopathies (HAIM) in Salvador, Brazil

Adriele Ribeiro França Viriato  1 , Marcela Câmara Machado Costa  1 , Edmar Zanoteli  2 , Luiz Antônio R de Freitas  3   4 , Thessika Hialla Almeida Araújo  1 , Ney Boa-Sorte  1   3 , Maria Fernanda Rios Grassi  1   4 , Bernardo Galvão-Castro  1   4
Affiliations

Prevalence of human T-cell leukemia virus type 1 associated inflammatory myopathies (HAIM) in Salvador, Brazil

Adriele Ribeiro França Viriato et al. PLoS Negl Trop Dis. .

Abstract

Background: Human T-cell leukemia virus type 1 (HTLV-1) causes inflammatory diseases and is associated with various muscle abnormalities, including polymyositis. Elevated serum creatine kinase (CPK) levels are typically indicative of muscle damage.

Aims: This study aimed to determine the prevalence of HTLV-1 associated inflammatory myopathies (HAIM) in a large cohort of People living with HTLV-1 from Salvador, Brazil. Additionally, we sought to describe the clinical, laboratory, and histopathological findings of seven HTLV-1-infected patients with persistent hyperCKemia.

Methods: This study included 503 HTLV-1-infected patients from a cohort in Salvador, Brazil, who were analyzed for creatine phosphokinase (CPK) levels. Clinical, laboratory, and pathologic examinations were performed in patients whose CPK levels were above the upper limit of the normal range in the two tests performed at different time points.

Results: Polymyositis was the main cause of HAIM in the study population, with a prevalence rate of 0.6%. Two cases were diagnosed with muscular dystrophy and mitochondrial disease, and in two other patients the cause of hyperCKemia could not be determined and is currently under investigation.

Conclusion: Polymyositis was the main cause of HAIM in this cfohort of People living with HTLV-1.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart of the evaluation of HiperCKemia in HTLV-1 infected patients.
Fig 2
Fig 2. A) Case 1: The arrows delimit an area in which muscle fibers (M) are separated by fibrosis.
The muscle fibers have varying sizes and shapes. There is a focus of inflammatory infiltration of mononuclear cells (arrowhead) and there are adipocytes (A) permeating the muscle (Hematoxylin-eosin staining); B) Case 2: A focus of inflammatory infiltration of mononuclear cells can be observed in the endomysium (arrow) and adipocytes (A) are seen permeating the muscle. C) Case 2: Immunostaining shows CD8-positive lymphocytes permeating the endomysium.
Fig 3
Fig 3. Case 5 - Histological section stained with Hematoxylin & Eosin shows muscle fiber with size variation.
See this image and copyright information in PMC

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