title: Hepatitis C virus and human T-cell lymphotropic virus type 1 co-infection: impact on liver disease, virological markers, and neurological outcomes.
abstract: OBJECTIVE
  Human T-cell lymphotropic virus type 1 (HTLV-1) infection is associated with neurological abnormalities, such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and peripheral neuropathy (PN). Hepatitis C virus (HCV) infection is the leading cause of chronic liver disease worldwide, and causes PN in approximately 9% of patients. Because the interplay between these potentially neuropathogenic viruses in the same individual is still poorly understood, the clinical and laboratory outcomes of co-infected patients were evaluated and compared with those of controls.
  
  
  METHODS
  The prevalence rates of neurological and laboratory abnormalities were evaluated in HCV/HTLV-1 co-infected patients (n=50), and in subjects with single HCV (n=46) or HTLV-1 (n=150) infection.
  
  
  RESULTS
  A higher frequency of isolated PN was present in HCV-infected patients; this was not associated with cryoglobulinemia. No difference was found in the frequency of PN or HAM/TSP when co-infected subjects were compared to singly infected subjects. Hepatic involvement was present in HCV-infected subjects, as shown by increased levels of serum alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and bilirubin, in addition to thrombocytopenia. On the other hand, HCV/HTLV-1 co-infected individuals presented a better prognosis for hepatic involvement when compared with singly HCV-infected subjects.
  
  
  CONCLUSIONS
  These data suggest that HCV/HTLV-1 co-infection does not mutualistically alter the outcome with regard to neurological manifestations. Nonetheless, changes in the immunological environment induced by HTLV-1 infection could lead to a reduction in hepatic damage, even without significant HCV clearance.
authors.affiliation: Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute for Infectious Diseases (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil.
authors.forename: Otávio M
authors.initials: OM
authors.lastname: Espíndola
authors.affiliation: Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute for Infectious Diseases (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil.
authors.forename: Alexandre G
authors.initials: AG
authors.lastname: Vizzoni
authors.affiliation: Laboratory of Viral Hepatitis, Oswaldo Cruz Institute (IOC) - FIOCRUZ, Rio de Janeiro, Brazil.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lampe
authors.affiliation: Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute for Infectious Diseases (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Andrada-Serpa
authors.affiliation: Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute for Infectious Diseases (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil.
authors.forename: Abelardo Q C
authors.initials: AQC
authors.lastname: Araújo
authors.affiliation: Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute for Infectious Diseases (INI) - Oswaldo Cruz Foundation (FIOCRUZ), Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-900, Brazil. Electronic address: analeite1@bol.com.br.
authors.forename: Ana Claudia C
authors.initials: ACC
authors.lastname: Leite
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D060085:Coinfection / Q000150:complications*; D005260:Female; D015490:HTLV-I Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000209:etiology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology*
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Co-infection; HCV; HTLV-1; Hepatic involvement; Peripheral neuropathy