Rev ista da So ciedade B ras ileira d e M edicina Tro pical 2 9 (4 ):3 8 3 - 3 8 4 , jul- ago , 1 9 9 6 .
CO M UN ICA ÇÃ O
H T LV -I/n SERO PREV A LEN CE IN 55 BRA Z ILIA N PA TIEN TS
W IT H ID IO PA TH IC UV EITIS
Sônia R. Pinheiro, A nna B. C arneiro-Proietti, M aria V. Lim a-M artins, Fernando A. Proietti, A lexandre A. Pereira and Fernando O réfice
H u m an T-c ell ly m p ho tro p ic v irus ty p e I has b e e n asso c iated w ith ad ult T-c ell leu kem ia and ly m p ho m a, neu ro lo g ical d isease (tro p ical sp astic p arap aresis o r HTLV-I asso c iated m y elo p athy ) and , m o re recen tly , u v eitis. This v irus is hig hly end em ic in so m e regio ns o f the w o rld , esp ecially in so u th w est Jap an , C arib b ean island s, So uth A m e ric a an d p arts o f C e n tral A f ric a 1. T h e p re sen c e o f HTLV-I/ II in Braz il v aries acco rd ing to th e g eo g rap h ic al area, w ith sero p rev alence in h ealth y b lo o d d o n o rs rang ing fro m 0.08 to 1.35% in stu d ies c o n d u c ted b y the M inistry o f H ealth5. In Be lo H o riz o n te, th e c ap ital o f M inas G erais State, a sero p rev alen c e o f 0.32% 4 has b e e n o b serv ed in elig ib le b lo o d d o no rs.
In Ja p a n , s e ro p re v a le n c e f o r H TLV -I an tib o d ies am o n g p atients w ith id io p athic u v eitis ran g es fro m 35.4 to 44 .8% 2. In Braz il, to o u r kn o w led g e, there is n o d ata o n HTLV-I sero p rev alen c e am o n g ind iv id uals w ith this d iag no sis.
Fro m M arch to Se p tem b er o f 1994, w e tested 55 p atients w ith id io p athic uv eitis fo r the p re sen c e o f an tib o d ies to HTLV-I/ II by u sing an ELISA (O rth o D iag n o stic Sy stem s, N e w Je r s e y , U SA ) . P o s i ti v e te s ts w e r e c o n firm e d b y W estern b lo t (C am b rid g e Bio te c h , M ary land , USA ). N o ne o f the p atients p resen ted c linical o r lab o rato rial ev id en c e o f sy stem ic d isease related to o th er uv eitis ty p es su ch as to xo p lasm o sis, sy p hilis, tu b ercu lo sis, anky lo sing sp o nd y litis, sarco id o sis, Be h c e t’s d isease o r V o g t-Ko y anag i-H arad a’s d isease. T h e p atien ts’ag e ran g ed fro m 9 to 78 y ears (m ean , 36.2, SD , 17.52). Thirty -six (65.4% ) w ere fem ales and 19 (34.6% ) w ere m ales. Th e d istrib u tio n o f the an ato m ic al ty p es o f uv eitis
D e p a r t m e n t s o f O p h t a l m o l o g y a n d P r e v e n t i v e a n d S o c i a l M e d i c i n e , F e d e r a l U n i v e r s i t y o f M i n a s G e r a i s , F u n d a ç ã o H e m o m i n a s , B e l o H o r i z o n t e , M G .
A d d r e s s t o : D r a A n n a B . C a r n e i r o - P r o i e t t i . F u n d a ç ã o H e m o m i n a s . A l . E z e q u i e l D i a s 3 2 1 , 3 0 1 3 0 - 1 1 0 B e l o H o r i z o n t e , M G , B r a s i l .
Receb id o para p u blicação em 22/ 08/ 95.
w e re as f o llo w s : 28 ( 5 1 .0 % ) in te rm e d ia te , 21 (38.2% o ) a n te rio r , 3 ( 5 .4 % ) p o s te r io r , 2 (3-6% ) p o sterio r scleritis and 1 (1.8% ) d iffu se uv eitis.
Tw o (3-6%o) p atients (a m ale and a fem ale, w ith ag es o f 19 and
62
, resp ec tiv ely ) w ith u nilateral anterio r u v eitis w ere sero p o sitiv e fo r HTLV-I/ II. Th eir m ajo r c o m p lain t w as o c u lar hy p erem ia and v isu al acu ity w as slig htly lo w er than no rm al. Bo th had d iscrete iritis w ith less than 20 c ells in a field and m ild flare in th e an terio r c h am b er w ith fin e keratic p recip itates. Th ere w ere n o n o d u les in the iris and in the trab ec u lar m eshw o rk. T h e v itreo u s b o d y had o n ly a m o d erate reac tio n, w ith less than 10 c ells in a field . T h e o p h th alm o sc o p y w as no rm al in b o th c ases. Bo th p atients w ere treated w ith lo c al co rtic o stero id s and im p ro v ed in ab o u t fo u r w eeks.C o m p ared to d ata fro m Jap an , w e fo u n d a relativ ely lo w se ro p rev ale n c e o f HTLV-I/ II an tib o d ies in p atients w ith id io p ath ic u v eitis in Be lo H o riz o nte. H o w ev er, it w as ab o u t ten tim es h ig h er than that o f elig ib le b lo o d d o no rs fro m the sam e area. In o u r p atients, th e clin ic al p resen tatio n d ifferred c o n sid erab ly fro m o th er rep o rts, w h ere interm ed iate u v eitis2 o r an terio r g ranu lo m ato u s uv eitis3 w ere m o re c o m m o n .
A lth o u g h lim ite d to s e le c te d site s an d sa m p le , th e s e re s u lts su g g e s t a d if f e re n t ep id em io lo g ical p attern o f HTLV-I/ II in fec tio n in this g eo g rap h ic al reg io n , w h ic h n eed s to b e co nfirm ed b y fu rther stu d ies.
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