SYSTEMATIC REVIEW


Vitamin D and HTLV Infection: A Systematic Review



E Netto1, *, M Gomes-Neto2, C Brites3
1 Sarah Network of Rehabilitation Hospitals, Salvador, Bahia, Bahia, Brazil.
2 Physical Therapy Department, Federal University of Bahia, Brazil
3 Laboratório de Pesquisas em Infectologia, Hospital Universitário Edgard Santos, Federal University of Bahia, Bahia, Brazil.


© 2019 Netto et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Sarah Network of Rehabilitation Hospitals. Avenida Tancredo Neves, 2782, Caminho das Árvores, Salvador – BA, Zip Code: 41820-900; Tel: +55 (71) 98788.8525; +55 (71) 3351.2357; Email: elaine.netto@hotmail.com


Abstract

Background:

Vitamin D has been associated with the pathogenesis of infectious diseases.

Objective:

To perform a systematic review on the association of vitamin D and outcomes of HTLV (Human T-cell lymphotropic virus) infection.

Methods:

We searched PubMed, LILACs, Scielo, Embase and Cochrane Library for studies addressing vitamin D and HTLV infection. We included studies published in English since 1980. Studies associated with HIV, bone metabolism and not related to HTLV- associated myelopathy/ tropical spastic paraparesis (HAM/TSP) or adult T cell leukemia/lymphoma (ATL) were excluded.

Results:

Twenty-three studies were selected and sixteen studies were included in the review (eight experimental studies, three case reports, three cases series, one cross-sectional study and one review). Fourteen studies were focused on ATL, and two on HAM/TSP. The available data show that in vitro exposure to 1,25(OH)2D inhibits proliferation of HTLV-infected lymphocytes in patients with ATL or HAM/TSP. It has been observed that hypercalcemia, the main cause of death in patients with ATL, is not associated with serum levels of 1,25(OH)2D or parathyroid hormone-related protein, but leukemia inhibitory factor/D factor seems to be an important factor for hypercalcemia pathogenesis. It was also demonstrated an association between the VDR ApaI gene polymorphism and a decreased risk of HAM/TSP in HTLV positive individuals.

Conclusion:

Despite the small number and heterogeneity of the studies, this systematic review suggests that vitamin D play a role in the pathogenesis of HTLV-associated diseases.

Key words: 25(OH)D, Vitamin D, HTLV, Calcitriol, Adult T-cell lymphoma/leukemia, antigen-presenting cells (APC).