Human T-cell lymphotropic virus type 1 as a promoter of tuberculosis in a country with low HIV prevalence

Tuberculosis (TB) control depends on rapid detection and initiation of treatment. Several factors may increase susceptibility to TB such as HIV coinfection or diabetes. Infection by the human Tcell lymphotropic virus type 1 (HTLV-1) has not yet been properly evaluated but could increase the severity of presentation of TB disease and increase mortality and transmission of TB to household contacts, impeding the proper control of TB. The first part of the thesis will focus on performing a systematic review of published literature on the association between HTLV-1 and TB and on the association with severity of TB disease. The second part will explore in a prospective cohort the frequency of HTLV-1 among TB patients and features of TB/HTLV-1 coinfection such as disease presentation, severity and treatment outcomes. The third part will evaluate the frequency of transmission of TB in household contacts of HTLV positive and negative TB patients and in HTLV positive and negative household contacts of TB patients. Finally, we will look for a history of TB in a retrospective 2 HTLV-1 cohort, to evaluate the risk of TB disease and the association of TB to HTLV-1 related diseases. Data will be collected through prospective and retrospective cohort studies which will be conducted within the Peruvian National Tuberculosis Program in different districts of Lima, Peru and in the HTLV-1 clinic at the Institute of Tropical Medicine Alexander von Humboldt (IMTAvH) at Universidad Peruana Cayetano Heredia in Lima. These studies will generate knowledge with potential implications on TB control in Peru and similar settings. They could help to develop recommendations on screening for HTLV-1 infection among TB patients and prevention of TB among HTLV-1 infected persons through the use of preventive isoniazid therapy.

Trefwoorden:B680-volksgezondheid