Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the cause of Coronavirus Disease 2019 (COVID-19). Although Real Time Reverse Transcription Polymerase Chain Reaction (qRT-PCR) of respiratory specimens is the gold standard test for detection of SARS-CoV-2 infection, collecting nasopharyngeal swabs causes discomfort to patients and may represent considerable risk for healthcare workers. The use of saliva as a diagnostic sample has several advantages. The aim of this study was to validate the use of saliva as a biological sample for diagnosis of COVID-19. This study was conducted at Infectious Diseases Research Laboratory (LAPI), in Salvador, Brazil. Participants presenting with signs/symptoms suggesting SARS-CoV-2 infection underwent a nasopharyngeal swab (NPS) and/or oropharyngeal swab (OPS), and saliva collection. Saliva samples were diluted in PBS, followed by RNA isolation and RT-Real Time PCR for SARS-CoV-2. Results of conventional vs saliva samples testing were compared. Statistical analyses were performed using Statistical Package for the Social Sciences software (SPSS) version 18.0. One hundred fifty-five participants were recruited and samples pairs of NPS/OPS and saliva were collected. The sensitivity and specificity of RT-PCR using saliva samples were 94.4% (95% CI 86.4–97.8) and 97.62% (95% CI 91.7–99.3), respectively. There was an overall high agreement (96.1%) between the two tests. Use of self-collected saliva samples is an easy, convenient, and low-cost alternative to conventional NP swab-based molecular tests. These results may allow a broader use of molecular tests for management of COVID19 pandemic, especially in resources-limited settings.

Monkeypox infection is rapidly spreading across the world. Despite the increasing number of cases, only a few reports have been published, and most are on people living without HIV. We report here the first two cases of monkeypox infection in Bahia, Brazil, one of them in a person living with HIV, on stable treatment. Both cases had a similar evolution, with a limited number of lesions and mild symptoms, with a complete recovery after 7–10 days. The potential route of transmission was via oral sex for the first case and was undefined for the second one. Both cases were confirmed through detection of the viral genome by PCR, and the partial sequence of the first case indicates the infection was caused by the West African clade. These cases confirm that monkeypox infection is currently being transmitted in Brazil and that people living with HIV on stable treatment are not likely to present a more severe form of monkeypox.

Molecular surveillance of the new coronavirus through new genomic sequencing technologies revealed the circulation of important variants of SARS-CoV-2. Sanger sequencing has been useful in identifying important variants of SARS-CoV-2 without the need for whole-genome sequencing. A sequencing protocol was constructed to cover a region of 1000 base pairs, from a 1120 bp product generated after a two-step RT-PCR assay in samples positive for SARS-CoV-2. Consensus sequence construction and mutation identification were performed. Of all 103 samples sequenced, 69 contained relevant variants represented by 20 BA.1, 13 delta, 22 gamma, and 14 zeta, identified between June 2020 and February 2022. All sequences found were aligned with representative sequences of the variants. Using the Sanger sequencing methodology, we were able to develop a more accessible protocol to assist viral surveillance with a more accessible platform.

Human T-cell lymphotropic virus (HTLV) infection affects over ten million people worldwide, but there is no effective treatment so far. This review describes the virological, immunological, and clinical outcomes of antiretroviral therapy (ART) in people with HTLV infection. This systematic review followed PRISMA reporting guidelines and was registered in PROSPERO: CRD42022350076. The Newcastle–Ottawa Scale, adapted for cross-sectional studies, and Rob-2 were used to assess the methodological quality of these studies. Systematic searches were conducted in the Medline (PubMed), Scopus (Elsevier), Cochrane Library, and Web of Science (Clarivate Analytics) databases. We retrieved data from eight methodologically diverse articles on treatment of patients infected by HTLV-1 or HTLV-2 alone, or coinfected by HIV-1, who received Raltegravir, Tenofovir, Lamivudine, or Zidovudine. The proviral load decreased in three out of seven studies over 4 to 48 weeks of antiretroviral use. Cellular immune response (CD4, CD8, CD25, CD69, and CD71 cells) was evaluated in six studies. While no significant clinical improvement was observed, all studies reported clinical stability during treatment. Despite the demonstrated antiviral activity of ART, in vitro, clinical improvement was not proven. Most studies showed disease stability during ART use, suggesting potential clinical benefits. There is a need of larger, well-controlled trials to define the role of ART in the treatment of HTLV infection.

Human T-cell lymphotropic virus (HTLV) infection lacks effective treatment. This review describes the virological, immunological and clinical outcomes of antiretroviral therapy (ART) in people with HTLV infection. This systematic review followed PRISMA reporting guidelines and was registered in PROSPERO: CRD42022350076. The Newcastle-Ottawa Scales, adapted for cross-sectional studies, and Rob-2 were employed to assess the methodological quality of studies. A systematic search was conducted in Medline (PubMed), Scopus (Elsevier), Cochrane Library, and Web of Science (Clarivate Analytics) databases. We retrieved data from 08 methodologically diverse articles, on treatment of patients infected by HTLV-1 or HTLV-2 alone, or coinfected by HIV-1 with Raltegravir, Tenofovir, Lamivudine and Zidovudine. Proviral load decreased in 3 of 7 studies, during 4 to 48 weeks of antiretrovirals use. Cellular immune response (CD4, CD8, CD25, CD69 and CD71 cells) were evaluated in six studies. There was no significant clinical improvement in the studies but all of them detected clinical stability during treatment. Despite the demonstrated antiviral activity of ART, in vitro, clinical improvement was not proven. Most studies showed disease stability during ART use, suggesting potential clinical benefits. There is a need of larger, well-controlled trials, to define the role of ART for treatment of HTLV infection.

Human T-cell lymphotropic virus type 1 (HTLV-1) causes HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a chronic, immune-mediated spinal cord disease in which peripheral immune activation is thought to fuel central neuroinflammation. To delineate cell type-specific programs linked to disease, we performed single-cell RNA sequencing on the peripheral blood mononuclear cells (PBMCs) of the HTLV-1 infected asymptomatic carrier (AC) and HAM/TSP patient. Differential expression and pathway analysis localized the most pronounced transcriptional divergence to the monocyte compartment, revealing coordinated remodeling of macrophage classical (M1-like) activation, IL-10-regulatory signaling, leukocyte adhesion/diapedesis, and trans-endothelial migration pathway, and cytokine storm-related modules. Ingenuity Pathway Analysis highlighted overlap with multiple sclerosis-associated signaling, consistent with myeloid-driven neuroinflammation and potential blood-spinal cord barrier involvement. In an independent validation phase, we assayed the selected subsets of up- and down-regulated monocyte genes in AC and HAM/TSP participants enrolled in a randomized, open-label pilot trial in Brazil. Expression of several inflammatory markers was higher at baseline in HAM/TSP and decreased during dolutegravir (DTG) therapy, paralleling reductions in HTLV-1 proviral load (PVL) in the DTG arm. Collectively, these data suggest that antiviral strategies may modulate immune cell transcriptional programs that help reduce HTLV-1 PVL.