The Open Infectious Diseases Journal
2019, 11 : 35-42Published online 2019 July 31. DOI: 10.2174/1874279301911010035
Publisher ID: TOIDJ-11-35
SYSTEMATIC REVIEW
Vitamin D and HTLV Infection: A Systematic Review
* 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.