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The present study aimed to quantify HTLV-1 proviral load (PVL) in vaginal fluid, and to investigate correlations with PVL in peripheral blood mononuclear cells (PBMCs). In addition, cytopathological alterations and vaginal microbiota were evaluated. Methods: HTLV-1-infected women were consecutively recruited at a multidisciplinary center for HTLV patients in Salvador, Brazil. All women underwent gynecological examinations to obtain cervicovaginal fluid and venipuncture for blood collection. PVL, as measured by real-time quantitative polymerase chain reaction (RT\u2013qPCR), was expressed as the number of copies of HTLV-1\/106 cells in blood and vaginal fluid samples. Light microscopy was used to assess cervicovaginal cytopathology and vaginal microbiota. Results: In the 56 included women (43 asymptomatic carriers and 13 diagnosed with HTLV-1-associated myelopathy\/tropical spastic paraparesis\u2014HAM\/TSP), mean age was 35.9 (SD \u00b1 7.2) years. PVL was higher in PBMCs (median: 23,264 copies\/106 cells; IQR: 6776\u201360,036) than in vaginal fluid (451.9 copies\/106 cells; IQR: 0\u20132490) (p &lt; 0.0001). PVL in PBMCs was observed to correlate directly with PVL in vaginal fluid (R = 0.37, p = 0.006). PVL was detected in the vaginal fluid of 24 of 43 (55.8%) asymptomatic women compared to 12 of 13 (92.3%) HAM\/TSP patients, p = 0.02. Cytopathologic analyses revealed no differences between women with detectable or undetectable PVL. Conclusion: HTLV-1 proviral load is detectable in vaginal fluid and correlates directly with proviral load in peripheral blood. This finding suggests that sexual transmission of HTLV-1 from females to males may occur, as well as vertical transmission, particularly in the context of vaginal delivery.<\/jats:p>","DOI":"10.3390\/pathogens12050682","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T02:56:51Z","timestamp":1683255411000},"page":"682","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["HTLV-1 Proviral Load in Vaginal Fluid Correlates with Levels in Peripheral Blood Mononuclear Cells"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1527-8836","authenticated-orcid":false,"given":"Alisson","family":"de Aquino Firmino","sequence":"first","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Roberto Tavares Gomes","family":"Filho","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adenilda Lima Lopes","family":"Martins","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"},{"name":"Department of Health (DSAU), State University of Feira de Santana (UEFS), Feira de Santana 44036-900, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thessika Hialla","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-3558","authenticated-orcid":false,"given":"Luana Leandro","family":"Gois","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"},{"name":"Department of Biointeraction Sciences, Institute of Health Sciences, Federal University of Bahia (UFBA), Salvador 40110-902, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everton","family":"da Silva Batista","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Paulo Lacerda","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernardo","family":"Galv\u00e3o-Castro","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"},{"name":"Advanced Laboratory of Public Health (LASP), Gon\u00e7alo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador 40296-710, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Fernanda Rios","family":"Grassi","sequence":"additional","affiliation":[{"name":"Integrative Multidisciplinary HTLV Center (CHTLV), Bahiana School of Medicine and Public Health (EBMSP), Salvador 40290-000, Bahia, Brazil"},{"name":"Advanced Laboratory of Public Health (LASP), Gon\u00e7alo Moniz Institute, Oswaldo Cruz Foundation (Fiocruz), Salvador 40296-710, Bahia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","article-title":"Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma","volume":"77","author":"Poiesz","year":"1980","journal-title":"Proc. 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