{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:15:30Z","timestamp":1787030130842,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Council for Scientific and Technological Development (CNPq)","award":["442522\/2019-3"],"award-info":[{"award-number":["442522\/2019-3"]}]},{"name":"National Council for Scientific and Technological Development (CNPq)","award":["302935\/2021-5"],"award-info":[{"award-number":["302935\/2021-5"]}]},{"name":"National Council for Scientific and Technological Development (CNPq)","award":["402412\/2021-4"],"award-info":[{"award-number":["402412\/2021-4"]}]},{"name":"National Council for Scientific and Technological Development (CNPq)","award":["406360\/2022-7"],"award-info":[{"award-number":["406360\/2022-7"]}]},{"name":"Instituto Nacional de Ci\u00eancia e Tecnologia em Viroses Emergentes e Reemergentes\u2014INCT-VER","award":["442522\/2019-3"],"award-info":[{"award-number":["442522\/2019-3"]}]},{"name":"Instituto Nacional de Ci\u00eancia e Tecnologia em Viroses Emergentes e Reemergentes\u2014INCT-VER","award":["302935\/2021-5"],"award-info":[{"award-number":["302935\/2021-5"]}]},{"name":"Instituto Nacional de Ci\u00eancia e Tecnologia em Viroses Emergentes e Reemergentes\u2014INCT-VER","award":["402412\/2021-4"],"award-info":[{"award-number":["402412\/2021-4"]}]},{"name":"Instituto Nacional de Ci\u00eancia e Tecnologia em Viroses Emergentes e Reemergentes\u2014INCT-VER","award":["406360\/2022-7"],"award-info":[{"award-number":["406360\/2022-7"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Human T-lymphotropic virus 1 (HTLV-1) infection has been associated with inflammatory, autoimmune, and lymphoproliferative diseases with a wide spectrum of clinical manifestations. Among patients with inflammatory rheumatological disease manifestations, cases of rheumatoid arthritis, Sj\u00f6gren\u2019s syndrome, polymyositis, and fibromyalgia, among others, have been reported. Another common feature of rheumatological diseases is the presence of joint manifestations, such as arthralgia and arthritis. In the present study, we sought to determine the laboratory profile and clinical rheumatological manifestations of people living with HTLV-1\/2 residing in a metropolitan area in the Brazilian Amazon. A total of 957 individuals were screened for HTLV-1\/2 infection by enzyme-linked immunosorbent assay (ELISA), and samples from seropositive individuals were subjected to infection confirmation by Western blotting or quantitative polymerase chain reaction (qPCR). Individuals with confirmed HTLV-1 and HTLV-2 infection were clinically evaluated for signs and symptoms of rheumatological diseases. Of the 957 individuals tested, 69 were positive for HTLV-1\/2 infection, with 56 confirmed cases of HTLV-1 infection (5.9%), 12 of HTLV-2 infection (1.2%), and 1 classified as undetermined (0.1%). After clinical screening, 15 infected individuals with complaints suggestive of rheumatological disease were selected for evaluation by a rheumatologist (11 with HTLV-1 infection (1.1%) and 4 with HTLV-2 infection (0.4%)). The predominant pain pattern was symmetrical polyarthralgia, with large joints predominantly being affected. The diseases diagnosed were psoriatic arthritis, osteoarthritis, fibromyalgia, and regional pain syndromes. Antinuclear antibody (ANA) positivity was observed in two patients. Our findings confirm that HTLV-1 infection is associated with rheumatological disease manifestations and highlight the novel finding of cases of HTLV-2 infection in patients with rheumatoid arthritis symptoms.<\/jats:p>","DOI":"10.3390\/v17070874","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T11:23:24Z","timestamp":1750418604000},"page":"874","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Rheumatological Manifestations in People Living with Human T-Lymphotropic Viruses 1 and 2 (HTLV-1 and HTLV-2) in Northern Brazil"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2916-4036","authenticated-orcid":false,"given":"M\u00e1rcio Yutaka","family":"Tsukimata","sequence":"first","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Lumi Inomata","family":"da Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonn Mendes Soares","family":"Pereira","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9341-9350","authenticated-orcid":false,"given":"Bruno Jos\u00e9 Sarmento","family":"Botelho","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Cristina Coelho","family":"Santos","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos David Ara\u00fajo","family":"Bichara","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Amaral Costa Medicina Diagn\u00f3stica, Bel\u00e9m 66055-050, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7825-9384","authenticated-orcid":false,"given":"Gabriel dos Santos Pereira","family":"Neto","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline Cecy Rocha","family":"Lima","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Erivan da Cunha","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nat\u00e1lia Pinheiro","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Marques","family":"Galdino","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danniele Chagas","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludmila do Carmo de Souza","family":"Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourena Camila Oliveira","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Ronaldo","family":"Matos Carneiro","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosana de Britto Pereira","family":"Cruz","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Ishak","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1135-6507","authenticated-orcid":false,"given":"Antonio Carlos Ros\u00e1rio","family":"Vallinoto","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara Nascimento de Carvalho","family":"Klemz","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Instituto de Ci\u00eancias M\u00e9dica, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izaura Maria Vieira Cayres","family":"Vallinoto","sequence":"additional","affiliation":[{"name":"Laboratory of Virology, Institute of Biological Sciences, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"},{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Biologia de Agentes Infecciosos e Parasit\u00e1rios, Universidade Federal do Par\u00e1, Bel\u00e9m 66075-110, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","unstructured":"ICTV\u2014International Committee on Taxonomy of Viruses (2025, June 18). Taxonomy History: Primate T-Lymphotropic Virus 1. Available online: https:\/\/ictv.global\/report\/chapter\/retroviridae\/retroviridae\/deltaretrovirus."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12977-019-0483-0","article-title":"Comparative virology of HTLV-1 and HTLV-2","volume":"16","author":"Martinez","year":"2019","journal-title":"Retrovirology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1038\/294268a0","article-title":"Isolation of a new type C retrovirus (HTLV) in primary uncultured cells of a patient with S\u00e9zary T-cell leukaemia","volume":"294","author":"Poiesz","year":"1981","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1126\/science.6981847","article-title":"A new subtype of human T-cell leukemia virus (HTLV-II) associated with a T-cell variant of hairy cell leukemia","volume":"218","author":"Kalyanaraman","year":"1982","journal-title":"Science"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"7994","DOI":"10.1073\/pnas.0501734102","article-title":"Emergence of unique primate T-lymphotropic viruses among central African bushmeat hunters","volume":"102","author":"Wolfe","year":"2005","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1089\/aid.2008.0128","article-title":"Short communication: Absence of evidence of HTLV-3 and HTLV-4 in patients with large granular lymphocyte (LGL) leukemia","volume":"24","author":"Duong","year":"2008","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1128\/CMR.00063-09","article-title":"Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases","volume":"23","author":"Proietti","year":"2010","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1590\/S0365-05962008000400011","article-title":"Adult T-cell leukemia\/lymphoma","volume":"83","author":"Bittencourt","year":"2008","journal-title":"An. Bras. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s11908-014-0459-0","article-title":"Update on Neurological Manifestations of HTLV-1 Infection","volume":"17","author":"Araujo","year":"2015","journal-title":"Curr. Infect. Dis. Rep."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Honarbakhsh, S., and Taylor, G.P. (2015). High prevalence of bronchiectasis is linked to HTLV-1-associated inflammatory disease. BMC Infect. Dis., 15.","DOI":"10.1186\/s12879-015-1002-0"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1590\/S0482-50042006000500003","article-title":"Frequ\u00eancia de doen\u00e7as reum\u00e1ticas em indiv\u00edduos infectados pelo HTLV-1","volume":"46","author":"Giozza","year":"2006","journal-title":"Rev. Bras. Reumatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S364","DOI":"10.1590\/S0365-05962005001000017","article-title":"Infective dermatitis associated with the HTLV-I (IDH) in children and adults","volume":"80","author":"Bittencourt","year":"2005","journal-title":"An. Bras. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kamoi, K., Watanabe, T., Uchimaru, K., Okayama, A., Kato, S., Kawamata, T., Kurozumi-Karube, H., Horiguchi, N., Zong, Y., and Yamano, Y. (2022). Updates on HTLV-1 Uveitis. Viruses., 14.","DOI":"10.3390\/v14040794"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1002\/ana.20126","article-title":"Human T-lymphotropic virus type II and neurological disease","volume":"56","author":"Araujo","year":"2004","journal-title":"Ann. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1093\/trstmh\/trab173","article-title":"Neurodegenerative disease in association with sexual transmission of human T-cell lymphotropic virus type 2 subtype b in Argentina","volume":"116","author":"Blanco","year":"2022","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_16","first-page":"144","article-title":"The epidemiology and disease outcomes of human T-lymphotropic virus type II","volume":"6","author":"Roucoux","year":"2004","journal-title":"AIDS Rev."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Silva, B.L.I., Rodrigues, F.E.C., Tsukimata, M.Y., Botelho, B.J.S., Santos, L.C.C., Pereira Neto, G.S., Lima, A.C.R., Andr\u00e9, N.P., Galdino, S.M., and Monteiro, D.C. (2024). Fibromyalgia in patients infected with HTLV-1 and HTLV-2. Front. Med., 11.","DOI":"10.3389\/fmed.2024.1419801"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1002\/art.1780390314","article-title":"High seroprevalence of anti-HTLV-I antibody in rheumatoid arthritis","volume":"39","author":"Eguchi","year":"1996","journal-title":"Arthritis Rheum."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1016\/S0140-6736(89)91793-5","article-title":"HTLV-1 and polymyositis in Jamaica","volume":"2","author":"Morgan","year":"1989","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"A54","DOI":"10.1097\/00042560-199904010-00200","article-title":"High prevalence of HTLV-I infection among patients with rheumatoid arthritis living in Porto Alegre, Brazil","volume":"20","author":"Lonzetti","year":"1999","journal-title":"J. Acquir. Immune Defic. Syndr. Hum. Retrovirol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1136\/ard.51.6.769","article-title":"Primary Sj\u00f6gren\u2019s syndrome with antibodies to HTLV-I: Clinical and laboratory features","volume":"51","author":"Eguchi","year":"1992","journal-title":"Ann. Rheum. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/S0140-6736(94)90630-0","article-title":"Prevalence of serum and salivary antibodies to HTLV-1 in Sj\u00f6gren\u2019s syndrome","volume":"344","author":"Terada","year":"1994","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1136\/ard.55.3.193","article-title":"High prevalence of arthropathy in HTLV-I carriers on a Japanese island","volume":"55","author":"Motokawa","year":"1996","journal-title":"Ann. Rheum. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1002\/art.1780340612","article-title":"Arthritis in patients infected with human T lymphotropic virus type I. Clinical and immunopathologic features","volume":"34","author":"Sato","year":"1991","journal-title":"Arthritis Rheum."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1089\/aid.2006.0140","article-title":"Clinical manifestations associated with HTLV type I infection: A cross-sectional study","volume":"23","author":"Caskey","year":"2007","journal-title":"AIDS Res. Hum. Retroviruses."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Umekita, K., and Okayama, A. (2020). HTLV-1 Infection and Rheumatic Diseases. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.00152"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Umekita, K. (2022). Effect of HTLV-1 Infection on the Clinical Course of Patients with Rheumatoid Arthritis. Viruses, 14.","DOI":"10.3390\/v14071460"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Quaresma, J.A., Yoshikawa, G.T., Koyama, R.V., Dias, G.A., Fujihara, S., and Fuzii, H.T. (2015). HTLV-1, Immune Response and Autoimmunity. Viruses, 8.","DOI":"10.3390\/v8010005"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1002\/art.1780310824","article-title":"Adult T cell leukemia presenting with proliferative synovitis","volume":"31","author":"Taniguchi","year":"1988","journal-title":"Arthritis Rheum."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0140-6736(88)92744-4","article-title":"T-lymphocyte alveolitis, tropical spastic paresis, and Sj\u00f6gren syndrome","volume":"1","author":"Vernant","year":"1988","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1172\/JCI115436","article-title":"Detection of human T cell lymphotropic virus type I proviral DNA and its gene expression in synovial cells in chronic inflammatory arthropathy","volume":"88","author":"Kitajima","year":"1991","journal-title":"J. Clin. Investig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.4049\/jimmunol.155.3.1588","article-title":"Autoimmunity induction by human T cell leukemia virus type 1 in transgenic mice that develop chronic inflammatory arthropathy resembling rheumatoid arthritis in humans","volume":"155","author":"Iwakura","year":"1995","journal-title":"J. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1590\/S0102-311X2005000300027","article-title":"Heterogeneous geographic distribution of human T-cell lymphotropic viruses I and II (HTLV-I\/II): Serological screening prevalence rates in blood donors from large urban areas in Brazil","volume":"21","author":"Proietti","year":"2005","journal-title":"Cad. Sa\u00fade P\u00fablica."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Lopes, F.T., Sousa, R.S., Gomes, J.L.C., Vallinoto, M.C., Lima, A.C.R., Lima, S.S., Freitas, F.B., Feitosa, R.N.M., Rangel da Silva, N.A.M., and Machado, L.F.A. (2022). The Relevance of a Diagnostic and Counseling Service for People Living With HTLV-1\/2 in a Metropolis of the Brazilian Amazon. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.864861"},{"key":"ref_35","unstructured":"Minist\u00e9rio da Sa\u00fade do Brasil (2025, April 15). Guia de Manejo Cl\u00ednico da Infec\u00e7\u00e3o pelo HTLV, Available online: https:\/\/www.gov.br\/aids\/pt-br\/central-de-conteudo\/publicacoes\/2022\/guia_htlv_internet_24-11-21-2_3.pdf\/view."},{"key":"ref_36","unstructured":"Porto, C.C. (2017). Semiologia M\u00e9dica, Editora Guanabara Koogan."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1590\/S0482-50042012000100010","article-title":"Conceitos atuais e relevantes sobre artrite psori\u00e1sica","volume":"52","author":"Favarato","year":"2012","journal-title":"Rev. Bras. Reumatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1590\/S0104-42302010000300021","article-title":"O v\u00edrus linfotr\u00f3pico de c\u00e9lulas T humanos tipo 1 (HTLV-1): Quando suspeitar da infec\u00e7\u00e3o?","volume":"56","author":"Romanelli","year":"2010","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e2020605","DOI":"10.1590\/s1679-497420200006000015.esp1","article-title":"Protocolo Brasileiro para Infec\u00e7\u00f5es Sexualmente Transmiss\u00edveis 2020: Infec\u00e7\u00e3o pelo v\u00edrus linfotr\u00f3pico de c\u00e9lulas T humanas (HTLV)","volume":"30","author":"Rosadas","year":"2021","journal-title":"Epidemiol. Serv. Sa\u00fade"},{"key":"ref_40","first-page":"2300","article-title":"Higher prevalence of fibromyalgia in patients infected with human T cell lymphotropic virus type I","volume":"33","author":"Cruz","year":"2006","journal-title":"J. Rheumatol."},{"key":"ref_41","first-page":"20","article-title":"Fibromyalgia and infectious stress: Possible associations between fibromyalgia syndrome and chronic viral infections","volume":"45","author":"Ribeiro","year":"2005","journal-title":"Rev. Bras. Reumatol."},{"key":"ref_42","unstructured":"Shinjo, S.K., and Moreira, C. (2021). Livro da Sociedade Brasileira de Reumatologia, Manole. [2nd ed.]."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/7\/874\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:56:01Z","timestamp":1760032561000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/17\/7\/874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":42,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["v17070874"],"URL":"https:\/\/doi.org\/10.3390\/v17070874","relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.174029600.06579803\/v1","asserted-by":"object"}]},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,20]]}}}