Diagnóstico molecular de vírus T-linfotrópico humano (HTLV): histórico e estado da arte
DOI:
https://doi.org/10.57148/bepa.2021.v.18.36571Palavras-chave:
vírus T-linfotrópico humano (HTLV); vírus T-linfotrópico humano 1 (HTLV-1); vírus T-linfotrópico 2 (HTLV-2); Diagnóstico; Técnicas de amplificação de ácidos nucleicos (NAAT); Reação em cadeia da polimerase (PCR).Resumo
Técnicas de amplificação de ácidos nucleicos (nucleic acid amplification techniques, NAATs) que pesquisam partes do genoma proviral de vírus T-linfotrópicos humanos (human T-lymphotropic virus, HTLVs) são importantes ferramentas para a caracterização molecular, diagnóstico e quantificação de carga proviral. No Brasil, os HTLV-1 e HTLV-2 são endêmicos, e o diagnóstico diferencial entre eles é de suma importância, uma vez que o HTLV-1 está relacionado a doenças graves como a mielopatia associada ao HTLV-1 e a leucemia/linfoma de células T adultas, enquanto o HTLV-2 parece não ser patogênico. Este trabalho faz uma revisão narrativa das NAATs utilizadas ao longo dos anos na pesquisa de HTLVs; apresenta um quadro com dados de autor/ano de publicação, local de realização do trabalho, técnica empregada, genes alvo e objetivo do estudo. Outrossim, relata causas de possíveis falhas no diagnóstico molecular; apresenta novas metodologias e pesquisas sobre técnicas que mais se adequam à realidade brasileira; esclarece sobre a necessidade de se implantar o diagnóstico molecular na rede pública de saúde, tomando como base seu melhor custo-benefício para laboratórios que dispõem de infraestrutura e pessoal capacitado. Concluindo, fornece informações úteis para a implementação de políticas públicas de saúde dentro do âmbito do SUS, uma vez que a infecção por HTLV-1 vem ganhando notoriedade junto ao Ministério da Saúde do Brasil e a Organização Mundial da Saúde, por ser de alta prevalência, estar associada a doenças de alta morbidade e letalidade, carecer de cura, e só ser controlada com medidas de prevenção da infecção que dependem do diagnóstico.
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