Iranian Journal of Basic Medical Sciences
Volume:16 Issue: 3, Mar 2013

The study of tumor viruses opens an exciting avenue for understanding the mechanisms of virus pathogenesis. Human T-cell lymphotropic virus-I (HTLV-I) is a member of Retroviridae family Deltaretrovirus genus. The vast majority of HTLV-I infected subjects (~95%) do not develop any significant diseases; however, a small proportion, about 2-3 percent, will develop associated diseases which usually occur after several decades of infection. The virus is endemic in several regions of the world, such as southwestern Japan, the Caribbean, Central Africa, South America, the Melanesian Islands and the Middle East. Khorasan provinces in northeast of Iran is an endemic area for this virus. Although, there are speculations for the origin of the virus in this area, the source of the virus still remains unknown. It has been known that HTLV-I was brought in the New World by human migrations. Historically the Silk Road has been one of the important parts of the ancient trade routes. It is also a land bridge between the Iranian plateau, central Asia and Indus valley. Therefore, it seems that the land routes of this road or the sea routes (more likely) has been facilitated the spreading of HTLV-I in Khorasan. HTLV-I was considered by researches from two different aspects. Firstly, HTLV-I is asymptomatic in more than 95 % of infected subjects, however, it can be considered as a neglected public health problem whose nature of transmission and diseases may be unknown to many health professionals. Furthermore, unscientific nomenclature in this part of the world by physicians causes threatening attitude and the lack of care in public health for HTLV-I, and prolongs the infection among people. Thus, HTLV-I infected subjects experience an “invisibility” of their demands and feel strong depression. Therefore, HTLV-I can be considered as a neglected public health problem and needs more attention from authorities. Secondly, HTLV-I pathogencity, its oncogenicity and inflammatory reactions is very important to bring it to attention of researches, In very small minority of infected subjects (2-5%), the virus is associated with two important human diseases: a neoplastic disease, adult T-cell leukemia/ lymphoma (ATL) and the inflammatory condition, HTLV-I- associated myelopathy/tropical spastic paraparesis (HAM/TSP). Moreover, there are studies which introduce this virus as a cause for infective dermatitis and uveitis. To share the spirit of the successful studies on Human T Lymphotropic Virus (HTLV-I), we hope that this special issue on HTLV-I and related diseases will provide good opportunity for scientific discussions and exchange of ideas, data and reagents and particularly introduce academic activities in this endemic region to our colleagues around the world. To promote such interactions, and to encourage participants to present results in Iranian Journal of Basic Medical Sciences (IJBMS), the clinical and basic articles are presented in the same issue. The HTLV-I studies around the world have already benefited from many collaborative and a relatively free flow of reagents. In case of HTLV-I, cellular and viral protein interactions open avenue for discovery of new classes of cellular modulators, which may induce cell cycle deregulation and disrupting host immune responses toward malignancy and autoimmunity. Therefore, we wish to encourage researchers to share their data and establish exciting series of collaborations on the field of oncogenicity and immunopathology. You are very welcome to the site of IJBMS in Mashhad University of Medical Sciences, and do not hesitate to contact us if you have any questions and queries.

The study of tumor viruses paves the way for understanding the mechanisms of virus pathogenesis, including those involved in establishing infection and dissemination in the host tumor affecting immune-compromised patients. The processes ranging from viral infection to progressing malignancy are slow and usually insufficient for establishment of transformed cells that develop cancer in only a minority of infected subjects. Therefore, viral infection is usually not the only cause of cancer, and further environmental and host factors, may be implicated. HTLV-I, in particular, is considered as an oncovirus cause of lymphoproliferative disease such as adult T cell leukemia/lymphoma (ATL) and disturbs the immune responses which results in HTLV-I associated meylopathy/tropical spastic parapresis (HAM/TSP). HTLV-I infection causes ATL in a small proportion of infected subjects (2-5%) following a prolonged incubation period (15-30 years) despite a strong adaptive immune response against the virus. Overall, these conditions offer a prospect to study the molecular basis of tumorgenicity in mammalian cells. In this review, the oncogencity of HTLV-I is being considered as an oncovirus in context of ATL.

High prevalence of human T-cell lymphotropic virus type 1 (HTLV-I) infection in the northeastern of Iran has been proven. However, there is no overall estimation of the infection in the country. This systematic review was conducted to make an accurate estimation of HTLV-I infection prevalence in the Iranian blood donors. All cross-sectional studies which had reported the prevalence of HTLV-I infection in the Iranian blood donors in both English and Persian languages until August 2011 were adopted. The inclusion criteria were proper sampling methods, adequate sample size, and valid measurement methods. The overall prevalence rate was estimated using meta-analysis as well as survey data analysis methods. From 843 electronic searched citations, and 245 surveys found in gray literatures, 13 studies met the inclusion criteria. They were from 7 provinces including Razavi Khorasan (0.38-1.16%), West Azarbaijan (0.34%), Ilam (0.21%), Hormozgan (0.18%), Alborz (0.11%), South Khorasan (0.04%), and Bushehr (0.01%). The overall estimation of the HTLV-I prevalence rate in Iranian blood donors was 0.119% (95% confidence interval (CI): 0.050- 0.287 percent). It is concluded that HTLV-I infection in Iranian blood donors is considerably prevalent. It is highly recommended to continue prevention programs such as strict blood screening.

Human T-cell lymphotropic virus (HTLV) types 1 and 2 belong to the Oncorna group of retroviridae, a large family of viruses, grouped initially by pathogenic features, but later revised on the basis of genome structure and nucleotide sequence. HTLV-I was the first discovered human retrovirus to be associated with a malignancy in 1980. The malignancy, first described by Uchiyama and co-workers in southwestern Japan, was named Adult T-cell Leukemia/Lymphoma (ATL) and characterized with cutaneous and respiratory involvement, hepatosplenomegaly, lymphadenopathy and various metabolic abnormalities such as hypercalcemia. The HTLV-I has been known to be endemic to certain parts of Iran like the province of Khorasan in the northeast since 1990, with a 2.3% prevalence rate of infection. The main manifestations of HTLV-I infection are neurologic and hematologic (such as ATL) disorders, but it has also other manifestations such as uveitis, arthritis, dermatitis, vitiligo and lymphocytic alveolitis. Its main neurologic manifestation is a chronic progressive myelopathy that is referred to HTLV-I Associated Myelopathy (HAM) in Japan and Tropical Spastic Paraparesis (TSP) in Caribbean. But other disorders such as peripheral neuropathy, polyradiculoneuropathy, myopathy, peripheral facial paresis, and so on have been reported too. In this review we wish to give some brief information on the different aspects (including epidemiology, pathogenesis and pathology, clinical findings, and treatment) of HTLV-I infection according to our twenty-year researches. The department of neurology of Mashhad University of Medical Sciences has been a pioneer in researches on HTLV-I in the last twenty years.

Human T Lymphocyte Virus Type one (HTLV-I) is a retrovirus that infects about 10-20 million people worldwide. Khorasan province in Iran is an endemic area. The majority of HTLV-I-infected individuals sustain healthy carriers but small proportion of infected population developed two progressive diseases: HAM/TSP and ATL. The proviral load could be a virological marker for disease monitoring, therefore in the present study HTLV-I proviral load has been evaluated in ATL and compared to HAM/TSP and healthy carriers. In this case series study, 47 HTLV-I infected individuals including 13 ATL, 23 HAM/TSP and 11 asymptomatic subjects were studied. Peripheral blood mononuclear cells (PBMCs) were investigated for presence of HTLV-I DNA provirus by PCR using LTR and Tax fragments. Then in infected subjects, HTLV-I proviral load was measured using real time PCR TaqMan method. The average age of patients in ATL was 52±8, in HAM/TSP 45.52±15.17 and in carrier’s 38.65±14.9 years which differences were not statistically significant. The analysis of data showed a significant difference in mean WBC among study groups (ATL vs HAM/ TSP and carriers P=0.0001). Moreover, mean HTLV-I proviral load was 11967.2 ± 5078, 409 ± 71.3 and 373.6 ± 143.3 in ATL, HAM/TSP and Healthy Carriers, respectively. The highest HTLV-I proviral load was measured in ATL group that had a significant correlation with WBC count (R=0.495, P=0.001). The proviral load variations between study groups was strongly significant (ATL vs carrier P=0.0001; ATL vs HAM/TSP P= 0.0001 and HAM/TSP vs carriers P< 0.05). The present study demonstrated that HTLV-I proviral load was higher in ATL group in comparison with HAM/TSP and healthy carriers. Therefore, HTLV-I proviral load is a prognostic factor for development of HTLV-I associated diseases and can be used as a monitoring marker for the efficiency of therapeutic regime.

Human T-Cell Lymphotropic Virus Type I (HTLV-I) associated myelopathy/ tropical spastic paraparesis (HAM/TSP) is an endemic disease observed in Japan, Africa, Caribbean basin, and north-east Iran. It is usually presented as a chronic and progressive spastic paraparesis. There are some options for treatment of HAM/TSP patients. The aim of this study was to compare the effects of danazol controlled with placebo in relieving the symptoms and signs of HAM/TSP patients. Among 77 patients with definite diagnosis of HAM/TSP based on clinical and para-clinical findings, 71 patients had the required criteria for entering the study. Severity of symptoms and the degree of motor disability were determined before the beginning of treatment based on motor disability grading (MDG) in both groups of patients and were followed during 6 months in 1 month intervals for changes in symptoms and their motor disabilities. Among 38 patients of the first group, after 6 months therapy with danazol, mean difference between MDG0 (before starting the treatment) and MDG6 (after six months), as an indicator of motor improvement in the patients, was 0.89. Meanwhile, among the 33 patients treated with identical appearing placebo, there was no significant difference between MDG0 and MDG6 (P< 0.001). Moreover, there was a significant difference in improvement of symptoms between two study groups. This study showed that danazol provides relative effects on improving motor disabilities and symptoms of HAM/TSP patients that can be considered according to its lower side effects compared to other suggested treatments such as corticosteroids, and its lower costs in particular patients.

Few studies have shown the association between HTLV-I infection and coronary artery disease (CAD). HTLV-I has been detected in heart autopsies, particularly in lymphoma\leukemia cases. Mashhad and Neyshabour (Razavi Khorasan Province, Iran) are endemic regions for HTLV-I. Therefore, the present study was carried out to evaluate the impact of HTLV-I on CAD in Neyshabourian patients. 7590 patients admitted to Razavi and Imam Reza Hospitals (2007-2008) were included in this study. The seroprevalance of HTLV-I infection was determined by the ELISA method and confirmed with the PCR method. Statistical analyses were performed using the SPSS software. Out of the 7590 studied subjects, 564 patients were born and had resided in Neyshabour. The HTLV-I sero-prevalence among these subjects was 13% (n=73). 294 subjects had an abnormal angiography (CAD) and among them 43 (14.6%) were sero-positive for HTLV-I. In the remaining 227 subjects who had a normal angiography, 30 cases were HTLV-I seropositve. The PCR test was performed on 35 cases in order to confirm the presence of infection, which was positive in 31. Regarding the initial population of 294, the rate of PCR-confirmed infection was 10.54%. This sero-prevalence of HTLV-I in subjects with heart complications in Neyshabour was nearly 3 times more than the general population of this city (10.5 % vs 3.4%). However, the results of this study show that in addition to HTLV-I infection, there might be other co-factors leading to the development of heart complications in Neyshabour.

Since each unit of Intravenous Immunoglobulin (IVIG) is obtained from different blood donors, blood-borne viral diseases is of high importance. We aimed at investigating the prevalence of various viral infections: Human T-cell Lymphotropic Virus Type 1 (HTLV-I), Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV) among patients referred for IVIG therapy section in Mashhad University of Medical Sciences, Mashhad, Iran. A prospective study was conducted on 130 IVIG recipients admitted to different wards of our Medical Centre: Immunology, Hematology, and Neurology, in 2010. After filling the informed consent form, a 5 cc blood sample was initially taken from each patient. Viral infections including HTLV-I Ab, HIV-Ab, HBsAg, HBc-Ab, and HBV-Ab were assessed using the ELISA technique before and after six three months treatment. Test results for HTLV-I Ab, HBsAg, HBc Ab, HIV Ab, and HCV Ab were negativein all cases before IVIG therapy. After receiving IVIG, two female cases with CIDP showed positive results for HBV Ab (0.8%) and HBS Ag (0.8%) with ELISA and only one patient confirmed with PCR. There was not any significant relation between HBV Ag (P=0.14) and HBC Ab with type of disorder (P=0.66). This study showed that HTLV-I viral replication and the other investigated viral transmissions do not occur in plasma; therefore, the IVIG products are safe.

Human T-cell lymphotropic virus type-1 is an oncornavirus that causes adult T cell leukemia (ATL) HTLV-I-associated myelopathy⁄tropical spastic paraparesis (HAM/TSP). Golestan province is located in North West of Khorasan province known as an endemic area for HTLV-I in Iran. This study aimed to evaluate seroprevalence of HTLV-Iin Golestan province. In this cross-sectional descriptive study in 2007, blood samples were collected from 2034 healthy people residing in different parts of Golestan province. Sera were assessed for HTLV-I/II–specific antibodies by ELISA method and reactive samples were confirmed by Western blot. Demographic and serologic data were entered in SPSS version 11.5 and statistical analysis was performed. An overall HTLV-I/II prevalence of 0.7% was observed in 15 cases by ELISA. Six out of 15 were confirmed as HTLV-I by western blot. Regional variation in the prevalence of HTLV-I was observed; 0%, 0%, 0.1%, 1.9%, 0.3%, 0%, and 2.6% tested HTLV-I-positive from west to east of Golestan Province regions, respectively. Seropositivity increased with age. No association between HTLV-I infection and sex status was detected. Highest rate of HTLV-I seroprevalence was shown in east of this region located in neighborhood with Khorasan province, the only confirmed endemic area in Iran. It seems that eastern area of our province is endemic for HTLV-I. Further comprehensive detailed epidemiological and molecular studies are recommended.

Although HTLV-I infection is endemic in different geographical parts of the world including Northeast of Iran, there have been no documents of HTLV-II infection in this region. It is reported that one possible reason for seroindeterminate state in HTLV western blot is HTLV-II virus. This study aimed to investigate the presence of HTLV-II among blood donors with seroindeterminate western blot results. Three ml whole blood obtained from 50 blood donors referring to Mashhad Blood Transfusion Organization who had reactive Elisa for HTLV-I and seroindeterminate HTLV western blot state. A conventional PCR was applied to detect HTLV-I provirus using specific primers while a nested PCR was designed with specific external and internal primers for the detection of HTLV-II. The average age of participants, 39 males and 11 females, was 37.12± 14.36 years. The average OD of the Elisa assay was 1.767± 1.195. The most common indeterminate patterns were Rgp46-II alone (n=12, 27.3%), Rgp46-I alone (n=7, 15.9%), and Rgp46-I with GD21 (n=7, 15.9%).After introducing the DNA to the PCR tests, results revealed 10 (20%) HTLV-I PCR positive samples while no HTLV-II positive sample was detected by nested PCR. There were no significant age, blood group, Optical Density of the Elisa assay, and western blot indeterminate pattern differences between HTLV-I PCR positive and negative samples. No HTLV-II positive sample was detected in this study which confirms the absence of HTLV-II infection in this region. However, high frequency of HTLV-I PCR positive samples among the seroindeterminate cases implies on the important role of molecular techniques for further confirmation of the infection.

Human T lymphotropic virus type I (HTLV-I) is a retrovirus which is associated with adult T cells leukaemia (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in a minority of HTLV-I-infected individuals. It is not clear why a minority of HTLV-I-infected individuals develop HAM/TSP and majority remains lifelong carriers. It seems that the interaction between the virus and the immune response plays an important role in HTLV-I-associated diseases. Although the role of the immune response in HTLV-I pathogenesis is not fully understood, however it seems that the efficacy of the immune response which is involved in controlling or limiting of viral persistence determines the outcome of HTLV-I-associated diseases. Here we discuss the role of innate and adaptive immune response and also the risk factors contribute to the observed differences between HAM/TSP patients and asymptomatic HTLV-I carriers.

Non-Hodgkin’s lymphoma (NHL) is a lymphoproliferative malignancy in which cells undergo microscopic changes with unknown etiology, and risk factors such as age, sex, genetic and environmental factors are involved. The relationship between the presence of infectious agents and the development of lymphoproliferative diseases has been an interesting research topic. HTLV-I (Human T Cell Lymphotropic Virus Type- 1) predisposes the infected individulas to opportunistic neoplasms and lymphoid malignancies. HCV (Hepatitis C Virus) the etiologic agent of hepatitis C, is hepatotropic, and long-term infection with HCV can continuously stimulate and expand lymphocyte clones, resulting in further transformation and finally aggressive malignancies. 54 tissue samples diagnosed with NHL were selected to be studied for the presence of HTLV-I and HCV viruses. DNA and RNA were extracted from samples, cDNA was synthesized and using specific primers presence of HTLV-I and HCV viruses were investigated by PCR and nested RT-PCR methods. In 10 out of 54 (18.8%) samples (7 men and 3 women), HTLV-I was present, and 4 out of 54 (7.4%) samples (3 men and one woman) were positive for HCV. Based on our results, it is recommended that in patients with NHL, infection with HTLV-I and HCV viruses need to be screened.

Infection caused by Human T-Lymphotropic Virus Type 1 (HTLV-I) can be observed in some areas of Iran in form of endemic. Most of the cases are asymptomatic, and few cases progress to malignancies and neural diseases. Designing and implementing a model to screen people especially in endemic regions can help timely detection ofinfected people and improve the prognosis of the disease. In this study, results of the complete blood count (CBC-diff) for 599 healthy people and the patients with different types of Leukemia and HTLV-I have been examined. Modeling was made using CHAID method. The final model was carried out based on the number of white blood cells (WBC), platelets, and percentages of eosinophils. The accuracy of the final model was 91%. By applying this model to the CBC diff results of people without symptoms or miscellaneous patients in endemic regions of our country, disease carriers can be identified and referred for supplementary tests. With regard to the prevalence of different complications in infected people, these individuals can be identified earlier, leading to the improvement of the prognosis of this disease and the increase of the health status especially in endemic regions.

Systemic lupus erythematosus (SLE) is an autoimmune disease with unknown etiology. Some environmental factors can induce SLE in genetically susceptible individuals; for example, sun exposure and some viral infections may emerge the disease manifestations. Human T lymphotropic virus type 1 (HTLV-I) can dysregulate the human immune system, and the role of this virus in the pathogenesis of autoimmune diseases is under investigation. There are conflicting data about the role of HTLV-I in the pathogenesis of several autoimmune diseases such as SLE. In this study, we have focused on the correlation between HTLV-I infection and SLE in the northeast of Iran, an endemic area for the virus. One hundred and thirty women with SLE and 915 healthy controls were screened for HTLV-I by enzyme linked immunosorbent assay (ELISA). Western blot method was used for confirmation of the positive results done by ELISA in the patients and the control group. Two (1.5%) of the patients and 23 (2.5%) of the healthy controls were HTLV-I seropositive. There was not a statistical difference between patients and controls in the number of HTLV-I seropositive samples (P=0.49). This cross-sectional case-control study did not find any association between HTLV-I and SLE. With regard to the previous studies, these controversies may stem from differences in ethnic background. Geographical and environmental factors should also be taken into account.

The underlying mechanisms leading to the development of human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) in HTLV-I infected individuals are not fully understood. Host genetic factors appear to be involved as risk factors for developing HAM/TSP. We investigated the possible contribution of interleukin-10 (IL-10) as a risk factor to HAM/TSP by comparing frequencies of promoter region single nucleotide polymorphisms in HTLV-I infected Iranian patients who either remained asymptomatic or developed HAM/TSP and asymptomatic HTLV-I carriers. Healthy, uninfected individuals from the same region served as healthy controls. Significant differences were observed in the distribution of IL-10 promoter alleles and genotypes at position -819 and -592 between HAM/TSP patients and healthy controls (P=0.01), and between HTLV-I carriers and healthy controls (P=0.02). The frequency of the low IL-10 producer haplotype (-1082*A, -819*T, -592*A) was significantly associated with HTLV-I carriage or HAM/TSP compared with healthy controls (P= 0.02 and 0.01, respectively). Our results suggest that IL-10 -819*T and -592*A alleles are significant risk factors for developing HTLLV-I infection but do not appear to convey additional risk for developing HAM/TSP.

The underlying mechanisms leading to the development of human T-cell lymphotropic virus type I (HTLV-I) associated myelopathy/tropical spastic paraparesis (HAM/TSP) in HTLV-I infected individuals are not fully understood. Host genetic factors appear to be involved as risk factors for developing HAM/TSP. We investigated the possible contribution of interleukin-10 (IL-10) as a risk factor to HAM/TSP by comparing frequencies of promoter region single nucleotide polymorphisms in HTLV-I infected Iranian patients who either remained asymptomatic or developed HAM/TSP and asymptomatic HTLV-I carriers.Healthy, uninfected individuals from the same region served as healthy controls. Significant differences were observed in the distribution of IL-10 promoter alleles and genotypes at position -819 and -592 between HAM/TSP patients and healthy controls (P=0.01), and between HTLV-I carriers and healthy controls (P=0.02). The frequency of the low IL-10 producer haplotype (-1082*A, -819*T, -592*A) was significantly associated with HTLV-I carriage or HAM/TSP compared with healthy controls (P=0.02 and 0.01, respectively). Our results suggest that IL-10 -819*T and -592*A alleles are significant risk factors for developing HTLLV-I infection but do not appear to convey additional risk for developing HAM/TSP.

HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is the most common neurological manifestation of HTLV-I. The northeast of Iran is an endemic area for this virus. Host genetic and viral factors play important roles in developing HAM/TSP. The aim of this study was to evaluate the proviral load, and clinical features of HAM/TSP among Iranian to compare with other endemic parts of the world. In this systematic retrospective study, HTLV-I proviral load of 102 Iranian patients with HAM/TS,P and 34 healthy carriers in peripheral blood mononuclear cells (PBMCs) were measured using real-time quantitative PCR assay. The diagnosis of HAM/TSP was made in accordance with the World Health Organization criteria. The mean HTLV-I proviral load of Iranian HAM/TSP patients (626 ± 53.03 copies/ 104 PBMCs) was lower than other populations (in Japanese about 800 copies/104 PBMCs and in Brazilians 912.5 ± 778.6 copies/104 PBMCs). In contrast, the mean HTLV-I proviral load amongst Iranian healthy carriers (193 ± 44.375 copies/104 PBMCs) was higher than that of Japanese healthy carriers (about 140 copies/104 PBMCs), and lower than Brazilians (240.5 ± 452.8 copies/104 PBMCs according to the literatures). The most common HAM/TSP neurological symptoms among Iranian, Japanese, and Brazilian populations were gait disturbance, urinary disturbance, paresthesias, weakness, constipation, and lower back pain. The HTLV-I proviral load in HAM/TSP patients and healthy carriers was not significantly associated with age and gender. Differences in HTLV-I proviral load and consequently clinical manifestations among Iranian and other endemic populations might be due the differences in host genetic background and environmental conditions of these populations.

Infection with the human T-cell lymphotrophic virus type-I (HTLV-I) is endemic in Mashhad, Iran. In our research we evaluated the relation between exposure to this infection and the occurrence of dermatologic manifestations. 100 blood donors, who were seropositive but asymptomatic for infection with HTLV-I, were selected as case group. They were identified by the Blood Transfusion Organization Mashhad via the ELISA test and documented by PCR. Another 100 blood donors, that were seronegative for HTLV-I via the ELISA test and who were matched to the case group for age, gender, and existence of systemic diseases, were considered as the controls. Dermatologic evaluations and skin biopsies were performed if deemed necessary, and the results were statistically analyzed. 73% of the case and control groups were male, while 27% in each of these groups were female. The mean age in both groups was 40.96±11.94 years. The examination indicated that 58% of the case group and 37% of the control group had cutaneous manifestations (P<0.01). The most common diseases found in the case group were aphthous stomatitis, herpes labialis, and non-genital warts, while common diseases found in the control group were herpes labialis, aphthous stomatitis, and skin tag. The frequency of aphthous stomatitis, eczema, and non-genital warts in the case group were significantly more than the control group (P<0.05). Cutaneous diseases can be found more frequent in asymptomatic carriers of HTLV-I than those who are HTLV-I seronegative. The aphthous stomatitis, eczema, and non-genital warts are more prevalent in those infected by HTLV-I.

Lichen Planus is a common disease with unknown etiology which affects the skin and mucosa. Recent studies have focused on the possible role of the virus in the pathogenesis of Lichen Planus. The purpose of this study was to determine the association between the human T-cell lymphotropic virus type I and Lichen Planus. Methods and Materials: This case control study was conducted on a total of 200 patients. The case group consisted of 100 patients with a confirmed histopathological diagnosis of lichen planus disease and the control group consisted of 100 healthy blood donors without any signs or symptoms of skin diseases, who were similar in age and sex to the case group. Blood samples of both participants in the case and control group were examined for the presence of anti –HTLV-I antibodies using the ELISA method. The polymerase chain reaction for human T-cell lymphotropic virus type I was conducted in cases in which the anti- human T-cell lymphotropic virus type I antibody was positive, and statistical analysis was conducted on the obtained results. One case in the case group was infected with human T-cell lymphotropic virus type I; however, no infection was observed in the control group. The difference was not statistically significant (P = 1). Based on the obtained results, no association was observed between human T cell lymphotropic virus type I infection and Lichen Planus.

One of the different types of skin leishmaniasis is the Chronic Lupoid Leishmaniasis (CLL), which is caused by abnormal immune response. On the other hand, HTLV-I has been known to exist in some infectious diseases. Human T cell lymphotropic virus type1 (HTLV-I) and cutanous leishmaniasis exists endemically in Mashhad. The objective of this study was to evaluate the prevalence of HTLV-I in CLL patients. This cross sectional study involved 51 CLL patients admitted to cutaneous leishmaniasis clinics of Ghaem and Imam Reza hospitals in Mashhad, Iran. The blood samples were examined for serology tests through ELISA method. The results of the experiments for evaluating the existence of HTLV-I in 51 patients under study in this research were proved to be negative. According to this pilot study, the distribution of HTLV-I in CLL patients is not higher than normal population