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Gut Microbiome Dysbiosis is Associated With Human T‐Lymphotropic Virus Type 1 (HTLV‐1) Infection and Disease Progression to HTLV‐1‐Associated Myelopathy/Tropical Spastic Paraparesis: A Cross‐Sectional Study

L. A. Fernandes, Ana Olívia Winiemko de Souza, Y. Nukui, R. Marcusso, A. C. D. de Oliveira, J. Casseb, P. B. Clissa, Silas G. Villas-Boas et al.

Smart Medicine, 2026

112 participants · 3 citations

Abstract

Human T‐lymphotropic virus type 1 (HTLV‐1)‐associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic neuroinflammatory disease. Given the established role of the gut‐brain axis in other neurological diseases such as multiple sclerosis, the role of the gut microbiome in the pathogenesis of HAM/TSP remains a critical unexplored area. The aim of this study was to characterize alterations in the gut microbiome associated with HTLV‐1 infection and its clinical stages. We performed a cross‐sectional analysis of the gut microbiome from 112 Brazilian individuals, including 24 healthy controls and 88 HTLV‐1‐infected individuals at different disease stages: 38 HAM patients, 17 patients with intermediate syndromes, and 33 asymptomatic carriers. Fecal samples were collected and analyzed using Illumina MiSeq sequencing to assess bacterial composition and diversity. Functional analysis was performed to identify differentially enriched gene categories and Kyoto Encyclopedia of Genes and Genomes (KEGG) modules. Significant dysbiosis was observed in HTLV‐1‐infected individuals, characterized by reduced bacterial diversity, an inverted Firmicutes/Bacteroidetes ratio, and specific changes in bacterial genera. Notably, HAM patients exhibited decreased Faecalibacterium and increased Ruminococcus_g2 abundance. These associations should be interpreted with caution, as patient cohorts were significantly older and differed in sex distribution from healthy controls. Functional…

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