000131698 001__ 131698 000131698 005__ 20241125101159.0 000131698 0247_ $$2doi$$a10.1016/j.jcv.2023.105619 000131698 0248_ $$2sideral$$a137163 000131698 037__ $$aART-2023-137163 000131698 041__ $$aeng 000131698 100__ $$ade-Mendoza, Carmen 000131698 245__ $$aHTLV-1-associated myelopathy in Spain 000131698 260__ $$c2023 000131698 5203_ $$aBackground HTLV-1 infection is a neglected disease. Over 10 million people are infected worldwide, with hot spots of high endemicity across all continents. Roughly 5% of HTLV-1 carriers develop HTLV-1-associated myelopathy (HAM), a progressive subacute neurological disabling disease. Methods We report the main features of patients diagnosed with HAM up to date in Spain, a non-endemic country with a relatively high migrant flow from Latin America and Equatorial Africa, where HTLV-1 is endemic. Results A total of 451 cases of HTLV-1 had been recorded in Spain until the end of year 2022. HAM had been diagnosed in 58 (12.9%). The current incidence is of 2–3 new cases per year. Women represent 76%. Mean age at diagnosis is 49 years-old. Nearly 60% are Latin Americans. Although sexual transmission is the most likely route of HTLV-1 acquisition, up to 6 individuals had been infected following solid organ transplantation. Rapid onset myelopathy developed in all but one of these transplant recipients from three HTLV-1-positive donors. HTLV-1 subtype 1a transcontinental was the only variant recognized in HAM patients. HTLV-1 proviral load was significantly greater in HAM patients than in asymptomatic HTLV-1 carriers (677 vs 104 HTLV-1 DNA copies/104 PBMC; p = 0.012). Symptom relief medications and physiotherapy have been the only treatment providing some benefit to HAM patients. Neither significant clinical nor virological efficacy was noticed using antiretrovirals in at least 9 HAM patients. Two thirds of HAM patients ended up in a wheelchair and with urinary/fecal sphincter incontinence. Conclusion HAM is the most frequent clinical manifestation of HTLV-1 infection in Spain, a non-endemic country. Middle aged women migrants from Latin America are the most frequently affected. Two thirds end up in a wheelchair despite using antiretroviral therapy. 000131698 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI21-1717 000131698 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000131698 590__ $$a4.0$$b2023 000131698 592__ $$a1.344$$b2023 000131698 591__ $$aVIROLOGY$$b14 / 41 = 0.341$$c2023$$dQ2$$eT2 000131698 593__ $$aVirology$$c2023$$dQ1 000131698 593__ $$aInfectious Diseases$$c2023$$dQ1 000131698 594__ $$a22.7$$b2023 000131698 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000131698 700__ $$aPérez, Leire 000131698 700__ $$aRando, Ariadna 000131698 700__ $$aReina, Gabriel 000131698 700__ $$aAguilera, Antonio 000131698 700__ $$0(orcid)0000-0001-5134-1006$$aBenito, Rafael$$uUniversidad de Zaragoza 000131698 700__ $$aEirós, José María 000131698 700__ $$aRodríguez-Avial, Itziar 000131698 700__ $$aOrtega, Diego$$uUniversidad de Zaragoza 000131698 700__ $$aPozuelo, María José 000131698 700__ $$aPena, María José 000131698 700__ $$aSoriano, Vicente 000131698 7102_ $$11011$$2630$$aUniversidad de Zaragoza$$bDpto. Microb.Ped.Radio.Sal.Pú.$$cÁrea Microbiología 000131698 773__ $$g169 (2023), 105619 [5 pp.]$$pJ. clin. virol.$$tJOURNAL OF CLINICAL VIROLOGY$$x1386-6532 000131698 8564_ $$s409946$$uhttps://zaguan.unizar.es/record/131698/files/texto_completo.pdf$$yVersión publicada 000131698 8564_ $$s2119121$$uhttps://zaguan.unizar.es/record/131698/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000131698 909CO $$ooai:zaguan.unizar.es:131698$$particulos$$pdriver 000131698 951__ $$a2024-11-22-12:10:49 000131698 980__ $$aARTICLE