131698 20241125101159.0 doi 10.1016/j.jcv.2023.105619 sideral 137163 ART-2023-137163 eng de-Mendoza, Carmen HTLV-1-associated myelopathy in Spain 2023 Background 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. info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI21-1717 info:eu-repo/semantics/closedAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 4.0 2023 VIROLOGY 14 / 41 = 0.341 2023 Q2 T2 1.344 2023 Virology 2023 Q1 Infectious Diseases 2023 Q1 22.7 2023 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Pérez, Leire Rando, Ariadna Reina, Gabriel Aguilera, Antonio Benito, Rafael Universidad de Zaragoza (orcid)0000-0001-5134-1006 Eirós, José María Rodríguez-Avial, Itziar Ortega, Diego Universidad de Zaragoza Pozuelo, María José Pena, María José Soriano, Vicente 1011 630 Universidad de Zaragoza Dpto. Microb.Ped.Radio.Sal.Pú. Área Microbiología 169 (2023), 105619 [5 pp.] J. clin. virol. JOURNAL OF CLINICAL VIROLOGY 1386-6532 409946 http://zaguan.unizar.es/record/131698/files/texto_completo.pdf Versión publicada 2119121 http://zaguan.unizar.es/record/131698/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:131698 articulos driver 2024-11-22-12:10:49 ARTICLE