HTLV-1-associated myelopathy in Spain
de-Mendoza, Carmen ; Pérez, Leire ; Rando, Ariadna ; Reina, Gabriel ; Aguilera, Antonio ; Benito, Rafael (Universidad de Zaragoza) ; Eirós, José María ; Rodríguez-Avial, Itziar ; Ortega, Diego (Universidad de Zaragoza) ; Pozuelo, María José ; Pena, María José ; Soriano, Vicente
Resumen: 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.
Idioma: Inglés
DOI: 10.1016/j.jcv.2023.105619
Año: 2023
Publicado en: JOURNAL OF CLINICAL VIROLOGY 169 (2023), 105619 [5 pp.]
ISSN: 1386-6532
Factor impacto JCR: 4.0 (2023)
Categ. JCR: VIROLOGY rank: 14 / 41 = 0.341 (2023) - Q2 - T2
Factor impacto CITESCORE: 22.7 - Infectious Diseases (Q1) - Virology (Q1)
Factor impacto SCIMAGO: 1.344 - Virology (Q1) - Infectious Diseases (Q1)
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI21-1717
Tipo y forma: Article (Published version)
Área (Departamento): Área Microbiología (Dpto. Microb.Ped.Radio.Sal.Pú.)
Exportado de SIDERAL (2024-11-22-12:10:49)
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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.
Idioma: Inglés
DOI: 10.1016/j.jcv.2023.105619
Año: 2023
Publicado en: JOURNAL OF CLINICAL VIROLOGY 169 (2023), 105619 [5 pp.]
ISSN: 1386-6532
Factor impacto JCR: 4.0 (2023)
Categ. JCR: VIROLOGY rank: 14 / 41 = 0.341 (2023) - Q2 - T2
Factor impacto CITESCORE: 22.7 - Infectious Diseases (Q1) - Virology (Q1)
Factor impacto SCIMAGO: 1.344 - Virology (Q1) - Infectious Diseases (Q1)
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI21-1717
Tipo y forma: Article (Published version)
Área (Departamento): Área Microbiología (Dpto. Microb.Ped.Radio.Sal.Pú.)
Exportado de SIDERAL (2024-11-22-12:10:49)
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Este artículo se encuentra en las siguientes colecciones:
articulos > articulos-por-area > microbiologia
Notice créée le 2024-02-19, modifiée le 2024-11-25