Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain

Mendoza, Carmen de ; Pirón, María ; González, Rocío ; Jiménez, Ana ; Caballero, Estrella ; Roc, Lourdes ; Benito, Rafael (Universidad de Zaragoza) ; Ramos, José Manuel ; Soriano, Vicente

Resumen: Background: although only 8%-10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods: a nationwide HTLV-1 register was created in Spain in 1989. A total of 351 infected persons had been reported by the end of 2017. We examined all new HTLV-1 diagnoses during the last decade and compared their clinical presentation. Results: a total of 247 individuals with HTLV-1 infection had been reported in Spain since year 2008. The incidence has remained stable with 20-25 new diagnoses yearly. Women represented 62%. Only 12% were native Spaniards, most of whom were foreigners from Latin America (72.5%). Up to 57 (23%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (n = 24; 42.1%), T-cell lymphoma (n = 19; 33.3%), or Strongyloides stercoralis infestation (n = 8; 14%). Human T-cell leukemia virus type 1 diagnosis had been made either at blood banks (n = 109; 44%) or at clinics (n = 138; 56%). It is interesting to note that Spaniards and especially Africans were overrepresented among patients presenting with HTLV-1-associated illnesses, suggesting that misdiagnosis and late presentation are more frequent in these populations compared to Latin Americans. Conclusions: given that 23% of new HTLV-1 diagnoses in Spain are symptomatic, underdiagnosis must be common. Although screening in blood banks mostly identifies asymptomatic Latin American carriers, a disproportionately high number of Spaniards and Africans are unveiled too late, that is, they already suffer from classic HTLV-1 illnesses.

Idioma: Inglés

DOI: 10.1093/ofid/ofz036

Año: 2019

Publicado en: Open Forum Infectious Diseases 6, 2 (2019), ofz036 [4 pp]
ISSN: 2328-8957

Factor impacto JCR: 3.656 (2019)

Categ. JCR: IMMUNOLOGY rank: 68 / 158 = 0.43 (2019) - Q2 - T2
Categ. JCR: MICROBIOLOGY rank: 45 / 133 = 0.338 (2019) - Q2 - T2
Categ. JCR: INFECTIOUS DISEASES rank: 28 / 93 = 0.301 (2019) - Q2 - T1

Factor impacto SCIMAGO: 1.449 - Oncology (Q1) - Neurology (clinical) (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Microbiología (Dpto. Microb.Med.Pr.,Sal.Públ.)