Clinical features of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in northeast Iran

Abstract

This study aimed to introduce clinical manifestations of patients in northeast Iran with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and describe the epidemiological features, as well as risk factors for HTLV-1 infection. This is a cross-sectional study of HTLV-1 infected cases and HAM/TSP patients referred by outpatient neurology clinics as well as Mashhad Blood Transfusion Center from 2005 to 2010. The study comprises 513 cases, including 358 healthy carriers (HCs) and 145 HAM/TSP patients. The majority of carriers were male (73.5%), whereas 67.6% of HAM/TSP sufferers were female (P < 0.001). The mean age of HAM/TSP patients and HCs was 45.9 ± 13.6 and 39.5 ± 11.58 years, respectively (P < 0.001). The history of transfusion, surgery, hospitalization and cupping was observed in a significant greater number of HAM/TSP patients than the HCs (P < 0.001, P < 0.001, P < 0.001 and P = 0.029, respectively). Gait disturbance was the most common complaint in HAM/TSP patients (72.4%). This research develops an HTLV-1 data registry in an endemic area such as Mashhad which can serve useful purposes, including evaluation of clinical and laboratory characteristics of HAM/TSP patients and epidemiological data of HTLV-1-infected cases.

Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon

“…This increment may be associated with the overtime accumulation of risky sexual exposure or of other transmission risk factors 25 , 26 , 27 . A study showed that among HTLV-I positive blood donor carriers from Iran, males predominated, probably reflecting the lower tradition of female blood donors in this country, whereas among HAM/TSP patients, females predominated 28 . …”

Can HTLV-1 Infection Be a Potential Risk Factor for Atherosclerosis?

“…HTLV-1 infection is endemic in certain parts of the world including southwestern Japan, Central Africa, the Caribbean islands, regions of South America, Australo-Melanesia as well as Khorasan Razavi, a province in northeastern Iran [7]. Based on epidemiological studies, it is estimated that about 2.3-3% of the general population in this province are infected with the HTLV-1 virus [8]. …”

“…HTLV-1 is believed to trigger several diseases such as adult T-cell leukemia, HTLV-1-associated myelopathy/tropical spastic paraparesis, sensorimotor polyneuropathy and optic neuritis [8]. There have been a few animal studies regarding HTLV-1 atherogenicity [9].…”

Is human T‐lymphotropic virus type 1 infection associated with hearing loss?

“…HTLV‐1 infection may cause diverse neurological presentations such as myelopathy, cerebellar ataxia, dementia, myositis, vertigo, nystagmus, cranial neuropathy, polyneuropathy, optic neuritis, and an amyotrophic lateral sclerosis–like syndrome . Various mechanisms have been proposed regarding the pathogenesis of central nervous system involvement.…”

“…1,7 HTLV-1 infection may cause diverse neurological presentations such as myelopathy, cerebellar ataxia, dementia, myositis, vertigo, nystagmus, cranial neuropathy, polyneuropathy, optic neuritis, and an amyotrophic lateral sclerosis-like syndrome. 1,[7][8][9][10] Various mechanisms have been proposed regarding the pathogenesis of central nervous system involvement. Direct attack of the virus to the neurons is not confirmed; however, indirect damage of the nervous system by lymphocytes and autoimmune mechanisms (both humeral and cellular) is a more acceptable hypothesis.…”