Nationwide survey of HTLV‐I–associated myelopathy in Japan: Association with blood transfusion

Abstract

To study the epidemiology of human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Japan, we conducted two nationwide surveys between October 1986 and March 1989. A total of 710 patients with HAM (definite HAM, 589; probable HAM, 121) were reported. Of the 589 patients with definite HAM, 69% were residents of the areas with the highest prevalence HTLV-I in Japan. To determine the importance of blood transfusion in the pathogenesis of HAM/TSP, we performed a case-control study in the Kagoshima district in southern Japan. Significantly more patients with HAM reported a history of blood transfusion (26/129, or 20%) than did subjects in a health survey of the general population (41/1,290, or 3%; odds ratio = 7.7, p less than 0.001) or than did hospitalized neurological patients (6/119, or 5%; odds ratio = 4.8, p less than 0.001). Furthermore, the cumulative percentages of the intervals between blood transfusion and the onset of the symptoms of HAM fit a lognormal curve, suggesting that transfusion was an important common exposure. Blood transfusion probably transmitted HTLV-I to the patients with transfusion-associated HAM because there was a significant decrease in the number of patients with the transfusion-associated HAM who received blood after implementation of nationwide screening of blood donors in 1986 (p = 0.004). In the first 2 years, screening the blood supply in Japan appears to have decreased the number of reported patients with HAM by 16%.

Frequency of the CCRdelta32 allele in Brazilians: a study in colorectal cancer and in HTLV-I infection

“…However, 1 in every 1000-2000 individuals with positive serology per year develop adult T-cell leukemia/lymphoma (ATLL) (Poiesz et al, 1980;Tajima, 1990) and other patients may present with myelopathy (HAM) (Gessain et al, 1985). The prevalence of the latter has been estimated to be 2.4% in the United States (Murphy et al, 1997) but only about 0.07% among the Japanese (Osame et al, 1990). Several genetic aspects, viral or human, have been tested as possible determinants of clinical course of the HTLV-I infection.…”

Seroprevalencia del virus linfotrópico humano de tipos I y II en donantes del Banco de Sangre de la Fundación Valle del Lili, Cali, Colombia, 2008-2014

“…Se ha reportado la asociación entre el desarrollo de un tipo específico de enfermedad y la vía de transmisión del virus. Fujino, et al, concluyeron que el riesgo de desarrollar leucemia o linfoma de células T por infección con el HTLV es mayor cuando el virus se adquiere a través de la leche materna (11); Osame, et al, demostraron que existía un mayor riesgo para el desarrollo de paraparesia espástica tropical o miopatía asociada al HTLV en pacientes que habían adquirido el virus por transfusión sanguínea (12). La infección simultánea con el virus de la inmunodeficiencia humana (HIV) se presenta con frecuencia en áreas urbanas de Europa y África, donde se ha encontrado con mayor frecuencia en pacientes que tienen linfoma de células T con complicaciones neurológicas, por lo cual se los considera en riesgo de complicaciones de mayor gravedad (13).…”

Monographs on the Evaluation of Carcinogenic Risks to Humans

“…Reliable estimates of TSPIHAM incidence and prevaIence are available only for Japan, sorne Caribbean areas and rare clusters in Africa and South America (Gessain & Gout, 1992). Thus, the prevaIence of TSPIHAM ranges from 8.6/100000 inhabitants in Kyushu (Japan) (Shibasaki et al, 1989;Kaplan et al, 1990;Osame et al, 1990) to 128/100000 in Mahé (Seychelles) (Gessain & Gout, 1992). Estimates of the annual incidence range from 0.04/100000 in Kyushu (Shibasaki et al, 1989;Kaplan et al, 1990) to 3/100000 in Lisala (Zaire) (Kayembe et al, 1990).…”

“…People infected with HTL V -1 through blood transfusion have a higher risk for developing TSP/HAM than people infected by other means (Gout et al, 1990;Osame et al, 1990). ln Japan and Martinique, up to 20% of TSP/HAM patients had a blood transfusion in the five years preceding onset of the disease.…”