Prevalence and clinical features of HTLV neurologic disease in the HTLV Outcomes Study

Orland, Jennie; Engstrom, John W.; Fridey, Joy; Sacher, Ronald A.; Smith, James W.; Nass, Catharie C.; Garratty, George; Newman, Bruce; Smith, Donna M.; Wang, B.; Loughlin, K.; Murphy, Edward L.

doi:10.1212/01.wnl.0000096011.92542.da

Cited by 151 publications

(120 citation statements)

References 31 publications

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“…TSP, designated HAM/TSP by a WHO working group, is characterized by a slowly progressive spastic paraparesis due to white matter degeneration and fibrosis of the thoracic spinal cord (191,192). HAM/TSP typically develops in up to 4% of HTLV-1-infected patients (273). The majority of individuals are diagnosed in the fourth or fifth decade of life.…”

Section: Viral Infections Infections Caused By Htlv-1/2mentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Section: Viral Infections Infections Caused By Htlv-1/2mentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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“…Human Tlymphotropic virus I and II (HTLV-I/II) are other transfusion-transmitted human retroviruses. HTLV-I is associated with adult T-cell leukemia/lymphoma and tropical spastic paraparesis myelopathy (TSP/HAM), and HTLV-II has been reported to be associated with neurological disorders [10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of serological markers and nucleic acid for blood-borne viral infections in blood donors in Al-Baha, Saudi Arabia

Almutairi

AlAhmari²,

Al-Zahran³

et al. 2016

J Infect Dev Ctries

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Introduction: Data on blood-borne viral infections in some regions in Saudi Arabia remain scarce. This study investigates the prevalence of serological markers and nucleic acid for blood-borne viruses among blood donors in Al-Baha, Kingdom of Saudi Arabia. Methodology: In this cross-sectional study, 2,807 donors who donated blood between January 2009 and November 2011 were investigated for blood-borne viral serological markers including HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, and anti-HTLVI/III in addition to viral nucleic acid. Results: All donors were males between 16 to 66 years of age (mean: 31.5 ± 9.3 years). Viral nucleic acid and/or serological markers were detected in a total of 36 (1.3%) donors; of them, 26 (72.2%) had nucleic acid concomitant with serological markers, 6 (16.7%) had only viral nucleic acid, while 4 (11.1%) had only serological markers. Of all donors, 22 (0.8%) had HBsAg, 227 (8.0%) had anti-HBc, 157 (5.0%) had anti-HBs, 2,577 (91.8%) had no HBV markers, 2 (0.07%) had anti-HIV, 1 (0.04%) had anti-HCV, and 1 (0.04%) had anti-HTLVI/II. The donors who were born during HBV vaccination era showed no HBsAg (0.0%; p = 0.052), lower rates of anti-HBc (1.5%; p < 0.001) and antiHBs (0.7%; p < 0.001), while the majority had no HBV markers (98.5%; p < 0.001). Conclusions: Combined viral nucleic acid and serological testing of donated blood enhances blood safety. The absence of HBV markers among donors suggests susceptibility or declined anti-HBs levels. Thus, HBV revaccination or a vaccine boost among adolescents and adults might be indispensable.

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“…It has been described that HTLV-II also may account for some unique cases 14,16,18,21 . Thus, the cases reported in this study may represent a common feature in the HIV/AIDS epidemic in countries where these two retroviruses are highly endemic, as is the case of Brazil.…”

Section: Discussionmentioning

confidence: 99%

“…Patients who have at least two pyramidal signs, such as paresis, hypertonicity or spasticity, hyperreflexia, clonus, diminished or absent superficial reflexes, or the presence of pathological reflexes (e.g., Babinsky, Hoffmann, or Trömner signals), were diagnosed as having myelopathy. It was excluded potential differential diagnosis such B12 deficiency, syphilis, thyroid dysfunction, or spinal cord compression 18 . Incapacity and functional disability scale (FDS), from a modified Kurtzke Disability Status Scale (EDSS) was used to grade the severity of motor symptoms of myelopathy 3 .…”

Section: Methodsmentioning

confidence: 99%

“…HTLV-II has not been etiologically linked with any disease, although a number of case reports and a few cross-sectional studies suggest an association with a tropical spastic paraparesis/HTLVassociated myelopathy (TSP)-like syndrome 4,17 . In addition, other manifestations such as pneumonia, bronchitis and urinary tract infection have been associated to HTLV-II infection 18 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical and epidemiological aspects of HTLV-II infection in São Paulo, Brazil: presence of Tropical Spastic Paraparesis/HTLV-Associated Myelopathy (TSP/HAM) simile diagnosis in HIV-1-co-infected subjects

Vergara

Montanheiro²,

Fukumori³

et al. 2006

Rev. Inst. Med. trop. S. Paulo

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SUMMARYIn this study, the epidemiological and clinical features observed in solely HTLV-II-infected individuals were compared to those in patients co-infected with HIV-1. A total of 380 subjects attended at the HTLV Out-Patient Clinic in the Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, Brazil, were evaluated every 3-6 months for the last seven years by infectious disease specialists and neurologists. Using a testing algorithm that employs the enzyme immuno assay, Western Blot and polymerase chain reaction, it was found that 201 (53%) were HTLV-I positive and 50 (13%) were infected with HTLV-II. Thirty-seven (74%) of the HTLV-II reactors were co-infected with HIV-1. Of the 13 (26%) solely HTLV-II-infected subjects, urinary tract infection was diagnosed in three (23%), one case of skin vasculitis (8%) and two cases of lumbar pain and erectile dysfunction (15%), but none myelopathy case was observed. Among 37 co-infected with HIV-1, four cases (10%) presented with tropical spastic paraparesis/ HTLV-associated myelopathy (TSP/HAM) simile. Two patients showed paraparesis as the initial symptom, two cases first presented with vesical and erectile disturbances, peripheral neuropathies were observed in other five patients (13%), and seven (19%) patients showed some neurological signal or symptoms, most of them with lumbar pain (five cases). The results obtained suggest that neurological manifestations may be more frequent in HTLV-II/HIV-1-infected subjects than those infected with HTLV-II only.

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Prevalence and clinical features of HTLV neurologic disease in the HTLV Outcomes Study

Abstract: Systematic screening of HTLV-infected blood donors reveals a high prevalence of HAM/TSP. The clinical course of HAM/TSP appears highly variable. HTLV-II-associated myelopathy generally presents with milder and more slowly progressive signs and symptoms.

Cited by 151 publications

References 31 publications

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Prevalence of serological markers and nucleic acid for blood-borne viral infections in blood donors in Al-Baha, Saudi Arabia

Clinical and epidemiological aspects of HTLV-II infection in São Paulo, Brazil: presence of Tropical Spastic Paraparesis/HTLV-Associated Myelopathy (TSP/HAM) simile diagnosis in HIV-1-co-infected subjects

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