Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies : on behalf of the Human T-lymphotropic Virus (HTLV) Spanish Network
De Mendoza, Carmen (Instituto de Investigación Sanitaria Puerta de Hierro)
Pérez, Leire (Hospital General Universitario Gregorio Marañón)
Fernández-Ruiz, Mario (Hospital Universitario 12 de Octubre (Madrid))
Pena López, María José (Hospital Universitario de Gran Canaria Dr. Negrín)
Ramos, José Manuel (Hospital General Universitario de Alicante (Alacant, País Valencià))
Richart, Alberto (Centro de Transfusión de la Comunidad de Madrid)
Piron, María (Banc de Sang i Teixits)
Rando, Ariadna (Hospital Universitari Vall d'Hebron)
Miró, Elisenda (Institut d'Investigació Biomèdica Sant Pau)
Reina, Gabriel (Clínica Universidad de Navarra)
Encinas, Beatriz (Instituto de Investigación Sanitaria Puerta de Hierro)
Rojo, Silvia (Hospital Clínico Universitario de Valladolid)
Rodríguez-Iglesias, Antonio Manuel (Universidad de Cádiz. Departamento de Microbiología)
Benito, Rafael (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Aguilera, Antonio (Universidade de Santiago de Compostela)
Treviño, Ana (Universidad Internacional de La Rioja)
Corral, Octavio (Universidad Internacional de La Rioja)
Soriano, Vicente (Universidad Internacional de La Rioja)

Fecha:	2022
Resumen:	Objectives: Although only 10% of persons infected with human T-lymphotropic virus type 1 (HTLV-1) may develop virus-associated illnesses over their lifetime, missing the earlier diagnosis of asymptomatic carriers frequently leads to late presentation. Methods: A nationwide HTLV-1 register was created in Spain in 1989. We examined the main demographics and clinical features at the time of the first diagnosis for more than three decades. Results: A total of 428 individuals infected with HTLV-1 had been reported in Spain until the end of 2021. Up to 96 (22%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (57%), T-cell lymphoma (34%), or Strongyloides stercoralis infestation (8%). Since 2008, HTLV-1 diagnosis has been made at blood banks (44%) or clinics (56%). Native Spaniards and Sub-Saharan Africans are overrepresented among patients presenting with HTLV-1-associated illnesses suggesting that poor epidemiological and/or clinical suspicion, which led to the late presentation are more frequent in them than carriers from Latin America (LATAM) (31. 7% vs 20. 4%, respectively; P = 0. 015). Conclusion: HTLV-1 infection in Spain is frequently diagnosed in patients presenting with characteristic illnesses. Although screening in blood banks mostly identifies asymptomatic carriers from LATAM, a disproportionately high number of Spaniards and Africans are diagnosed too late at the time of clinical manifestations. Expanding testing to all pregnant women and clinics for sexually transmitted infections could help to unveil HTLV-1 asymptomatic carriers.
Ayudas:	Instituto de Salud Carlos III PI21/1717
Nota:	Altres ajuts: Fundación Mutua Madrileña (AP-174112020).
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	HTLV-1 ; Myelopathy ; Diagnosis ; Late presentation ; Sexually transmitted infections
Publicado en:	International journal of infectious diseases, Vol. 122 (september 2022) , p. 970-975, ISSN 1878-3511

DOI: 10.1016/j.ijid.2022.07.043
PMID: 35902023

6 p, 1.5 MB

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