Clinical presentation of individuals with human T-cell leukemia virus type-1 infection in Spain
De Mendoza, C.; Piron, M.; Jimenez, A.; Caballero, E.; Roc, L.; Benito, R.; Ramos, J. M.; Soriano, V.; Rodriguez, C.; Vera, M.; Del Romero, J.; Marcaida, G.; Ocete, M. D.; Molina, I.; Aguilera, A.; Rodriguez-Calvino, J. J.; Navarro, D.; Rivero, C.; Vilarino, M. D.; Algarate, S.; Gil, J.; Ortiz De Lejarazu, R.; Rojo, S.; Eiros, J. M.; San Miguel, A.; Manzardo, C.; Miro, J. M.; García Costa, Juan; PAZ VIDAL, MARIA ISABEL; Poveda López, Eva; Calderon, E.; Escudero, D.; Trigo, M.; Diz, J.; García Campello, Marta; Rodriguez-Iglesias, M.; Hernandez-Betancor, A.; Martin, A. M.; Gimeno, A.; Gutierrez, F.; Rodriguez, J. C.; Sanchez, V.; Gomez-Hernando, C.; Cilla, G.; Perez-Trallero, E.; Lopez-Aldeguer, J.; Fernandez-Pereira, L.; Niubo, J.; Hernandez, M.; Lopez-Lirola, A. M.; Gomez-Sirvent, J. L.; Force, L.; Cifuentes, C.; Pérez Castro, Sonia; Morano Amado, Luis; Raya, C.; Gonzalez-Praetorius, A.; Perez, J. L.; Penaranda, M.; Hernaez-Crespo, S.; Montejo, J. M.; Martinez-Sapina, A.; Viciana, I.; Cabezas, T.; Lozano, A.; Fernandez, J. M.; Garcia-Bermejo, I.; Gaspar, G.; Garcia, R.; Gorgolas, M.; Vegas, C.; Blas, J.; Miralles, P.; Valeiro, M.; Aldamiz, T.; Margall, N.; Guardia, C.; Do Pico, E.; Polo, I.; Aguinaga, A.; Ezpeleta, C.; Sauleda, S.; Torres, P.; Gonzalez, R.; Blanco, L.; Suarez, A.; Rodriguez-Avial, I.; Perez-Rivilla, A.; Parra, P.; Fernandez, M.; Fernandez-Alonso, M.; Trevino, A.; Requena, S.; Benitez-Gutierrez, L.; Cuervas-Mons, V.; Barreiro, P.; Corral, O.; Gomez-Gallego, F.
Identificadores
Identificadores
URI: http://hdl.handle.net/20.500.11940/15975
PMID: 30815504
DOI: 10.1093/ofid/ofz036
ISSN: 2328-8957
Fecha de publicación
2019Título de revista
Open forum infectious diseases
Tipo de contenido
Artigo
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.
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