Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies

Identificadores
URI: http://hdl.handle.net/10498/28007
DOI: 10.1016/j.ijid.2022.07.043
ISSN: 1201-9712
Files
Statistics
Metrics and citations
Share
Metadata
Show full item recordAuthor/s
de Mendoza, Carmen; Pérez, Leire; Fernández-Ruiz, Mario; Pena, María José; Ramos, José Manuel; Richart, Alberto; Piron, María; Rando, Ariadna; Miró, Elisenda; Reina, Gabriel; Encinas, Beatriz; Rojo, Silvia; Rodríguez Iglesias, Manuel Antonio
Date
2022-09Department
Biomedicina, Biotecnología y Salud PúblicaSource
International Journal of Infectious Diseases Volume 122, September 2022, Pages 970-975Abstract
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. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )
Subjects
HTLV-1; Myelopathy Diagnosis; Late presentation; Sexually transmitted infectionsCollections
- Artículos Científicos [4817]
- Articulos Científicos Biomedicina [211]