Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain
Autor:
Mendoza, Carmen de
; Pirón, María
; González, Rocío
; Jiménez, Ana
; Caballero, Estrella
; Roc, Lourdes
; Benito, Rafael
; Soriano, Vicente
; Corral, Octavio Jorge
; ...et al.
; Gómez-Gallego, Felix
Fecha:
02/2019Palabra clave:
Revista / editorial:
Open Forum Infectious DiseasesTipo de Ítem:
Articulo Revista IndexadaDirección web:
https://academic.oup.com/ofid/article/6/2/ofz036/5290444Resumen:
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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