Abstract
PurposeHuman T-lymphotropic Virus type 1 (HTLV-1) was the first retrovirus to be identified and associated with oncogenic activity. It is estimated that approximately 10–20 million people in the world are infected with it. The clinical manifestations most commonly associated with HTLV-1 infection include T-cell leukemia/lymphoma and myelopathy associated to HTLV-1 infection. The purpose of this study is to describe clinical and demographic characteristics in pediatric patients with HTLV-1 infection.Methodology and PatientsAmbispective case series analysis, with collection of medical records and subsequent description of demographic data (sex, origin, age) and clinical characteristics in 16 patients with HTLV-1 infection were collected. Twelve of these patients were part of an initially reported cohort and four were recruited later in the study. The patients were collected between January 2017 and July 2021 in a pediatric institution in Cali, in a reference hospital in the southwest region of Colombia.ResultsThirteen of a total of sixteen patients came from the Colombian Pacific coast, where nine were with significant nutritional deficiencies. Seven showed dermatological compromise. Eight patients presented images compatible with inflammation and chronic lung injury, and six of the eight patients were with opportunistic infections. Coinfection with other microorganisms was also observed where one case presented with meningeal tuberculosis, another patient presented with simultaneous infections, namely, malaria, leptospirosis and toxoplasmosis, and a third patient presented intestinal parasitosis and soft tissue infection by Streptococcus pyogenes. Three patients had concomitant autoimmune diseases and a fourth patient was highly suspicious of having polymyositis.ConclusionsThe different clinical findings with simultaneous HTLV-1 infection broaden the panorama to suspect infection by this virus. More studies are required to achieve a direct association between structural lung disease, autoimmune diseases, immunodeficiency and HTLV-1 infection. This study aims to raise interest and awareness of an ancient but neglected disease.
Highlights
Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus with oncogenic properties that affects around 10 to 20 million people worldwide [1]
Few studies evaluate the clinical manifestations of this disease in children, most of the findings have focused in dermatologic manifestations, being infective dermatitis the main description
The nutritional status of the patients was evaluated according to the data provided in the clinical history, considering percentiles height for age in patients younger than 5 years and body mass index (BMI) for age in patients older than 5 years, finding nine of the sixteen patients with a classification of malnutrition
Summary
Human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus with oncogenic properties that affects around 10 to 20 million people worldwide [1]. The prevalence of HTLV-1 infection in children in Colombia is still unknown, being extrapolated from studies of this virus in other population groups such as blood donors and in endemic populations of the Pacific region [11]. A national study conducted by the country’s blood bank network demonstrated a prevalence of HTLV-1 and 2 antibodies in nationally donated blood between 2001 and 2014 of 0.3%. This value was higher in the state of Chocó with an antibody reactivity of 6.28% of the donated units, 20 times higher than the national average. It should be noted that the majority of infected people are asymptomatic or present mild symptoms (approximately 90% of the population), facilitating the different transmission mechanisms due to this carrier state [8, 11]
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