Clinical manifestations in individuals with recent diagnosis of HTLV type I infection

Abstract

Background Human T-lymphotropic virus type 1 (HTLV-1) is known to cause HTLV-associated myelopathy (HAM)/tropical spastic paraparesis and adult T cell leukemia. A growing body of evidence links HTLV-1 infection with an increasing spectrum of disease, including uveitis, periodontal disease, arthropathy, sicca syndrome, and neurologic deficits. Objectives Despite recent findings, the natural history of HTLV-1 infection remains poorly defined. This study was designed to better characterize initial clinical and neurological findings in individuals diagnosed with HTLV-1 infection. Study design We conducted a cross-sectional study of 71 individuals recently diagnosed with HTLV-1 and 71 uninfected age- and sex-matched blood donors in Salvador, Brazil. Subjects were administered a standardized questionnaire and underwent physical exam. Results HTLV-1 infected subjects were significantly more likely than controls to report complaints of hand and foot numbness (OR = 5.3; 95% CI: 1.8–15.3; p = 0.002 and OR = 4.0; 95% CI: 1.3–12; p = 0.013 respectively), difficulty running (OR = 4.0; 95% CI: 1.1–14.2; p = 0.032), nocturia (OR = 5.0; 95% CI: 1.1–22.8; p = 0.038), arthralgia (OR = 3.3; 95% CI: 1.4–7.7; p = 0.006), and photophobia (OR = 3.3; 95% CI: 1.4–7.7; p = 0.006). Conclusions Neurologic, ocular and rheumatologic complaints may be the first manifestations of HTLV-1 infection. Therefore, all patients presenting with initial diagnosis should be rigorously screened for these symptoms.