Interferon Beta-1a Improves Urinary Symptoms, Reduces Proviral Load, and Modifies the Immune Response in a Patient with HAM/TSP

Davi Tanajura Costa,André Luiz Muniz,Lúcia Passos,Silvane Santos,Michael Sundberg

doi:10.1155/2012/958786

Abstract

The human T-cell lymphotropic virus type 1 (HTLV-1) is the known causative agent of a chronic neurologic condition known as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Although several therapies have been evaluated for HAM/TSP, none have been approved for use in humans. In this paper, we describe a 55-year-old female patient with HAM/TSP who was treated with interferon beta-1a. This patient, in comparison to 20 female patients with HAM/TSP who were not treated, showed improvement in urinary symptoms over four years of therapy, as well as a reduction in HTLV-1 proviral load and serum cytokine levels typically observed in HAM/TSP. This improved outcome merits further controlled studies on the use and efficacy of interferon beta-1a as a therapy for HAM/TSP.

Highlights

human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic, insidious neurologic disease that presents with impairment of lower limb strength, autonomic abnormalities including neurogenic bladder and bowel, and mild changes in sensation [1]
Several different therapies have been considered and evaluated for HAM/TSP with some promise, none have yet been approved for use in patients
In an open trial evaluating different doses of interferon alpha in HAM/TSP patients, significant changes were detected in both motor and urinary scores with high doses of the medication [6]

Summary

Introduction

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic, insidious neurologic disease that presents with impairment of lower limb strength, autonomic abnormalities including neurogenic bladder and bowel, and mild changes in sensation [1]. There are no specific treatments for this condition, and therapy is guided by supportive measures for associated urinary symptoms, pain, and spasticity [2]. We present a HAM/TSP case treated with interferon beta-1a with a good outcome, compared to age- and gender-matched patients with HAM/TSP who were not treated

Case Report

Discussion