Abstract
Osteoporosis has been reported among Human T-cell Lymphotropic Virus type 1 (HTLV-1) infected aged patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) diagnosis. However, the association between osteoporosis and HTLV-1 infection remains unclear. This study aimed to evaluate the presence of bone disorders in young HTLV-1 asymptomatic individuals. A cross sectional study was carried out at the HTLV Reference Center in Salvador, Brazil. Forty-seven HTLV-1 infected asymptomatic and 108 healthy subjects aged between 20 to 45 years were included. Biochemical markers of bone metabolism were measured and bone mineral density (BMD) was determined at the femoral neck and at the lumbar spine (L1 -L4). Significant low BMD (Z-score <-1 ) was found in HTLV-1 infected individuals (1.177 ± 0.103) compared to control subjects (1.225 ± 0.146). In logistics regression analysis HTLV-1 infected subjects were more likely to have low BMD (OR = 3.48; 95%CI 1.29- 9.43) adjusted for low education and body mass index (BMI). Osteoporosis (Z-score <-2) was not found among HTLV-1-infected group. In conclusion, our results found a low BMD in patients infected with HTLV-1 compared to uninfected controls. However, osteoporosis was not observed. Further studies should be conducted to evaluate the relationship between HTLV-1-infection and low BMD.
Highlights
Human T-cell Lymphotropic Virus type 1 (HTLV-1) is endemic worldwide and it is estimated that 10 million people harbor the virus.[1]. This virus is etiologically linked with adult T cell leukemia (ATL),(2) HTLV-1associated myelopathy/tropical spastic paraparesis (HAM/TSP),(3,4) uveitis[5] and infective dermatitis.[6]. Several other diseases have been associated with HTLV-1, such as polymyositis, synositis, thyreoiditis, bronchi alveolar pneumonia, indicating a multi-systemic involvement in this infection.[7]. The city of Salvador, capital of Bahia State, located in the Northeast of Brazil has the highest prevalence of HTLV-1 infection in this country.[8]. Through a population-based study, we have demonstrated that the overall prevalence of HTLV-1 in this city was 1.74%, increasing with age reaching 9.0 % in women aged 50 years and older.[9]
We demonstrated that young HTLV-1 infected man have a low bone mineral density (BMD) compared to uninfected controls
Those subjects were 3.5 times more likely to have low BMD than healthy controls, no evidence of osteoporosis was found. This is the first report on low BMD among asymptomatic HTLV-1 carriers
Summary
Human T-cell Lymphotropic Virus type 1 (HTLV-1) is endemic worldwide and it is estimated that 10 million people harbor the virus.[1]. Previous studies have attempted to identify risk factors for bone disorders in retrovirus infection, mainly in HIV patients.[10,11] Osteoporosis associated with HTLV-1 has been reported in older symptomatic HAM-TSP patients with walking difficulties.[12]. We evaluate the presence of bone disorders in young HTLV-1 asymptomatic individuals from Salvador that could constitute a complication of this infection
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