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Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain

AuthorsMendoza, Carmen de; Pirón, María; González, Rocío; Jiménez, Ana; Caballero, Estrella; Roc, Lourdes; Benito, Rafael; Ramos, José M.; Soriano, Vicente
KeywordsAdult T-cell leukemia
Issue DateFeb-2019
PublisherOxford University Press
CitationOpen Forum Infectious Diseases 6(2): ofz036 (2019)
Abstract[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.
DescriptionHTLV Spanish Study Group.
Publisher version (URL)http://dx.doi.org/10.1093/ofid/ofz036
Identifiersdoi: 10.1093/ofid/ofz036
e-issn: 2328-8957
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