Case Series: Pediatric Human T-Lymphotropic Virus Type 1 and Its Clinical Expression

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.

Lymphocytic interstitial non-HIV-related pneumonia in pediatrics: a case report

“…In the case series published by Ingara et al in a pediatric population in southwestern Colombia with HTLV-1 positive, they found nutritional deficiencies, skin involvement, opportunistic diseases, autoimmune and/or chronic inflammatory diseases, polymyositis, and pulmonary involvement as clinical manifestations. The latter was found in half of the patients, but bronchiectasis was related to the co-diagnosis of opportunistic infections by M. tuberculosis and Aspergillus, which were not documented in our patient (35).…”

HTLV-1 uveitis in Colombia, an underrecognized complication of a hitherto neglected condition: a case series

“…9,15 Case 3 was partially described in a recent report on pediatric manifestations of HTLV-1 in Colombia. 16 However, ophthalmological manifestations were not described in detail then, and images of retinal lesions were not included in the original report. The patient was later classified as having Vogt-Koyanagi-Harada syndrome in relation to HTLV-1 infection.…”