Epidemiology of human T-lymphotropic virus type II (HTLV-II) infection in Spain

Abstract

The human T-lymphotropic virus type II (HTLV-II) has recently been associated with the genesis of some subacute neurological syndromes and, rarely, with atypical T-lymphoid malignancies. The virus is endemic in some Amerindian and African tribes, and among intravenous drug users (IDUs) in North America and Europe. Given that HTLV-II is transmitted by the same routes as other human retroviruses, the screening of antibodies to HTLV-II in blood donors has became a matter of controversy in some countries. Herein, we describe the clinical, epidemiological and virological features of 113 individuals with HTLV-II infection identified in Spain up to September 1995. Most of them (94/113; 83%) were male, and all but seven were natives. Four were African immigrants living in Madrid and 3 had been born in other European countries. All but six subjects were IDUs, and sexual transmission of HTLV-II and transfusion were involved in five and one individual, respectively. Eighty-four percent of the IDUs infected with HTLV-II were co-infected by HIV-I (93/107). Clinical manifestations potentially linked to HTLV-II were absent, although an IDU male co-infected by HIV-1 and HTLV-II developed a severe non-inflammatory proximal myopathy. In conclusion, HTLV-II infection is present in Spain, mainly among IDUs, with a growing incidence and a current overall prevalence of 2.0 percent.

High Rate of Human T Lymphotropic Virus Type IIa Infection in HIV Type 1-Infected Intravenous Drug Abusers in Ireland

“…RFLP analysis of the env gene region demonstrated that all samples were infected with the HTLV-IIa subtype. This finding contrasts with a number of studies from southern Europe and specifically in regions of Italy [28][29][30]32 and Spain, [33][34][35][36][37] where the HTLV-IIb subtype predominates and in some instances is the exclusive infection. A single report has suggested that, similar to Ireland, the HTLV-IIa subtype appears to predominate in an IVDA population in Stockholm, Sweden.…”

“…20 While studies of infection in European IVDAs have been somewhat limited, it has been suggested that in southern-Europe (specifically Spain and Italy) this involves predominanlly, and in many instances exclusively, the HTLV-IIb subtype. 18,[28][29][30][31][32][33][34][35][36][37][38] In contrast, a single report from Sweden has suggested that HTLV-IIa predominates in that country. 39 .To appreciate better the extent of HTLV-II infections within Europe, we have now investigated HTLV-I1 infections in a cohort of HIV-l-infected IVDAs in the Republic of Ireland.…”

Prevalence of HTLV-1/2 Infections in Spain: A Cross-Sectional Hospital-Based Survey

“…As in other prior surveys, HTLV-2 infection was mainly found in former intravenous drug users, most of whom were coinfected with HIV and/or HCV. 16,20 In other studies previously conducted in Spain testing groups with a larger proportion of foreigners coming from HTLV-1 endemic areas, such as pregnant women, the rate of HTLV infection was similarly low (0.06%), and again HTLV-2 was the predominant variant, which is reassuring. 21,22 The absence of HTLV-1 infections in our survey indicates that this virus has not spread very far beyond the immigrant population.…”

Spontaneous Production of C-C Chemokines by Individuals Infected with Human T Lymphotropic Virus Type II (HTLV-II) Alone and HTLV-II/HIV-1 Coinfected Individuals

“…Although the majority of in vitro studies have attempted to investigate the relationship between HTLV-I and HIV-1 coinfections, concomitant infections with HIV-1 and HTLV-II are of much greater clinical significance as it has been shown that as many as 30% of all IVDUs in urban areas of North America are coinfected (13)(14)(15)(16). The influence of HTLV-II infection on HIV-1 has not been extensively evaluated, and epidemiological studies have failed to agree upon what, if any, influence HTLV-II might have on HIV-1 disease progression (17)(18)(19)(20).…”