Epidemiology of tropical spastic paraparesis in colombia and associated HTLV-I infection

Abstract

The clinical syndrome earlier designated as paraparesia espástica del Pacífico is an isolated form of tropical spastic paraparesis (TSP) that was reported in 1981 in the southern Pacific lowlands of Columbia in and near Tumaco. The clinical features are similar to those of TSP reported in Jamaica, Martinique, the Seychelles, and the Ivory Coast of Africa and resemble also those clinical features of the human T-lymphotropic virus type I (HTLV-I)-associated myelopathy described in southern Japan. Since HTLV-I infection is closely associated with TSP, we conducted a case-control study to evaluate the role of HTLV-I-associated risk factors among patients from the endemic focus in Tumaco, Colombia, and the seroprevalence rates of this virus in other geographical areas of the Pacific Colombian lowlands with and without TSP. From our seroprevalence study of antibodies to HTLV-I among TSP index patients, matched controls, household contacts (first- and second-degree relatives), and healthy controls from these areas, we found a strong association between HTLV-I and TSP. Also, there is a high seroprevalence of HTLV-I among sexual partners of patients and to a lesser extent among their offspring and other relatives some of whom had an early mean acquisition of antibodies to HTLV-I. Heterosexual promiscuity and other close interpersonal contact may play an important role in the transmission of TSP in the Pacific lowlands of Colombia.

Evaluación serológica y virológica de la infección del virus linfotrópico humano 1 en grupos familiares de Tumaco, Colombia

“…In Colombia, as in many other regions of the world, HTLV-1 appears to be geographically concentrated on the Pacific coast, as well as in the Andean and Caribbean regions (17,18). Tumaco, a town located on the Pacific coast of SW Colombia, was the first area characterized as being endemic for HTLV-1 infection, featuring elevated rates of HAM/TSP (19)(20)(21).…”

“…Moreover, the incidence of seroconversion in children who were breastfed over 12 months was higher than among those given infant formula (26,27). Although some studies have established the risk of transmission from infected mothers to offspring in family groups (19,28), to date there has been no statistical evaluation of immunoglobulin class profiles and viral replication among family groups in endemic areas of Colombia as variables to correlate HTLV-1 infection with circulation of virus.…”

Reconstrucción de la evolución molecular de la infección actual por el virus linfotrópico humano tipo I en Colombia.

“…En Colombia, inicialmente se relacionó la presencia del HTLV-I y las enfermedades asociadas con este virus, como la ATL y la PET/ MAH, con individuos de raza negra habitantes de la Costa Pacífica colombiana; sin embargo, actualmente su distribución es amplia en todo el territorio nacional (29). Este estudio permitió obtener un conocimiento más detallado de la evolución del virus en zonas del suroccidente colombiano y en varias regiones del territorio colombiano donde la variación molecular del virus era totalmente desconocida.…”

Neuroepidemiology of Human T-Lymphotrophic Virus Type-I-Associated Tropical Spastic Paraparesis

“…Serological studies were not con ducted in this sample, so it is not known whether HTLV-I transmission had occurred between the TSP cases and their offspring or relatives. Arango et al [1] carried out seroprevalence studies among TSP index cases and household contacts (first and second de gree relatives). They found a high level of seropositivity of HTLV-I among sexual part ners of TSP patients and to a lesser extent among offspring and other relatives, com pared to the normal population in this geo graphic area [1], However, there was no clus tering of cases found in the same households as the index cases.…”

“…Arango et al [1] carried out seroprevalence studies among TSP index cases and household contacts (first and second de gree relatives). They found a high level of seropositivity of HTLV-I among sexual part ners of TSP patients and to a lesser extent among offspring and other relatives, com pared to the normal population in this geo graphic area [1], However, there was no clus tering of cases found in the same households as the index cases. In Jamaica, only 3 of 125 households containing TSP patients re ported a family history of a similar disorder [ 20].…”