Human T Cell Lymphotropic Virus Type-1—Associated Myelopathy/Tropical Spastic Paraparesis in Sao Paulo, Brazil: Association with Blood Transfusion

Domingues, Renan Barros; Muniz, Marcelo Ramos; Jorge, Maria Lucia G.; Mayo, Matthew S.; Saez-Alquezar, Amadeu; Chamone, Dalton F.; Scaff, Milberto; Marchiori, Paulo Eurípedes

doi:10.4269/ajtmh.1997.57.56

Cited by 13 publications

(7 citation statements)

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“…A similar trend was noticed in a study of risk factors for HAM/TSP carried out at our institution from March 1991 to May 1994 [31]. This particular feature strongly emphasizes the risk involved in blood transfusions for HTLV-1 infection in Brazil.…”

Section: Discussionsupporting

confidence: 58%

Human T Cell Lymphotropic Virus Type 1-Associated Myelopathy in São Paulo, Brazil

et al. 2002

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We report epidemiologic and clinical features of human T cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis in a Brazilian cohort of 86 patients from a university hospital. Cerebrospinal fluid (CSF) abnormalities and magnetic resonance imaging (MRI) findings were correlated with neurologic signs and symptoms. The patients’ mean age at disease onset was 43.2 years and the female to male ratio 1.5:1. Risk factors for retroviral exposure included blood transfusions, sexual transmission and intravenous drug use. Neurologic manifestations consisted mostly of spastic paraparesis, of gradual and asymmetric onset, with increased deep-tendon reflexes. Disability was associated with disease duration. CSF findings included mild mononuclear pleocytosis and elevated protein levels. MRI showed hemispheric areas of high signal intensity in 32.7% and spinal cord atrophy in 5.6% of cases, particularly in patients with longer duration of disease. A high frequency of past blood transfusion (32.6%) suggests that blood-borne infection was an important means of HTLV infection before implementation of screening of blood donors in Brazil.

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Section: Discussionsupporting

confidence: 58%

Human T Cell Lymphotropic Virus Type 1-Associated Myelopathy in São Paulo, Brazil

et al. 2002

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“…The overall 8% seropositivity rate in our investigation is similar to that recorded in a previous, pilot local survey 18 where 9% of screened patients suffering from neurological disease were found to have HTLV-I/II antibodies. The seropositivity rate in our study tended to be lower, however, if compared with those rates from other surveys conducted across Brazil, which varied from 14.7% to 57% 1,2,8 . A possible explanation for this difference is the fact that our study cohort comprised patients whose sera were tested for the presence of HTLV-I/ II antibodies primarily at the request of the referring local neurologists.…”

Section: Discussioncontrasting

confidence: 90%

“…Data from early studies conducted in North Brazil have postulated the relationship between HTLV-I infection and the development of Guillain-Barré syndrome in a 12 year-old boy 25 . The nationwide occurrence of HTLV-I infection in patients with HAM/TSP has been documented by several studies showing that both sexual promiscuity and blood transfusion appear to be the most important risk factors for transmission, with prevalence rates being higher among female subjects 1,2,3,7,8,9,31 . A pilot study conducted in Belém, Northern Brazil yielded a 9% prevalence rate of HTLV-I/II infection in a cohort of 144 patients presenting with clinical symptoms of myelopathy 18 .…”

Section: Introductionmentioning

confidence: 99%

Human T-cell lymphotropic virus types I and II infections in a cohort of patients with neurological disorders in Belém, Pará, Brazil

Macêdo

Ribeiro-Lima

Linhares

et al. 2004

Rev. Inst. Med. trop. S. Paulo

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Serum- and/or- cerebrospinal fluid (CSF) samples obtained from 190 patients suffering from chronic, progressive neurological disease were screened for the presence of human T-cell lymphotropic viruses type I (HTLV-I) and type II (HTLV-II) antibodies over a six-year period (1996 to 2001) in Belém, Pará, Brazil. Patients were of both sexes (male subjects, 52%) with ages ranging from 2 to 79 years (mean, 35.9). Overall, 15 (7.9%) subjects - of whom 12 (80%) were female adults - reacted HTLV-I/II-seropositive when screened by enzyme-linked immunosorbent assay (ELISA). Serum samples from 14 of these patients were also analyzed using a recombinant Western blot (WB) assay that yielded HTLV-I-, HTLV-II-, and HTLV-I/II- reactivities for 10 (71.4%), 3 (21.4%) and 1 (7.2%) of them, respectively. The yearly rates of HTLV-I/II antibodies ranged from 2.6% (2001) to 21.7% (2000), with progressively increasing seropositivities from 1998 to 2000. Altogether, walking difficulty (n = 5 subjects), spasticity (n = 4) and leg weakness (n = 3) accounted for 80% of symptoms recorded among the 15 patients whose sera had antibodies to HTLV-I/II as detected by ELISA. These findings provide evidence that both HTLV-I and HTLV-II play a role in the development of chronic myelopathy in Belém, Pará, Northern Brazil.

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“…Indeed, several posttransfusion cases of this chronic neurological disorder have been reported (11,14,17), and TSP/HAM cases have been diagnosed in neurological departments in Dakar (27). Moreover, transfusion is a major risk factor for TSP/HAM development in several areas of endemicity, such as Japan, the West Indies, and South America (8,29). Lastly, history of blood transfusion has been demonstrated to be an important risk factor for HTLV-1 infection in Africa, including urban population of Guinea Bissau (26) and children from Gabon, Central Africa (31).…”

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confidence: 99%

Seroprevalence and Molecular Epidemiology of Human T-Cell Leukemia Virus Type 1 (HTLV-1) and HTLV-2 in Blood Donors from Dakar, Senegal

et al. 2006

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In 2002, human T-cell leukemia virus type 1 (HTLV-1) and HTLV-2 seroprevalence was 0.16% (8/4,900) in blood donors from Dakar, Senegal. Most of the positive donors originated from the country's southern region. Seven donors were infected by HTLV-1 (of cosmopolitan subtype), and one was infected by HTLV-2. These data highlight the problem of transfusion safety in this area where HTLV-1-associated lymphoproliferative and neurological diseases are endemic.

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Human T Cell Lymphotropic Virus Type-1—Associated Myelopathy/Tropical Spastic Paraparesis in Sao Paulo, Brazil: Association with Blood Transfusion

Cited by 13 publications

References 0 publications

Human T Cell Lymphotropic Virus Type 1-Associated Myelopathy in São Paulo, Brazil

Human T Cell Lymphotropic Virus Type 1-Associated Myelopathy in São Paulo, Brazil

Human T-cell lymphotropic virus types I and II infections in a cohort of patients with neurological disorders in Belém, Pará, Brazil

Seroprevalence and Molecular Epidemiology of Human T-Cell Leukemia Virus Type 1 (HTLV-1) and HTLV-2 in Blood Donors from Dakar, Senegal

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