Prevalence of Bowel Symptoms in Patients Infected with Human T-Lymphotropic type 1 Virus

Abstract

Introduction: Bowel dysfunction is frequent in patients with spinal cord diseases, but little is known about the prevalence of bowel symptoms in human T-lymphotropic virus-(HTLV-1) infected individuals. The purpose of this study is to determine the frequency of bowel symptoms in HTLV-1 infected individuals and their correlation with the degree of neurologic disease. Methods: This is a cross-sectional study comparing the frequency of bowel symptoms in HTLV-1-infected individuals * and seronegative donors (controls). Patients answered a questionnaire, the Rome III Criteria was applied, and stool consistency was evaluated by the Bristol Stool Form Scale. The individuals were classified as HTLV-1 carriers, probable HTLV-1 myelopathy and definitive HTLV-1 associated myelopathy or tropical spastic paraparesis (definitive HAM / TSP) **. Results: We studied 72 HTLV-1 infected individuals and 72 controls with equal age and gender distribution. Constipation was the most frequent complaint, occurring in 38 % of HTLV-1 individuals and in 15 % of the controls. In comparison to the seronegative controls, the probability of constipation occurrence was approximately 18 times higher in definitive HAM / TSP patients. Straining, lumpy or hard stools, sensation of anorectal obstruction/blockage, fewer than 3 defecations per week, flatulence, soiling, evacuation pain, and bleeding were also more frequent in the HTLV-1 patients than in the controls. Moreover, bowel symptoms were more frequent in patients with definitive or probable HAM / TSP than in carriers. Conclusions: Bowel symptoms were more frequent in HTLV-1-infected patients than in seronegative controls and the frequency of bowel symptoms correlated with the severity of neurologic disease.

Brazilian Protocol for Sexually Transmitted Infections 2020: human T-cell lymphotropic virus (HTLV) infection

“…HTLV-1 infection shows a great variety of interactions with the human host and important clinical manifestations have been recognized in the eye 58 - 61 , skin 61 , 62 , lung 61 , 63 - 65 , joints 66 - 68 , thyroid 69 , 70 , heart 61 , 71 , 72 , intestines 61 , 73 and bladder 61 , 74 , 75 , among others. The broad spectrum of diseases reveals the infection's clinical complexity, which requires multidisciplinary attention for the infected patients' care.…”

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecção pelo vírus linfotrópico de células T humanas (HTLV)

“…El HTLV-1 está asociado con un linfoma agresivo, la enfermedad llamada leucemia/ linfoma de células T adultas (adult T cell leukemia/ lymphoma, ATLL), 51,52 y a una enfermedad neurodegenerativa, mielopatía asociada con HTLV-1 (HTLV-1 associated myelopathy, HAM). [53][54][55][56][57] La infección por HTLV-1 muestra una amplia variedad de interacciones con el huésped humano y se han reconocido importantes manifestaciones clínicas en los ojos, [58][59][60][61] piel, 61,62 pulmón, 61,[63][64][65] articulaciones, [66][67][68] tiroides, 69,70 corazón, 61,71,72 intestino, 61,73 y vejiga, 61,74,75 entre otros. El amplio espectro de enfermedades revela la complejidad clínica de la infección, por lo que requiere una atención multidisciplinar en el cuidado de los infectados.…”