Evolution of erectile dysfunction in individuals infected with human T-lymphotropic virus 1: a prospective cohort study

Virtually all patients with human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) have some degree of erectile dysfunction (ED), but ED is also found in a large percentage of HTLV-1 carriers. To evaluate the evolution of ED in individuals infected with HT...

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Published in:Journal of sexual medicine 2023-02, Vol.20 (3), p.269-276
Main Authors: de Oliveira, Cassius J V, Neto, José Abraão Carneiro, Liberato de Matos, Sheila N F, Oliveira, Paulo, Tannus, Matheus, Castro, Néviton, Rocha, Paulo N, Carvalho, Edgar M
Format: Article
Language:English
Subjects:
Adult
Disabled Persons
Erectile Dysfunction - complications
Human T-lymphotropic virus 1
Humans
Male
Middle Aged
Motor Disorders
Paraparesis, Tropical Spastic
Prospective Studies
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Summary:Virtually all patients with human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) have some degree of erectile dysfunction (ED), but ED is also found in a large percentage of HTLV-1 carriers. To evaluate the evolution of ED in individuals infected with HTLV-1 who were followed for up to 15 years. This prospective cohort study included men infected with HTLV-1 who had ED, were aged 18 to 70 years, and were followed from January 2004 to December 2019. We used the International Index of Erectile Function-5 (IIEF-5), the Expanded Disability Status Scale and Osame Motor Disability Scale, and the Overactive Bladder Symptom Score (OABSS) to define and stratify ED, neurologic disability, and bladder dysfunction, respectively. Time to development of severe ED was the main outcome. We studied 90 men with ED (mean ± SD age, 52.8 ± 9.78 years). At baseline, 42 were carriers, 16 had probable HAM/TSP, and 32 had definite HAM/TSP. IIEF-5 was highest among carriers and lowest in patients with definite HAM/TSP, whereas OABSS was lowest in carriers and highest in patients with definite HAM/TSP. Median (IQR) follow-up was 8.50 years (3.00-12.00). IIEF-5 fell significantly from baseline to last follow-up among carriers and patients with probable and definite HAM/TSP. There was an inverse correlation between the IIEF-5 and the OABSS at last follow-up (r = -0.62, P 
ISSN:1743-6095
1743-6109
DOI:10.1093/jsxmed/qdac050