Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain

Abstract Background Although only 8%–10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods A nationwide HTLV-1 register was created in Spain i...

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Bibliographic Details
Published in:Open forum infectious diseases 2019-02, Vol.6 (2), p.ofz036-ofz036
Main Authors: De Mendoza, Carmen, Pirón, Maria, Gonzalez, Rocío, Jiménez, Ana, Caballero, Estrella, Roc, Lourdes, Benito, Rafael, Ramos, Jose Manuel, Soriano, Vicente
Format: Article
Language:English
Subjects:
Blood banks
Brief Report
Development and progression
Epidemiology
Health aspects
Infection
Leukemia
Non-Hodgkin's lymphomas
T cells
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Summary:Abstract Background Although only 8%–10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods A nationwide HTLV-1 register was created in Spain in 1989. A total of 351 infected persons had been reported by the end of 2017. We examined all new HTLV-1 diagnoses during the last decade and compared their clinical presentation. Results A total of 247 individuals with HTLV-1 infection had been reported in Spain since year 2008. The incidence has remained stable with 20–25 new diagnoses yearly. Women represented 62%. Only 12% were native Spaniards, most of whom were foreigners from Latin America (72.5%). Up to 57 (23%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (n = 24; 42.1%), T-cell lymphoma (n = 19; 33.3%), or Strongyloides stercoralis infestation (n = 8; 14%). Human T-cell leukemia virus type 1 diagnosis had been made either at blood banks (n = 109; 44%) or at clinics (n = 138; 56%). It is interesting to note that Spaniards and especially Africans were overrepresented among patients presenting with HTLV-1-associated illnesses, suggesting that misdiagnosis and late presentation are more frequent in these populations compared to Latin Americans. Conclusions Given that 23% of new HTLV-1 diagnoses in Spain are symptomatic, underdiagnosis must be common. Although screening in blood banks mostly identifies asymptomatic Latin American carriers, a disproportionately high number of Spaniards and Africans are unveiled too late, that is, they already suffer from classic HTLV-1 illnesses.
ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofz036