1. Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain
- Author
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de Mendoza, C, Piron, M, Gonzalez, R, Jimenez, A, Caballero, E, Roc, L, Benito, R, Ramos, JM, Soriano, V, Rodriguez, C, Vera, M, del Romero, J, Marcaida, G, Ocete, MD, Molina, I, Aguilera, A, Rodriguez-Calvino, JJ, Navarro, D, Rivero, C, Vilarino, MD, Algarate, S, Gil, J, de Lejarazu, RO, Rojo, S, Eiros, JM, San Miguel, A, Manzardo, C, Miro, JM, Garcia, J, Paz, I, Poveda, E, Calderon, E, Escudero, D, Trigo, M, Diz, J, Garcia-Campello, M, Rodriguez-Iglesias, M, Hernandez-Betancor, A, Martin, AM, Gimeno, A, Gutierrez, F, Rodriguez, JC, Sanchez, V, Gomez-Hernando, C, Cilla, G, Perez-Trallero, E, Lopez-Aldeguer, J, Fernandez-Pereira, L, Niubo, J, Hernandez, M, Lopez-Lirola, AM, Gomez-Sirvent, JL, Force, L, Cifuentes, C, Perez, S, Morano, L, Raya, C, Gonzalez-Praetorius, A, Perez, JL, Penaranda, M, Hernaez-Crespo, S, Montejo, JM, Martinez-Sapina, A, Viciana, I, Cabezas, T, Lozano, A, Fernandez, JM, Garcia-Bermejo, I, Gaspar, G, Garcia, R, Gorgolas, M, Vegas, C, Blas, J, Miralles, P, Valeiro, M, Aldamiz, T, Margall, N, Guardia, C, do Pico, E, Polo, I, Aguinaga, A, Ezpeleta, C, Sauleda, S, Torres, P, Blanco, L, Suarez, A, Rodriguez-Avial, I, Perez-Rivilla, A, Parra, P, Fernandez, M, Fernandez-Alonso, M, Trevino, A, Requena, S, Benitez-Gutierrez, L, Cuervas-Mons, V, Barreiro, P, Corral, O, and Gomez-Gallego, F
- Subjects
myelopathy ,adult T-cell leukemia ,HTLV-1 ,screening ,epidemiology - 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.
- Published
- 2019