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

Author

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

5. HIV co-infection in HTLV-1 carriers in Spain

Author

de Mendoza, C, Caballero, E, Aguilera, A, Benito, R, Macia, D, Garcia-Costa, J, Soriano, V, Rodriguez, C, Vera, M, del Romero, J, Marcaida, G, Ocete, MD, Molina, I, 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, Mira, 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, Ramos, JM, 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, Raya, C, Gonzalez-Praetorius, A, Perez, JL, Penaranda, M, Hernaez-Crespo, S, Montejo, JM, Roc, L, 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, Piron, M, Gonzalez, R, Barea, L, Jimenez, A, Blanco, L, Suarez, A, Rodriguez-Avial, I, Perez-Rivilla, A, Parra, P, Fernandez, M, Fernandez-Alonso, M, Reina, G, Trevino, A, Requena, S, Benitez-Gutierrez, L, Cuervas-Mons, V, Barreiro, P, Corral, O, Gomez-Gallego, F, Perez, S, Morano, L, and Spanish HTLV Network

Subjects
AIDS, Epidemiology, Tropical spastic paraparesis, Adult T-cell leukemia, virus diseases, HIV, HTLV, Co-infection, Antiretroviral therapy, Late diagnosis
Abstract

Background: Human retroviruses HIV and HTLV share transmission routes. HIV widely spread in Spain during the 80 s through injection drug use and sex, and nowadays HIV rates in Spain account for one of the largest in Europe. In contrast, HTLV-1 is not endemic in Spain, despite hosting huge numbers of migrants from highly endemic regions. Herein, we report the rate and main features of the HIV-HTLV co-infected population in Spain. Methods: A national registry exists in Spain for HTLV since year 1989. Data from standardized case report forms and one centralized lab repository were reviewed, especially for the subset with HTLV-HIV co-infection. Results: Up to December 2018, a total of 369 individuals with HTLV-1 had been diagnosed in Spain. 64% of the population were females, and Latin American individuals accounted for 64.5%. Classical HTLV-associated illnesses were found in 12.7% (myelopathy) and 7.6% (leukemia). HIV coinfection was found in 12 (3.2%). Of those, 3 patients (25%) were female and 39 (75%) were of non Spanish origin. All but two harbored HIV-1 subtype B, being non-B variants found in the two West Africans. Exposure had been sexual in most cases, being 4 homosexual men. Seven HTLV-HIV co-infected patients had developed AIDS and two had developed myelopathy. There was no evidence for increased HTLV-1 clinical pathogenicity due to HIV coinfection. Conclusion: HIV coinfection is infrequent (< 5%) among HTLV-1 carriers in Spain. More than half of co-infected patients come from Latin America. Sexual contact is the most frequent risk behavior, being MSM one third of cases. Late diagnosis explains the high rate (9/12) of clinical manifestations in our HIV-HTLV co-infected population.

Published
2019

6. HTLV testing of solid organ transplant donors

Author

de Mendoza, C, Roc, L, Fernandez-Alonso, M, Soriano, V, Rodriguez, C, Vera, M, del Romero, J, Marcaida, G, Ocete, MD, Caballero, E, Aguilera, A, Rodriguez-Calvino, JJ, Rivero, C, Vilarino, MD, Benito, R, Algarate, S, de Lejarazu, RO, Rojo, S, Eiros, JM, Ramos, C, Manzardo, C, Miro, JM, Garcia-Costa, J, Calderon, E, Escudero, D, Trigo, M, Diz, J, Garcia-Campello, M, Rodriguez-Iglesias, M, Hernandez-Betancor, A, Martin, AM, Ramos, JM, Gimeno, A, Sanchez, V, Guzman, M, Gomez-Hernando, C, Echeverria, MJ, Cilla, G, Fernandez-Pereira, L, Hernandez, M, Lopez-Lirola, AM, Gomez-Sirvent, JL, Force, L, Cifuentes, C, Perez, S, Morano, L, Raya, C, Gonzalez-Praetorius, A, Penaranda, M, Nieto, MC, Montejo, JM, Viciana, I, Cabezas, T, Lozano, A, Perez-Camacho, I, Fernandez, JM, Garcia-Bermejo, I, Gaspar, G, Tellez, R, Gorgolas, M, Perez, L, Monsalvo, S, Valeiro, M, Aldamiz, T, Margall, N, Guardia, C, do Pico, E, Sauleda, S, Piron, M, Gonzalez, R, Richart, A, Barea, L, Jimenez, A, Blanco, L, Suarez, A, Rodriguez-Avial, I, Parra, P, Fernandez, M, Reina, G, Trevino, A, Requena, S, Benitez-Gutierrez, L, Cuervas-Mons, V, Barreiro, P, Corral, O, and Gomez-Gallego, F

Published
2019

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