Human T-lymphotropic virus type 1 infection and disease in Spain
: Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20-25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
AIDS (London, England) - 31(2017), 12 vom: 31. Juli, Seite 1653-1663 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Mendoza, Carmen [VerfasserIn] |
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| Anmerkungen: |
Date Completed 12.03.2018 Date Revised 08.04.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/QAD.0000000000001527 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM273764470 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a : Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20-25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 700 | 1 | |a Caballero, Estrella |e verfasserin |4 aut | |
| 700 | 1 | |a Aguilera, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Requena, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a de Lejarazu, Raúl Ortiz |e verfasserin |4 aut | |
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| 700 | 1 | |a González, Rocío |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Roc, Lourdes |e verfasserin |4 aut | |
| 700 | 1 | |a Treviño, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Benito, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Fernández-Alonso, Miriam |e verfasserin |4 aut | |
| 700 | 1 | |a Aguinaga, Aitziber |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a García-Costa, Juan |e verfasserin |4 aut | |
| 700 | 1 | |a Blanco, Lidia |e verfasserin |4 aut | |
| 700 | 1 | |a Ramos, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Calderón, Enrique |e verfasserin |4 aut | |
| 700 | 1 | |a Eirós, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Sauleda, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Barreiro, Pablo |e verfasserin |4 aut | |
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| 700 | 0 | |a Spanish HTLV Network |e verfasserin |4 aut | |
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