Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved..
OBJECTIVES: Although only 10% of persons infected with human T-lymphotropic virus type 1 (HTLV-1) may develop virus-associated illnesses over their lifetime, missing the earlier diagnosis of asymptomatic carriers frequently leads to late presentation.
METHODS: A nationwide HTLV-1 register was created in Spain in 1989. We examined the main demographics and clinical features at the time of the first diagnosis for more than three decades.
RESULTS: A total of 428 individuals infected with HTLV-1 had been reported in Spain until the end of 2021. Up to 96 (22%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (57%), T-cell lymphoma (34%), or Strongyloides stercoralis infestation (8%). Since 2008, HTLV-1 diagnosis has been made at blood banks (44%) or clinics (56%). Native Spaniards and Sub-Saharan Africans are overrepresented among patients presenting with HTLV-1-associated illnesses suggesting that poor epidemiological and/or clinical suspicion, which led to the late presentation are more frequent in them than carriers from Latin America (LATAM) (31.7% vs 20.4%, respectively; P = 0.015).
CONCLUSION: HTLV-1 infection in Spain is frequently diagnosed in patients presenting with characteristic illnesses. Although screening in blood banks mostly identifies asymptomatic carriers from LATAM, a disproportionately high number of Spaniards and Africans are diagnosed too late at the time of clinical manifestations. Expanding testing to all pregnant women and clinics for sexually transmitted infections could help to unveil HTLV-1 asymptomatic carriers.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:122 |
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| Enthalten in: |
International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases - 122(2022) vom: 31. Sept., Seite 970-975 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
de Mendoza, Carmen [VerfasserIn] |
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| Links: |
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| Themen: |
Diagnosis |
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| Anmerkungen: |
Date Completed 08.09.2022 Date Revised 08.09.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijid.2022.07.043 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344217485 |
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| 245 | 1 | 0 | |a Late presentation of human T-lymphotropic virus type 1 infection in Spain reflects suboptimal testing strategies |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVES: Although only 10% of persons infected with human T-lymphotropic virus type 1 (HTLV-1) may develop virus-associated illnesses over their lifetime, missing the earlier diagnosis of asymptomatic carriers frequently leads to late presentation | ||
| 520 | |a METHODS: A nationwide HTLV-1 register was created in Spain in 1989. We examined the main demographics and clinical features at the time of the first diagnosis for more than three decades | ||
| 520 | |a RESULTS: A total of 428 individuals infected with HTLV-1 had been reported in Spain until the end of 2021. Up to 96 (22%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (57%), T-cell lymphoma (34%), or Strongyloides stercoralis infestation (8%). Since 2008, HTLV-1 diagnosis has been made at blood banks (44%) or clinics (56%). Native Spaniards and Sub-Saharan Africans are overrepresented among patients presenting with HTLV-1-associated illnesses suggesting that poor epidemiological and/or clinical suspicion, which led to the late presentation are more frequent in them than carriers from Latin America (LATAM) (31.7% vs 20.4%, respectively; P = 0.015) | ||
| 520 | |a CONCLUSION: HTLV-1 infection in Spain is frequently diagnosed in patients presenting with characteristic illnesses. Although screening in blood banks mostly identifies asymptomatic carriers from LATAM, a disproportionately high number of Spaniards and Africans are diagnosed too late at the time of clinical manifestations. Expanding testing to all pregnant women and clinics for sexually transmitted infections could help to unveil HTLV-1 asymptomatic carriers | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diagnosis | |
| 650 | 4 | |a HTLV-1 | |
| 650 | 4 | |a Late presentation | |
| 650 | 4 | |a Myelopathy | |
| 650 | 4 | |a Sexually transmitted infections | |
| 700 | 1 | |a Pérez, Leire |e verfasserin |4 aut | |
| 700 | 1 | |a Fernández-Ruiz, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Pena, María José |e verfasserin |4 aut | |
| 700 | 1 | |a Ramos, José Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Richart, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Piron, María |e verfasserin |4 aut | |
| 700 | 1 | |a Rando, Ariadna |e verfasserin |4 aut | |
| 700 | 1 | |a Miró, Elisenda |e verfasserin |4 aut | |
| 700 | 1 | |a Reina, Gabriel |e verfasserin |4 aut | |
| 700 | 1 | |a Encinas, Beatriz |e verfasserin |4 aut | |
| 700 | 1 | |a Rojo, Silvia |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez-Iglesias, Antonio Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Benito, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Aguilera, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Treviño, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Corral, Octavio |e verfasserin |4 aut | |
| 700 | 1 | |a Soriano, Vicente |e verfasserin |4 aut | |
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