Early-onset HTLV-1-associated myelopathy/tropical spastic paraparesis

Pérez-Muto, V.; González Lagos, Elsa Violeta; Schwalb Calderon, Alvaro; Gotuzzo Herencia, José Eduardo; Tipismana, M.; Cachay Figueroa, Rodrigo Antonio; Mejía Cordero, Fernando Alonso; Álvarez, C.

dc.contributor.author	Schwalb Calderon, Alvaro
dc.contributor.author	Pérez-Muto, V.
dc.contributor.author	Cachay Figueroa, Rodrigo Antonio
dc.contributor.author	Tipismana, M.
dc.contributor.author	Álvarez, C.
dc.contributor.author	Mejía Cordero, Fernando Alonso
dc.contributor.author	González Lagos, Elsa Violeta
dc.contributor.author	Gotuzzo Herencia, José Eduardo
dc.date.accessioned	2020-12-14T16:10:12Z
dc.date.available	2020-12-14T16:10:12Z
dc.date.issued	2020
dc.identifier.uri	https://hdl.handle.net/20.500.12866/8803
dc.description.abstract	Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of patients with early-onset HAM/TSP, defined as disease onset before 20 years of age. Methods: This is a retrospective study from an HTLV-1 clinical cohort between 1989 and 2019. We searched for medical records of patients with (1) diagnosis of HTLV-1 infection using two ELISA and/or one Western blot, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) HAM/TSP symptom-onset before 20 years of age. Results: A total of 38 cases were identified in the cohort; 25 were female (66%). The median age of onset was 14 years old. 31 (82%) cases had HTLV-1 testing done among family members; 22 out of 25 tested mothers (88%) were HTLV-1 positive. Most patients (27/34) were breastfed for more than one year. Disease progression measured through EDSS and IPEC-1 showed an upward trend towards worsening spasticity with 18 patients (47%) eventually requiring mobility aids. Conclusions: Cases of early-onset HAM/TSP are not of rare occurrence, which translates into many more years of dependency, the use of mobility aids, and increased overall morbidity.	en_US
dc.language.iso	eng
dc.publisher	MDPI
dc.relation.ispartofseries	Pathogens
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	HAM/TSP	en_US
dc.subject	myelopathy	en_US
dc.subject	paraparesis	en_US
dc.subject	chronic infection	en_US
dc.subject	inflammation	en_US
dc.title	Early-onset HTLV-1-associated myelopathy/tropical spastic paraparesis	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.3390/pathogens9060450
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.01.09
dc.relation.issn	2076-0817