Rapid development of myelopathy after HTLV-I infection acquired by transfusion during cardiac transplantation
Human T cell lymphotropic virus Type I (HTLV-I) is thought to cause adult T cell lymphoma/leukemia and is associated with myelopathy, a disease of the spinal cord, and neuropathy, a nerve disease. HTLV-I is transmitted sexually from men to women, by breast milk from mother to child, and by blood transfusion. The infection occurs among intravenous drug abusers and in people from endemic areas, or regions where the virus is commonly found, such as Africa, the Caribbean, South America, and Japan. There is a long period between HTLV-I infection and the appearance of clinical symptoms. The benefit of screening blood donors in areas of low prevalence has been questioned. A case is described of a 41-year-old man from a nonendemic area who developed myelopathy 18 weeks after transfusion with a blood product contaminated with HTLV-I. Although he had no evidence of adult T cell lymphoma/leukemia, the patient's myelopathy was similar to that described in patients from endemic areas, such as the Caribbean and Japan. This case demonstrates the importance of screening blood donors for HTLV-I in nonendemic regions to prevent infection and subsequent development of disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: The New England Journal of Medicine
Risk factors for maternal HTLV-I infection in French Guiana: high HTLV-I prevalence in the Noir Marron population
Members of the Noir-Marron ethnic group in French Guiana appear to have a high rate of infection with the human T-cell lymphotropic virus type I (HTLV-I). HTLV-I infection is associated with a number of diseases including adult T-cell leukemia/lymphoma. It may be transmitted from mother to child through breastfeeding. Blood samples were taken from 1,873 mothers delivering between July 1991 and June 1993. Seventy-five of the women (4.4%) tested positive for HTLV-I infection. Ninety-three percent of those testing positive were members of the Noir-Marron ethnic group. Noir-Marrons account for 5.4% of the population in French Guiana. Of Noir-Marrons, 5.7% tested positive. Among Haitians, who account for 20% of the population, 6.3% tested positive. No Creole, Amerindian or Hmong women tested positive for infection. Among Noir-Marron women, being Rh negative, having given birth more than four times, having been pregnant more than six times and having had prior miscarriages and cesarean sections significantly increased the risk of being HTLV-I positive.
Publication Name: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Chronic myelopathy associated with human T-lymphotropic virus type I (HTLV-I)
Tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM) is a common neurological disease characterized by sensory and functional loss in the legs progressing to partial or complete paralysis. It is associated with infection by the human T-cell lymphoma virus type I (HTLV-I). It is prevalent in the Caribbean, Japan, Africa, the Seychelles, Central and South America and Melanesia. As many as 20% of TSP/HAM cases develop after receiving HTLV-1 contaminated blood. Experimental treatment with steroids and drugs that suppress the immune system have produced only short-lived results. Blood donors should be screened for HTLV-1 to prevent the spread of the disease and to lower the risk of patients developing TSP/HAM after receiving blood transfusions.
Publication Name: Annals of Internal Medicine
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