Spastic paraparesis associated with human T-lymphotropic virus type I: a clinical, serological, and genomic study in Iranian-born Mashhadi Jews.
The Mashhadi-Jewish community originating in Iran is a closed and ethnically segregated population with a unique history and a high rate of intrafamilial marriage among its members. A high risk of infection by human T-lymphotropic virus type I (HTLV-I) and of adult T-cell leukemia associated with such infection was found in this population. HTLV-I is also associated with a syndrome of progressive spastic paraparesis. We therefore evaluated the occurrence of HTLV-I infection and spastic paraparesis in Mashhadi-born Iranian Jews who immigrated to Israel. We examined 83 Mashhadi-born subjects (52 women, 31 men; mean age, 61 +/- 15.5 years) and 73 age-matched non-Mashhadi Iranian-born Jews. Blood samples were tested for HTLV-I antibodies by particle agglutination test. The polymerase chain reaction (PCR) was used to detect HTLV-I proviral DNA sequences from peripheral blood mononuclear cells. Fifteen Mashhadi-born Jews (18%) were both seropositive and PCR-positive for HTLV-I. Four HTLV-I-seronegative subjects were found to be positive for HTLV-I proviral DNA by PCR. Of the 19 HTLV-I-infected subjects (11 women, 8 men; mean age, 59 +/- 16 years), 13 (68%) had spastic paraparesis of varying severity. There were no signs of myelopathy in the Mashhadi-born subjects who were negative for HTLV-I proviral DNA by PCR. None of the non-Mashhadi Iranian Jews was seropositive or PCR-positive for HTLV-I proviral DNA, or had clinical signs of spastic paraparesis.(ABSTRACT TRUNCATED AT 250 WORDS)
Achiron
A
A
Department of Neurology, Beilinson Medical Center, Petah-Tiqva, Israel.
Pinhas-Hamiel
O
O
Doll
L
L
Djaldetti
R
R
Chen
A
A
Ziv
I
I
Avni
A
A
Frankel
G
G
Melamed
E
E
Shohat
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D004279:DNA, Viral / Q000032:analysis; D004196:Disease Outbreaks; D005260:Female; D015481:HTLV-I Antibodies / Q000032:analysis; D015368:Human T-lymphotropic virus 1 / Q000235:genetics; D006801:Humans; D015994:Incidence; D007492:Iran / Q000208:ethnology; D007557:Israel; D007585:Jews; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009460:Neurologic Examination; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis* / Q000208:ethnology* / Q000635:transmission; D012698:Serologic Tests
D004279:DNA, Viral; D015481:HTLV-I Antibodies