title: Neurological manifestations in HTLV-I-infected blood donors.
abstract: The human T-cell lymphotropic virus type 1 (HTLV-I) causes a neurological disease known as HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in a minority of infected individuals. Although other neurological outcomes have been described their prevalence is presently unknown. To evaluate the frequency and characteristics of neurological involvement in a population of HTLV-I-infected blood donors we investigated 196 HTLV-I positive and 196 negative blood donors from a blood center of Rio de Janeiro, Brazil. Individuals with abnormalities at the neurological examination were examined by three neurologists, and when pertinent, additional neurological investigations were performed. Descriptive analysis, Student's t-test and chi2 test were employed for statistical analysis. Neurological abnormalities were found in 71 (36.2%) of the HTLV-I positive blood donors and in only 29 (14.8%) of the HTLV-I negative donors (OR = 2.54, 95% CI = 1.67-3.59, p = 0.000002). Cases of myelopathy, motor neuron disease and myopathy were only found in the HTLV-I positive group. In addition, peripheral neuropathy (PN) was significantly more frequent in the positive group (p = 0.015). In summary, our data suggest that HTLV-I-infected individuals exhibit a wide variety of neurological manifestations apart from the classical picture of HAM/TSP.
authors.affiliation: The Reference Centers for Neurological Infections and HTLV, Evandro Chagas Clinical Research Institute--IPEC-FIOCRUZ, Av. Brasil, 4361, Rio de Janeiro 21045-900, Brazil.
authors.forename: Ana C C
authors.initials: AC
authors.lastname: Leite
authors.forename: Gulnar A S
authors.initials: GA
authors.lastname: Mendonça
authors.forename: Maria José Andrada
authors.initials: MJ
authors.lastname: Serpa
authors.forename: Osvaldo J M
authors.initials: OJ
authors.lastname: Nascimento
authors.forename: Abelardo Q-C
authors.initials: AQ
authors.lastname: Araújo
mesh_terms: D000328:Adult; D001782:Blood Donors; D001938:Brazil; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000453:epidemiology / Q000503:physiopathology; D009135:Muscular Diseases / Q000453:epidemiology / Q000503:physiopathology; D009420:Nervous System / Q000473:pathology / Q000503:physiopathology* / Q000821:virology; D009460:Neurologic Examination; D015493:Paraparesis, Tropical Spastic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology / Q000503:physiopathology; D015995:Prevalence