title: Clinical and epidemiological aspects of HTLV-II infection in São Paulo, Brazil: presence of tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile diagnosis in HIV-1-co-infected subjects.
abstract: In this study, the epidemiological and clinical features observed in solely HTLV-II-infected individuals were compared to those in patients co-infected with HIV-1. A total of 380 subjects attended at the HTLV Out-Patient Clinic in the Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, Brazil, were evaluated every 3-6 months for the last seven years by infectious disease specialists and neurologists. Using a testing algorithm that employs the enzyme immuno assay, Western Blot and polymerase chain reaction, it was found that 201 (53%) were HTLV-I positive and 50 (13%) were infected with HTLV-II. Thirty-seven (74%) of the HTLV-II reactors were co-infected with HIV-1. Of the 13 (26%) solely HTLV-II-infected subjects, urinary tract infection was diagnosed in three (23%), one case of skin vasculitis (8%) and two cases of lumbar pain and erectile dysfunction (15%), but none myelopathy case was observed. Among 37 co-infected with HIV-1, four cases (10%) presented with tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile. Two patients showed paraparesis as the initial symptom, two cases first presented with vesical and erectile disturbances, peripheral neuropathies were observed in other five patients (13%), and seven (19%) patients showed some neurological signal or symptoms, most of them with lumbar pain (five cases). The results obtained suggest that neurological manifestations may be more frequent in HTLV-II/HIV-1-infected subjects than those infected with HTLV-II only.
authors.affiliation: IHTLV Out-Patient Clinic, lnstitute of lnfectious Diseases Emílio Ribas, São Paulo, SP, Brazil.
authors.forename: Maria Paulina
authors.initials: MP
authors.lastname: Posada-Vergara
authors.forename: Patrícia
authors.initials: P
authors.lastname: Montanheiro
authors.forename: Ligia M I
authors.initials: LM
authors.lastname: Fukumori
authors.forename: Francisco
authors.initials: F
authors.lastname: Bonasser
authors.forename: Alberto José da Silva
authors.initials: AJ
authors.lastname: Duarte
authors.forename: Augusto Cesar
authors.initials: AC
authors.lastname: Penalva de Oliveira
authors.forename: Jorge
authors.initials: J
authors.lastname: Casseb
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001938:Brazil / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015497:HIV-1; D015491:HTLV-II Infections / Q000150:complications* / Q000453:epidemiology; D015367:Human T-lymphotropic virus 2; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis / Q000821:virology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors