Urinary symptoms associated with human T-cell lymphotropic virus type I infection: evidence of urinary manifestations in large group of HTLV-I carriers.
OBJECTIVE
To describe the frequency of urologic manifestations in human T-cell lymphotropic virus type I (HTLV-I) seropositive individuals from Salvador and other cities in Bahia, Brazil, with or without clinical HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP).


METHODS
A total of 218 HTLV-I seropositive subjects referred from blood banks or neurologic clinics were admitted to the HTLV-I multidisciplinary outpatient clinic from January 2001 to April 2004. They were assessed using a standardized questionnaire to determine urinary complaints and quality of life. Neurologic impairment was established using the Expanded Disability Status Scale (EDSS). HAM/TSP was considered as an EDSS score of 2 or greater.


RESULTS
Nocturia (35.8%) was the most frequent finding, followed by incontinence (29.8%), urgency (25.2%), frequency (22.0%), and dysuria (15.6%). Differences were found between individuals with an EDSS score of 0 and those with an EDSS score greater than 0 but less than 2 regarding frequency, nocturia, urgency, urinary loss of any degree, and quality of life. Dysuria and great or total urinary loss were more frequent among those with severe HAM/TSP (EDSS score greater than 6).


CONCLUSIONS
Even HTLV-I subjects considered not to have HAM/TSP may have prominent urinary findings already present. Urologic manifestations, including nocturia and urinary loss, might be early manifestations of neurologic disease in those with HTLV-I.
Castro
Néviton M
NM
Serviço de Imunologia do Hospital Unversitário Prof. Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil. neviton_castro@uol.com.br
Rodrigues
Waldyr
W
Freitas
Daniel M
DM
Muniz
André
A
Oliveira
Paulo
P
Carvalho
Edgar M
EM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015153:Blotting, Western; D001938:Brazil / Q000453:epidemiology; D002353:Carrier State / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D015331:Cohort Studies; D015897:Comorbidity; D053159:Dysuria / Q000453:epidemiology / Q000821:virology; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis / Q000453:epidemiology*; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D053158:Nocturia / Q000453:epidemiology / Q000821:virology; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D012189:Retrospective Studies; D012698:Serologic Tests; D012720:Severity of Illness Index; D017678:Sex Distribution; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology*