Early neurologic abnormalities associated with human T-cell lymphotropic virus type 1 infection in a cohort of Peruvian children.
OBJECTIVE
Because human T-cell lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) may occur in some children infected with HTLV-1, we sought to determine the prevalence of neurologic abnormalities and any associations of neurologic abnormalities with infective dermatitis in these children.


METHODS
We enrolled 58 children infected with HTLV-1 and 42 uninfected children (ages 3 to 17) of mothers infected with HTLV-1 in a family study in Lima, Peru. We obtained medical and developmental histories, surveyed current neurologic symptoms, and conducted a standardized neurologic examination without prior knowledge of HTLV-1 status.


RESULTS
HTLV-1 infection was associated with reported symptoms of lower extremity weakness/fatigue (odds ratio [OR], 6.1; confidence interval [CI], 0.7 to 281), lumbar pain (OR, 1.7; 95% CI, 0.4 to 8), and paresthesia/dysesthesia (OR, 2.6; CI, 0.6 to 15.8). HTLV-1 infection was associated with lower-extremity hyperreflexia (OR, 3.1; CI, 0.8 to 14.2), ankle clonus (OR, 5.0; CI, 1.0 to 48.3), and extensor plantar reflex (OR undefined; P = .2). Among children infected with HTLV-1, a history of infective dermatitis was associated with weakness (OR, 2.7; CI, 0.3 to 33), lumbar pain (OR, 1.3; CI, 0.2 to 8), paresthesia/dysesthesia (OR, 2.9; CI, 0.5 to 20), and urinary disturbances (OR, 5.7; CI, 0.5 to 290).


CONCLUSIONS
Abnormal neurologic findings were common in Peruvian children infected with HTLV-1, and several findings were co-prevalent with infective dermatitis. Pediatricians should monitor children infected with HTLV-1 for neurologic abnormalities.
Kendall
Emily A
EA
Institute for Global Health, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
González
Elsa
E
Espinoza
Iván
I
Tipismana
Martín
M
Verdonck
Kristien
K
Clark
Daniel
D
Vermund
Sten H
SH
Gotuzzo
Eduardo
E
D000293:Adolescent; D017677:Age Distribution; D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009460:Neurologic Examination; D016017:Odds Ratio; D020335:Paraparesis / Q000175:diagnosis / Q000453:epidemiology*; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D014555:Urination Disorders / Q000175:diagnosis / Q000453:epidemiology