title: A Peruvian family with a high burden of HTLV-1-associated myelopathy/tropical spastic paraparesis.
abstract: Human T-lymphotropic virus 1 (HTLV-1) is frequent in Peru; an estimated 1-2% of the Peruvian population carry this retrovirus. HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic disabling disease that affects about 1% of the carriers of HTLV-1. It is not yet known why some HTLV-1-infected people develop HAM/TSP while others do not. In this case report, we present a family with an unusually high burden of HAM/TSP: 5 (the 2 parents and 3 of their children) of 7 HTLV-1 carriers developed the same disease. We describe the clinical presentation and discuss the clustering of disease against the current knowledge of the pathogenesis of HAM/TSP. Families such as this may hold the key to discovering which factors trigger the development of HAM/TSP.
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, KU Leuven-University of Leuven, Leuven, Belgium.
authors.forename: Carolina
authors.identifier: http://orcid.org/0000-0001-5240-3002
authors.initials: C
authors.lastname: Alvarez
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
authors.forename: Kristien
authors.initials: K
authors.lastname: Verdonck
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru Servicio de Neurología, Hospital Cayetano Heredia, Lima, Peru.
authors.forename: Martín
authors.initials: M
authors.lastname: Tipismana
authors.affiliation: Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Cayetano Heredia, Lima, Peru.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gotuzzo
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005192:Family Health; D005260:Female; D015368:Human T-lymphotropic virus 1; D006801:Humans; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000097:blood* / Q000175:diagnosis*; D010568:Peru; D055815:Young Adult