title: Factors associated with pain in individuals infected by human T-cell lymphotropic virus type 1 (HTLV-1).
abstract: BACKGROUND
  Despite the high prevalence of chronic pain in individuals infected with HTLV-1, predictive and protective factors for its development are still unclear.
  
  
  OBJECTIVE
  To identify factors associated with chronic pain in individuals with HTLV-1.
  
  
  METHODS
  This cross-sectional study was conducted in a reference center for treatment of patients infected with HTLV-1 in Salvador, Bahia, Brazil. The study included individuals infected with HTLV-1, over 18 years, and excluded those with difficulty to respond the pain protocol. Data on sociodemographic, health behavior, and clinical characteristics were collected in a standardized way. The prevalence ratio (PR) of pain is described, as well as the factors independently associated with the presence of pain, which were assessed by multiple logistic regression.
  
  
  RESULTS
  A total of 142 individuals were included in the study, mostly female (62.7%), aged 20-64 years (73.2%), married (61.3%), with less than eight years of education (54.2%), and with a steady income (79.6%). Multivariate analysis showed that being symptomatic for HTLV-1 - sensory manifestations, erectile dysfunction, overactive bladder, and/or HAM/TSP (PR=1.21, 95% CI: 1.05 to 1.38), self-medication (PR=1.29, 95% CI: 1.08-1.53), physiotherapy (PR=1.15, 95% CI: 1.02-1.28), and depression (PR=1.14, 95% CI: 1.01-1.29) were associated with an increased likelihood of presenting pain. On the other hand, physical activity (PR=0.79, 95% CI: 0.67-0.93) and religious practice (PR=0.83, 95% CI: 0.72-0.95) were associated with a decreased likelihood of having pain.
  
  
  CONCLUSIONS
  The use of self-medication, physiotherapy and the presence of depression are independently associated with neurological symptoms in HTLV-1 infected patients. Religious practice and physical activity are both protective for the development of pain.
authors.affiliation: Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brazil; Universidade Federal da Bahia, Laboratório de Eletroestimulação Funcional, Salvador, BA, Brazil; Universidade Federal da Bahia, Hospital Professor Edgard Santos, Serviço de Imunologia, Salvador, BA, Brazil.
authors.forename: Dislene N Dos
authors.initials: DN
authors.lastname: Santos
authors.affiliation: Universidade Federal da Bahia, Laboratório de Eletroestimulação Funcional, Salvador, BA, Brazil.
authors.forename: Kionna O B
authors.initials: KO
authors.lastname: Santos
authors.affiliation: Universidade Federal da Bahia, Laboratório de Eletroestimulação Funcional, Salvador, BA, Brazil.
authors.forename: Alaí B
authors.initials: AB
authors.lastname: Paixão
authors.affiliation: Universidade Federal da Bahia, Hospital Professor Edgard Santos, Serviço de Imunologia, Salvador, BA, Brazil.
authors.forename: Rosana Cristina P de
authors.initials: RC
authors.lastname: Andrade
authors.affiliation: Universidade Federal da Bahia, Hospital Professor Edgard Santos, Serviço de Imunologia, Salvador, BA, Brazil; Universidade Estadual do Sudoeste da Bahia, Vitoria da Conquista, BA, Brazil.
authors.forename: Davi T
authors.initials: DT
authors.lastname: Costa
authors.affiliation: Universidade Federal da Bahia, Laboratório de Eletroestimulação Funcional, Salvador, BA, Brazil; Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Salvador, BA, Brazil.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: S-Martin
authors.affiliation: Universidade Federal da Bahia, Laboratório de Eletroestimulação Funcional, Salvador, BA, Brazil; Escola Bahiana de Medicina e Saúde Pública, Pós graduação e pesquisa, Salvador, BA, Brazil.
authors.forename: Katia N
authors.initials: KN
authors.lastname: Sá
authors.affiliation: Universidade Federal da Bahia, Programa de Pós-graduação em Medicina e Saúde, Salvador, BA, Brazil; Universidade Federal da Bahia, Laboratório de Eletroestimulação Funcional, Salvador, BA, Brazil; Escola Bahiana de Medicina e Saúde Pública, Pós graduação e pesquisa, Salvador, BA, Brazil. Electronic address: afbaptista@ufba.br.
authors.forename: Abrahão F
authors.initials: AF
authors.lastname: Baptista
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D015490:HTLV-I Infections / Q000150:complications*; D015368:Human T-lymphotropic virus 1; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D015995:Prevalence; D012067:Religion; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Chronic pain; Human T-cell lymphotropic virus type I (HTLV-1); Retroviridae infections; Tropical spastic paraparesis