Importance of Human T Lymphotropic Virus Type I detection in neurological syndroms in Argentina

EIRIN ME, BERINI C, SALOMÓN H, BIGLIONE M

Montego Bay, Jamaica

Congreso; 12th International Conference on Human Retrovirology; 2005

International Retrovirology Association and The University of the West Indies

Introduction: HTLV-I associated Myelopathy / Tropical Spastic Paraparesis (HAM/TSP) is a neurological disease  characterized by demyelinating lesions in the brain and the spinal chord. The Individuals that develop HAM/TSP present spastic paraparesis in low limbs, hyperreflexia and bladder dysfunction.  HAM/TSP is frequently found in areas with high prevalence for HTLV-I infection. HTLV-I infection and its associated diseases has been detected as endemic in the Northwest region of Argentina. Objective: The aim of this study was to analyze retrospectively cases of patients derived by neurological services from  Buenos Aires (a non endemic city)  to the NRCA  for HTLV-I/II diagnosis from November 1996 to March 2004. Materials and Methods: We analyzed 87 samples (in plasma and/or cerebrospinal fluid)  of patients with paraparesis or suspected of HAM/TSP. Antibodies anti-HTLV-I/II were detected by Particle Agglutination (PA) (Serodia, Fujirebio, Japan) and reactive samples  were confirmed by Western Blot (WB) (HTLV Blot 2.4 Genelabs Diagnostics, Singapore). Results: Out of 87 patients, 16 (18.4%) (CI 95% 9.7-27.1) were confirmed HTLV-I seropositive, 10 (11.5%) (CI 95% 4.2-18.8) resulted indeterminate by WB. Five relatives from 2 cases of HAM/TSP were confirmed HTLV-I seropositive. Among the 21 HTLV-I infected individuals, 4 were HIV seropositive, 11 patients or their parents were born in endemic areas of Argentina and 6 patients in other endemic countries such as Bolivia, Peru and Japan. Conclusions: HTLV-I was the ethiologic agent of the neurological pathology more than expected for a non endemic area. In this study, the prevalence of HTLV-I among the 87 patients studied  was significantly lower than in endemic areas (45.2%) (CI 95% 41.51-48.95 ) (P<0.001) but higher than in non endemic ones (0.41 %) (CI 95% 0.11-1.31) (p<0.001). All HTLV-I cases had risk antecedents for this infection. In summary, HTLV-I diagnosis must be considered in patients with neurological syndromes related to HAM/TSP even in non endemic cities of our country. Alerting their relatives about the possibility of infection must be considered.