Frequency and characteristics of HTLV in migrants: results from the plus Redivi collaborative network in Spain
Por:
Norman, F, Salvador, F, Gullon, B, Diaz-Menendez, M, Perez-Ayala, A, Rodriguez-Guardado, A, Garcia-Rodriguez, M, Henriquez-Camacho, C, Goikoetxea, J, Bosch-Nicolau, P, Calle, F, Ramos-Rincon, J, Aznar, M, Penaranda, M, Calabuig, E, Suarez-Garcia, I, Perez-Molina, J and Lopez-Velez, R
Publicada:
4 nov 2022
Ahead of Print:
1 feb 2022
Resumen:
Introduction The objective of this study was to describe the main characteristics of migrants diagnosed with human T-lymphotropic virus (HTLV) infection within the +Redivi Spanish network. Methods Patients with a diagnosis of HTLV type 1 or 2 in +Redivi from October 2009 to December 2020 were included. Diagnosis was based on positive HTLV serology (enzyme-linked immunosorbent assay (ELISA)/chemiluminescent immunoassay (CLIA)) with line immunoassay (LIA)/Western blot with/without polymerase chain reaction (PCR). Results A total of 107/17 007 cases (0.6%) had a final diagnosis of HTLV infection: 83 (77.67%) HTLV-1 infections, 6 (5.6%) HTLV-2 infections and 18 (16.8%) non-specified. The majority (76, 71%) were female, median age was 42 years and median time from arrival to Spain until consultation was 10 years. The group included 100 (93.5%) immigrants and 7 (6.6%) visiting friends and relatives (VFR)-immigrants. Most patients were from South America (71, 66.4%), followed by Sub-Saharan Africa (15, 14%) and Central America-Caribbean (13, 12.1%). Around 90% of patients were asymptomatic at presentation and diagnosed as part of screening programs. Median duration of follow-up was 5 years (IQR 2-7). Regarding HTLV-associated conditions, 90 patients (84.2%) had none, 7 (6.5%) had tropical spastic paraparesis , 5 (4.7%) had other associated conditions (dermatitis, uveitis, pulmonary disease), 3 (2.8%) had other neurological symptoms and 2 (1.9%) had adult T-cell leukaemia/lymphoma. No patients with HTLV-2 had HTLV-associated conditions. Four patients (3.7%) died. Concomitant diagnoses were found in 41 (38.3%) patients, including strongyloidiasis in 15 (14%) and HIV co-infection in 4 (3.7%). In 70% of patients, screening of potential contacts was not performed/recorded. Conclusions HTLV infections (the majority due to HTLV-1) were mainly diagnosed in asymptomatic migrants from Latin America (generally long-settled immigrants and the majority female with the consequent implications for screening/prevention). A high rate of association with strongyloidiasis was found. In the majority, screening of potential contacts was not performed, representing a missed opportunity for decreasing the under diagnosis of this infection.
Filiaciones:
Norman, F:
Ramon y Cajal Univ Hosp, Infect Dis Dept, Natl Referral Unit Trop Dis, CIBER Enfermedades Infecciosas, Madrid, Spain
Salvador, F:
Vall Hebron Univ Hosp, Infect Dis Dept, PROSICS Barcelona, Barcelona, Spain
Gullon, B:
Ramon y Cajal Univ Hosp, Infect Dis Dept, Natl Referral Unit Trop Dis, CIBER Enfermedades Infecciosas, Madrid, Spain
Diaz-Menendez, M:
Hosp Univ Paz Carlos III, Natl Referral Ctr Imported Trop Dis, Madrid, Spain
Perez-Ayala, A:
12 Octubre Univ Hosp, Madrid, Spain
Rodriguez-Guardado, A:
Asturias Cent Univ Hosp, Oviedo, Spain
Garcia-Rodriguez, M:
Valencia Gen Univ Hosp, Valencia, Spain
Henriquez-Camacho, C:
Rey Juan Carlos Univ Hosp, Madrid, Spain
Goikoetxea, J:
Cruces Univ Hosp, Baracaldo, Spain
Bosch-Nicolau, P:
Vall Hebron Univ Hosp, Infect Dis Dept, PROSICS Barcelona, Barcelona, Spain
Calle, F:
Hosp Univ Paz Carlos III, Natl Referral Ctr Imported Trop Dis, Madrid, Spain
:
Alicante Gen Univ Hosp, Alicante, Spain
Aznar, M:
Vall Hebron Univ Hosp, Unitat Med Trop & Salut Int Vall Hebron Drassane, PROSICS Barcelona, Barcelona, Spain
Penaranda, M:
Son Espases Univ Hosp, Islas Baleares, Spain
Calabuig, E:
Univ Valencia, La Fe Univ & Polytech Hosp, Med Dept, Unidad Enfermedades Infecciosas, Valencia, Spain
Suarez-Garcia, I:
Infanta Sofia Univ Hosp, Madrid, Spain
Perez-Molina, J:
Ramon y Cajal Univ Hosp, Infect Dis Dept, Natl Referral Unit Trop Dis, CIBER Enfermedades Infecciosas, Madrid, Spain
Lopez-Velez, R:
Ramon y Cajal Univ Hosp, Infect Dis Dept, Natl Referral Unit Trop Dis, CIBER Enfermedades Infecciosas, Madrid, Spain
Open Access
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