“HTLV-I Infection” Twenty-Year Research in Neurology Department of Mashhad University of Medical Sciences

Document Type: Review Article

Authors

1 Assistant Professor of Neurology, Mashhad University of Medical Sciences

2 Professor of Neurology, Mashhad University of Medical Sciences

3 Neurologist, Rafsanjan University of Medical Sciences

4 Resident of Neurology, Mashhad University of Medical Sciences

Abstract

 
 
Human T-cell lymphotropic virus (HTLV) types 1 and 2 belong to the Oncorna group of retroviridae, a large family of viruses, grouped initially by pathogenic features, but later revised on the basis of genome structure and nucleotide sequence. HTLV-I was the first discovered human retrovirus to be associated with a malignancy in 1980. The malignancy, first described by Uchiyama and co-workers in southwestern Japan, was named Adult T-cell Leukemia/Lymphoma (ATL) and characterized with cutaneous and respiratory involvement, hepatosplenomegaly, lymphadenopathy and various metabolic abnormalities such as hypercalcemia. The HTLV-I has been known to be endemic to certain parts of Iran like the province of Khorasan in the northeast since 1990, with a 2.3% prevalence rate of infection. The main manifestations of HTLV-I infection are neurologic and hematologic (such as ATL) disorders, but it has also other manifestations such as uveitis, arthritis, dermatitis, vitiligo and lymphocytic alveolitis. Its main neurologic manifestation is a chronic progressive myelopathy that is referred to HTLV-I Associated Myelopathy (HAM) in Japan and Tropical Spastic Paraparesis (TSP) in Caribbean. But other disorders such as peripheral neuropathy, polyradiculoneuropathy, myopathy, peripheral facial paresis, and so on have been reported too. In this review we wish to give some brief information on the different aspects (including epidemiology, pathogenesis and pathology, clinical findings, and treatment) of HTLV-I infection according to our twenty-year researches. The department of neurology of Mashhad University of Medical Sciences has been a pioneer in researches on HTLV-I in the last twenty years.
 

Keywords


Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Neurology in

Clinical Practice.5th ed .Philadelphia: Elsevier; 2008

2. Gessain A. [Human retrovirus HTLV-I: descriptive and molecular epidemiology, origin, evolution, diagnosis and associated diseases]. Bull Soc Pathol Exot 2011; 104:167-180. Epub 2011/07/29. Le retrovirus humain oncogene HTLV-I: epidemiologie descriptive et moleculaire, origine, evolution et aspects diagnostiques et maladies associees.

 

3. Gessain A, Mahieux R. Epidemiology, origins and genetic diversity of HTLV-I retrovirus and STLV-1 simian affiliated retroviruses. Bull Soc Pathol Exot 2000; 93:163-171.

 

4. Goncalves DU, Proietti FA, Ribas JG, Araujo MG, Pinheiro SR, Guedes AC,

 

 

et al

. Epidemiology, treatment, and prevention of human T-cell leukemia virus type 1-associated diseases. Clin Microbiol Rev 2010; 23:577-89. Epub 2010/07/09.

5. Osame M, Nakagawa M, Umehara F, Ijichi S, Moritoyo T, Higuchi I,

 

 

et al

. Recent studies on the epidemiology, clinical features and pathogenic mechanisms of HTLV-I associated myelopathy (HAM/ TSP) and other diseases associated to HTLV. J Neurovirol 1997; 1:S50-1. Epub 1997/05/01.

6. Roucoux DF, Murphy EL. The epidemiology and disease outcomes of human T-lymphotropic virus type II. AIDS Rev 2004; 6:144-154. Epub 2004/12/15

 

7. Etemadi M, Farid R, Rezaee SA, Boostani R. HTLV-I and Associated Diseases. 1st ed. Iran: Mashhad University of medical sciences; 2010.

 

8. Farid R, Etemadi M, Baradaran H, Nikbin B. Seroepidemiology and virology of HTLV-I in the city of Mashhad, northeastern Iran. Serodiagnosis and immunotherapy in infectious disease 1993; 5:251-252.

 

9. Hedayati-Moghaddam M, Fathimoghadam F, Mashhadi IE, Soghandi L, Bidkhori H. Epidemiology of HTLV-I in Neyshabour, Northeast of Iran. Iran Red Crescent Med J 2011; 13:424.

 

10. Rafatpanah HFR, Golanbar G, Jabbari-Azad F. HTLV-I Infection: Virus Structure, Immune Responses to the Virus and Genetic Association Studies in HTLV-I-Infected Individuals. Iran J Allergy Asthma Immunol 2006; 5:153-166.

 

11. Hedayati Moghadam MR ea. HTLVI Twenty Years Research in Khorasan. 1st ed ed. Iran: Regional Educational Transfusion organization of Khorasan; 2011.

 

12. Manns A, Hisada M,Grenade LL. Human T-lymphotropic virus type I infection.Lancet 1999; 353:1951-1958.

 

13. Khameneh Z, Baradaran M, Sepehrvand N. Survey of the seroprovalence of HTLV I/II in hemodialysis patients and blood donors in Urmia. Saudi J Kidney Dis Transplant 2008; 19:838.

 

14. Costa CM, Dom R, Carton H, Santos Tde J, Andrada-Serpa MJ. Neuropathology of human and experimental TSP/HAM: a critical review. Acta Neurol Belgica 2002; 102:21-29. Epub 2002/07/04

 

15. de Castro-Costa CM, Dom R, Carton H, Goubau P, Santos TDT, Ferreira MVP,

 

 

et al

. Neuropathology of two brazilian autopsied cases of tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM) of long evolution. Arq Neuro-Psiquiat 2002; 60:531- 536.

16. Izumo S. Neuropathology of HTLV-I-associated myelopathy (HAM/TSP). Neuropathology 2010. Epub 2010/06/25.

 

17. Kira J. [Physiopathology and therapy of HTLV-I-associated myelopathy]. Fukuoka igaku zasshi .17 Hukuoka acta medica. 1996; 87:1-7. Epub 1996/01/01

 

18. Liberski PP, Buczynski J, Yanagihara R, Mora C, Gibbs CJ, Gajdusek DC,

 

 

et al

. Ultrastructural pathology of a Chilean case of tropical spastic paraparesis human T-cell lymphotropic type I-associated myelopathy (TSP/HAM). Ultrastruct Pathol 1999; 23:157-162.

19. Etemadi MM RH, Salari M, Boostani R. Clinical, immunological and neuroimaging in HTLV-I associated myelopathy patients. Med J Mashhad Univ Med Sci 2002;77.

 

20. Poetker SKW, Porto AF, Giozza SP, Muniz AL, Caskey MF, Carvalho EM,

 

 

et al

. Clinical manifestations in individuals with recent diagnosis of HTLV type I infection. J Clin Virol 2011; 51:54-58.

21. Liesz A, Hahnel S, Korn K, Esiri M, Hacke W, Wildemann B. [HTLV-I-associated myelopathy/tropical spastic paraparesis : A differential diagnosis in multiple sclerosis]. Der Nervenarzt. 2012;83:1028-1034. Epub 2012/05/17. HTLV-I-assoziierte Myelopathie/tropische spastische Paraparese : Eine Differenzialdiagnose

 

 

 

 

214

 

 

der Multiplen Sklerose.

22. Ishak R, Cavalcante F, Vallinoto AC, Azevedo VN, Ishak MO. HTLV-I associated myelopathy in the northern region of Brazil (Belem- Para): serological and clinical features of three cases. Revista da Epub 2002; 6:243.Sociedade Brasileira de Medicina Tropical. 2002

23. Takahashi T, Takase H, Urano T, Sugita S, Miyata K, Miyata N

,et al

. Clinical features of human T-lymphotropic virus type 1 uveitis: a long-term follow-up. Ocular Immunol inflamm 2001; 8:235-241.

24. Nakagawa M, Izumo S, Ijichi S, Kubota H, Arimura K, Kawabata M

 

 

,et al

. HTLV-I-associated myelopathy: analysis of 213 patients based on clinical features and laboratory findings. J Neurovirol 1995; 1:50-61.

25. Lezin A, Olindo S, Oliere S, Varrin-Doyer M, Marlin R, Cabre P

 

 

, et al

. Human T lymphotropic virus type I (HTLV-I) proviral load in cerebrospinal fluid: a new criterion for the diagnosis of HTLV-I-associated myelopathy/tropical spastic paraparesis? J Infect Dis 2005; 191:1830-1834.

26. Posada-Vergara MP, Montanheiro P, Fukumori LM, Bonasser F, Duarte AJ, Penalva de Oliveira AC,

 

 

et al

. Clinical and epidemiological aspects of HTLV-II infection in Sao Paulo, Brazil :presence of tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile diagnosis in HIV-1-co-infected subjects. Rev Inst Med Trop Sao Paulo 2006; 48:207-210.

27. Slater CM, Ribeiro LC, Puccioni-Sohler M. Difficulties in HAM/TSP diagnosis. Arq Neuro-Psiquiat 2012; 70:686-690.

 

28. Sheremata W, Brown A, Lowis G. HAM/TSP is important in the differential diagnosis of multiple sclerosis. Mult Scler 2007; 13:S224-S5.

 

29. Puccioni-Sohler M, Rios M, Carvalho SMF, Oliveira C, de Oliveira MSP, Correa R

 

 

,et al

. The value of the cerebrospinal analysis for the diagnosis and prognosis of HAM/TSP. Aids Res Hum Retrov 2001; 17:S65-S.

30. Puccioni-Sohler M, Yamano Y, Goncalves RG, Vasconcelos CCF, Papais-Alvarenga R, Jacobson S. The importance of the detection of proviral load in PBMNC and CSF in the differential diagnosis between HAM/TSP and multiple sclerosis. J Neurol Sci 2005; 238:S305-S306.

 

31. Nagai M, Osame M. Pathogenesis and treatment of31 .human T-cell lymphotropic virus Type I-associated myelopathy. Exp Rev Neurotherapeutics 2002; 2:891-899.

 

32. Pot C, Chizzolini C, Vokatch N, Tiercy JM, Ribi C, Landis T,

 

 

et a

. Combined antiviral- immunosuppresive treatment in human T-lymphotrophic virus 1-Sjogren-associated myelopathy. Arch Neurol 2006; 63:1318-1320.

33. Gotuzzo E, Cabrera J, Tipismana M, Verdonck K. Empirical treatment of rapidly progressive Tsp/Ham. Aids Res Hum Retrov 2005; 21:466.

 

34. Olindo S, Belrose G, Lezin A, Gillet N, Defoiche J, Rodriguez S

 

 

,et al

. Long-Term Treatment with Valproic Acid Does Not Alleviate the Condition of HAM/TSP. Aids Res Hum Retrov 2009; 25:1217.

35. Olindo S, Belrose G, Gillet N, Rodriguez S, Boxus M, Verlaeten O

 

 

,et al

. Safety of long-term treatment of HAM/TSP patients with valproic acid. Blood 2011; 118:6306-6309.

36. Carod-Artal FJ. [Immunopathogenesis and treatment of the myelopathy associated to the HTLV-I virus]. Rev Nurol 2009; 48:147- 155.9/02/12. Inmunopatogenesis y tratamiento de la mielopatia asociada al virus linfotropico humano de celulas T (HTLV-I).

 

37. Casseb J, Smid J, Vidal J, Okajima R, Oliveira ACP. Valproic acid for the treatment of myelopathy associated with HTLV-I/Tropical spastic paraparesis (HAM/TSP). J Neurovirol 2010; 16:17.

 

38. Rafatpanah H, Rezaee A, Etemadi MM, Hosseini RF, Khorram B, Afsahr L

 

 

,et al

. The impact of interferon-alpha treatment on clinical and immunovirological aspects of HTLV-I-associated myelopathy in northeast of Iran. J Neuroimmunol 2012; 250:87-93.

39. Yamano Y, Sato T, Ando H, Araya N, Yagishita N. [The current and future approaches to the treatment of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP)]. Nihon Rinsho 2012; 70:705-713.

 

40. Oh U, Jacobson S. Treatment of HTLV-I-associated myelopathy/ tropical spastic paraparesis: toward rational targeted therapy. Neurologic Clin 2008; 26:781-97, ix-x. Epub 2008/07/29.