Original ArticleEarly Neurologic Abnormalities Associated with Human T-Cell Lymphotropic Virus Type 1 Infection in a Cohort of Peruvian Children
Section snippets
Methods
We conducted standardized, blinded neurological evaluations of children, with and without HTLV-1 infection, of mothers infected with HTLV-1 in Lima, Peru, where the estimated prevalence of HTLV-1 infection in pregnant women is 1.7%.37 Study participants were drawn from an ongoing HTLV-1 family cohort study (>600 families) at the Institute of Tropical Medicine, “Alexander von Humboldt” in Lima,2 a cohort composed primarily of families of patients who have visited or been referred to the hospital
Results
According to records for >600 HTLV-1 cohort families, 104 families had children eligible for this study. Of these, 66 families were reached and agreed to participate, ultimately yielding 103 eligible study participants from 63 families: 58 children were infected with HTLV-1 and 42 children were uninfected (and 3 were excluded based on indeterminate serological results). None had previously-recognized HAM/TSP. Age and sex profiles are similar for HTLV-1–infected and uninfected subject groups (
Discussion
We found that childhood HTLV-1 infection was associated with lower pyramidal tract signs and neuromuscular symptoms consistent with early HAM/TSP. Nearly all of the signs and symptoms evaluated were present more frequently in children with infection, and, although differences for some infrequent findings may have been due to chance, overall there is a significant association of infection with an abnormal examination. The association of HTLV-1 infection with lower extremity hyperreflexia is
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Supported by the Directorate-General for Development Cooperation of the Belgian Government through a Framework Agreement with the Institute of Tropical Medicine in Antwerp (DGOS-II); the Flemish Interuniversity Council Programme (VLIR); Vanderbilt University School of Medicine Emphasis Program; the Vanderbilt-Meharry Center for AIDS Research (NIH grant P30AI054999); and the Vanderbilt-Meharry Framework Program for Global Health (NIH grant R25TW007766).
The authors declare no potential conflicts of interest.