HTLV Detection Kits and Automated Systems
HTLV Technical Information
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Clinical Presentations of HTLV
HTLV-1 causes majority of human infections. The virus has been seriously implicated in several kinds of diseases including HTLV-1-associated myelopathy (HAM), Strongyloides stercoralis hyper-infection, and a cancer link for ATLL, a rare and highly aggressive non-Hodgkin T-cell lymphoma, which may also involved in certain demyelinating diseases, such as tropical spastic paraparesis (TSP). Between 1/20 and 1/25 infected persons are thought to develop cancer because of HTLV-1 viral infection.
Most infections are generally asymptomatic and usually the virus will be in latent phase. Upon manifestation, the following are clinical manifestations of ATLL and HAM/TSP:
There are 4 types of Adult T-cell Leukemia/Lymphoma; Acute, Chronic, Smoldering and Lymphoma. Acute is the most common.
Characterized by infiltration of lymph nodes, viscera and skin with malignant cells, resulting in a constellation of clinical features (Lymphadenopathy).
Circulating abnormal lymphocytes, called flower cells are generally seen
Lifetime risk of 1-5% and occurs in males> females
Pulmonary complications, immunosuppresssion to opportunistic infections (Strongyloides stercoralis hyper-infection).
Hypercalcemia, abnormal liver functions values and lytic bone lesions are common.
Rapidly fatal if not treated. Median survival is 11 months from diagnosis. Conventional chemotherapy is not curative and relapses often occur quickly, although prolonged survival has been reported. ATLL has been estimated to occur in 2%-4% of persons infected with HTLV-I in region where HTLV-I is endemic and where early childhood infection is common. ATLL occurs most frequently among persons 40-60 years of age, suggesting that a latent period as long as a few decades may be required for the disease to develop.
HTLV-I associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP).
Characterized by slow progressive spastic paraparesis (usually present for 8-10 years before diagnosis. Permanent lower-extremity weakness, spasticity, hyperreflexia, mild sensory impairment and urinary incontinence in later stage of disease.
Develops in less than 1% of HTLV-I infected persons, is believed to be immunologically mediated, and affects women more frequently than men between ages of 30-40 years.
Antibodies of HTLV-I are characteristically found in the cerebrospinal fluid.
The latency period for HAM/TSP is shorter than that for ATLL; cases of HAM/TSP have been associated with blood transfusion, with a median interval of 3.3 years between transfusion and development of HAM/TSP.
Diseases associated with HTLV-1 infection
Adult disease Association
Adult T-cell leukemia (ATL) ++++
HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) ++++
Uveities (frequent in Japan) ++++
Infective dermatitis (rare) +++
Polymyositis, inclusion body myositis ++
HTLV-1-associated arthritis ++
Pulmonary infiltrative pneumonitis ++
Sjogren's syndrome +
Childhood disease Association
Infective dermatitis (frequent in Jamaica) ++++
Tropical spastic paraparesis/HTLV-1-associated myelopathy (rare) ++++
Adult T-cell leukemia/lymphoma (vary rare) ++++
Persistent lymphadenopathy +
++++ proven association; +++ probable association; ++ likely association; +possible association Adapted from Mahieux R & Gessain A, 2003
Disclaimer Notice
The health information contained herein is provided for educational, reference purposes only, and is not intended to substitute professional medical advice, diagnosis, or treatment with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. Please check the availability and relevance of the information in your respective country.