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  • Title: Human T cell lymphotropic virus type 1 in Zimbabwe.
    Author: Houston S, Thornton C, Emmanuel J, Latif A.
    Journal: Trans R Soc Trop Med Hyg; 1994; 88(2):170-2. PubMed ID: 8036662.
    Abstract:
    Human T cell lymphotrophic virus type 1 (HTLV-1) causes myelopathy and adult T cell leukaemia. Knowledge of its distribution in Africa is limited. We performed HTLV-1 testing by enzyme immunoassay, with immunofluorescence assay confirmation, on 931 blood donors, 88 human immunodeficiency virus (HIV) seronegative patients with clinical features of acquired immune deficiency syndrome, 23 multi-transfused haemophiliacs, 8 patients with haematological malignancies, and 32 patients with neurological disease. One blood donor and 3 neurological patients, all 3 with spinal cord syndromes, were HTLV-1-seropositive. Two of the 3 HTLV-1-positive myelopathy patients were co-infected with HIV and both experienced unusually rapid progression of neurological disease. HTLV-1 is uncommon but can be associated with myelopathy in Zimbabwe. Reported is a study of the human T-cell lymphotropic virus type 1 (HTLV-1) seroprevalence in Zimbabwe. HTLV-1, a retrovirus, is known to cause myelopathy and adult T-cell leukemia. Three widely separated collection sites were used. Three testing techniques, the enzyme-linked immunosorbent assay (ELISA) (Dupont), the particle agglutination test, and ELISA (Virgo) were employed in processing the sera samples. All positives were confirmed using Western blot analysis (Dupont). Of the 1082 specimens analyzed, only 4 were determined as being strongly positive for HTLV-1, having an optical density reading (OD) of 1.5-2.0 using ELISA techniques. 8 patients were determined to have leukemia, 23 were hemophiliacs, and 88 were HIV-seronegative "AIDS" patients. None of these patients were HTLV-1 positive. There were 32 neurologically diseased patients; 11 (34.4%) were found to be HIV-seropositive and 3 were HTLV-1 seropositive. 2 of the 11 HIV-positive patients also tested positive for HTLV-1. Clinical histories of the 3 HTLV-1 seropositive patients are described. Case 1 was a 53-year-old, HIV-positive man who demonstrated problems in walking and urinary incontinence. Upon examination, it was determined he had a spastic quadraparesis with loss of sphincter control. Case 2 was a 21-year-old woman who reported a 5 month history of neurological symptoms. She was HIV seropositive and showed a loss of feeling in the thorax area of her body. Sphincter muscle control was also lacking. She deteriorated rapidly and died. Case 3 was a 38-year-old woman who had deteriorating weakness in her legs until, after 3 years, she could no longer walk. She was HIV seropositive. All 3 cases had normal myelograms. This study demonstrates that the prevalence of HTLV-1 is very low in Zimbabwe. There appears to be a strong association between spinal cord disease and HTLV-1 seropositivity. Co-infections of HTLV-1 and HIV-1 were also proven. These cases generally resulted in a faster progression of the neurological disease than seen in patients solely infected with HIV-1 or HTLV-1. HTLV-1 should be considered in any patient who displays an unexplainable spinal cord disease.
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