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Clinical manifestations in HTLV-1 infected individuals without HAM/TSP: Results of an 8 years cohort


HTLV-1 is an endemic virus in the northeast of Brazil and is related to HAM/TSP in up to 5% of infected individuals. Despite this low prevalence it is known that a higher number of carriers presents with clinical and neurological symptoms that can be sensory, motor, urinary, inflammatory or autonomic.


This is a cohort study with 440 HTLV-1 infected individuals in Salvador, Bahia. Symptoms were computed every year and incidence rates were calculated to each variable in data.


Applying international criteria 163 individuals had definite, possible or probable HAM/TSP and 266 were asymptomatic. The last was selected for analysis. Follow-up of at least one year was archived in 64 to 75% of patients, varying according to the studied variable. The symptoms incidence rate was 20.6% for hand numbness, 18.6% for feet numbness, 12.9% for nocturia, 12.6% for urgency and 13.3% for dry mouth. In the physical exam the incidence was 22.7% for gingivitis, 7.6% for legs hyperreflexia, 5.2% for legs paraparesis and 3.6% for Babinski sign. In annual applied EDSS scale the incidence rate of worsening 1 point was 13.4%. Cox regression was done with EDSS curves and identified proviral load and female gender as significant risk factors (ORs 3.36 [1-11.66] and 1.80 [1.09-2.97] respectively). Six patients developed HAM/TSP during the cohort.


Developing of neurological symptoms or signs occurred in up to 30% of asymptomatic patients during 8 years follow-up. The estimated incidence was 12% for overactive bladder syndrome and 2.25% for definite HAM/TSP.

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Correspondence to Davi Tanajura.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Tanajura, D., Castro, N., Oliveira, P. et al. Clinical manifestations in HTLV-1 infected individuals without HAM/TSP: Results of an 8 years cohort. Retrovirology 11 (Suppl 1), P3 (2014).

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