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  • Meeting abstract
  • Open Access

Changes in proviral load (PVL) among patients with rapidly progressive HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) receiving empirical therapy

  • 1, 2, 3Email author,
  • 1,
  • 1, 2,
  • 1,
  • 1,
  • 1, 4 and
  • 1, 5
Retrovirology20118(Suppl 1):A58

https://doi.org/10.1186/1742-4690-8-S1-A58

Published: 6 June 2011

Keywords

  • Prednisone
  • Median Time
  • Interquartile Range
  • Lamivudine
  • Zidovudine

Introduction

Previous studies suggest that HTLV-1 PVL remains constant over time. We compare PVL, at baseline and follow-up, in patients with rapidly progressive HAM/TSP who received empirical treatment.

Methods

Rapidly progressive HAM/TSP was defined by patients’ incapacity to walk unaided within two years after symptoms’ onset. These cases are treated at our center with prednisone in combination with Lamivudine and/or Zidovudine at standard doses. PVL were performed by duplicate in PBMC of blood samples drawn before (baseline) and during treatment; values are reported in copies /104 PBMC.

Results

We evaluated 11 patients (6 women); their median age was 50 years-old, interquartile range [IQR] 20, with significant differences between men and women (medians: 56 and 36, respectively, p=0.02). Median HAM/TSP duration at diagnosis was 12 months (IQR 4). The median time (all in months) between the symptoms onset and the beginning of therapy was 14 (IQR: 9); between HAM/TSP onset and the baseline PVL, 14 (IQR: 13); between PVL determinations, 7 (IQR: 7). Median PVL values were 1183 (IQR: 1425) at baseline, and 1002 at follow-up (IQR: 1425). In the group of 7/11 patients where PVL decreased, differences between baseline and follow-up determinations were significant (p=0.01), with a median paired reduction of 362 (IQR: 1425). In the four cases where PVL increased, differences were not significant (p=0.06).

Conclusions

In most of the cases here reported, PVL decreased significantly during empirical therapy. Clinical correlates and long-term evaluation of these findings demand controlled therapy trials.

Authors’ Affiliations

(1)
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú
(2)
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
(3)
Departamento de Enfermedades Infecciosas, Tropicales y Dermatología, Hospital Nacional Cayetano Heredia, Lima, Perú
(4)
Institute of Tropical Medicine, Antwerp, Belgium
(5)
Laboratorios de Investigación y Desarrollo (LID), Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Perú

Copyright

© Gotuzzo et al; licensee BioMed Central Ltd. 2011

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 (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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