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• W2938798009 abstract "In Peru, the Institute of Tropical Medicine Alexander von Humboldt, in partnership with Hospital Cayetano Heredia, promotes specialized care for persons with HTLV-1 infection since 1989. Briefly, we offer pre and post-test counseling, diagnostic services, and medical attention. People are eligible for diagnostic services if they have: a prior seropositive result in Blood Banks; a first-degree relative or sexual partner with HTLV-1 infection; a potential diagnosis of HTLV-1-associated diseases (mainly: HTLV-1-associated myelopathy (HAM/TSP), Strongyloides stercoralis (SS) infection, T-cell leukemia/lymphoma, uveitis, infective dermatitis). Given the limited capacity to continuously afford confirmatory testing, HTLV infection is also diagnosed with repeatedly reactive ELISA tests. Cases receive post-test counseling, and specialized medical services. This setting has promoted our HTLV-1 Cohort; for those consenting, enrollment is at time of HTLV-1 testing. Until June 2015, 8845 persons were enrolled in the cohort; the median age was 38.8 years (interquartile range: 26.5–52.3), 5042 (57.5%) were women and 4337 (49.0%) did not report being related to someone with HTLV-1 infection and were thus defined as index cases. The leading reasons for HTLV testing were family studies (3987, 45.1%), followed by potential diagnosis of HTLV-1 associated diseases (3365, 38.0%), and seropositive results in Blood Banks (718, 8.5%). HTLV infection was diagnosed in 3359 persons (48.0%), including 1202 (13.6%) with available confirmatory testing. Most (58.3%) were women; the median age was 43 years (IQR: 31.0–55.6), but 285 were children. The proportion of HTLV diagnosis varied by reason for testing: 79.0% for those with potential HAM/TPS, 69.8% for potential ATL, 31.0% in cases with SS; 79.0% in donors and 34.0% when testing was done as part of family studies. At entry, the cases with HTLV infection included potential HAM/TSP (621, 18.5%); other complications mostly of infectious nature (338, 10.1%); SS infection (238, 7.0%), and ATL (5.6%). Most cases (1426, 43.0%) were lost to follow-up in the first year after diagnosis; in those remaining, with 8227 person-years of follow-up up to December 31, 2016, there were 88 incident cases of HAM/TSP, 47 of SS, and 8 of ATL. In those not lost-to-follow-up, 113 out of 1933 (5.6%) died. Our cohort offers a valuable platform to increase the quality of evidence regarding clinical consequences of HTLV-1 infection; at the same time, the number of pediatric cases remark the imperative need to implement sound actions for prevention of transmission of HTLV-1 from mother-to-child." @default.
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• W2938798009 date "2019-04-01" @default.
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• W2938798009 title "A-107 A general description of the HTLV-1 Cohort at the Institute of Tropical Medicine Alexander von Humboldt (1989–2015)" @default.
• W2938798009 doi "https://doi.org/10.1097/01.qai.0000557947.21249.8e" @default.
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