Helminthic infection and the risk of neurologic disease progression in HTLV-1

J Clin Virol. 2012 Mar;53(3):251-5. doi: 10.1016/j.jcv.2011.12.018. Epub 2012 Jan 10.

Abstract

Background: Infection with the human T-cell lymphotropic virus, type 1 (HTLV-1) has been associated with an increased Th1 response. Interestingly, a higher prevalence of helminthic coinfection has been observed among infected individuals, and subsequent modulation of the immune response typically associated with helminths may influence clinical outcomes among HTLV-1 coinfected individuals.

Objective: This study was conducted to elucidate the association between helminthic coinfection and the development of clinically characterized neurologic disease that occurs in HTLV-1 infection.

Study design: In a cohort analysis, incidence of HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP) was recorded. Incidence of clinical outcomes and disease-free survival of several neurologic outcomes associated with HTLV-1 were estimated using the Kaplan-Meier method with log-rank tests. The relationships between helminthic infection and risk of HTLV-1 neurologic outcomes were assessed by Cox proportional hazard modeling.

Results: Seventy-four coinfected and 79 non-coinfected patients were followed, with 92 helminthic infections observed in the coinfected group. One patient per group developed HAM/TSP and the risk of progression to neurologic disease outcomes did not differ among those with and without helminthic coinfection (p>0.45). A significant difference was noted in the prevalence of neurologic disease outcomes among all patients at the conclusion of the study (p<0.01).

Conclusions: These data suggest that treated helminthic infection does not affect risk of development of neurologic disease in HTLV-1 infection, and reinforce that treatment of helminths does not adversely affect patients with HTLV-1. Importantly, among all patients, an overall progression of neurologic disease was observed.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Coinfection
  • Disease Progression
  • Disease-Free Survival
  • Feces / virology
  • Female
  • HTLV-I Infections / parasitology*
  • HTLV-I Infections / pathology
  • Helminthiasis / pathology
  • Helminthiasis / virology*
  • Human T-lymphotropic virus 1 / isolation & purification*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Paraparesis, Tropical Spastic / parasitology*
  • Paraparesis, Tropical Spastic / virology*
  • Prevalence