Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study
IntroductionHuman T-cell lymphotropic virus type 1 (HTLV-1) may cause spinal cord inflammation, leading to HTLV-1-associated myelopathy (HAM). HAM is a chronic and progressive neurological disorder that is associated with increased mortality and impaired quality of life. There are limited data on th...
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Frontiers Media S.A.
2025-01-01
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| author | Carolina Rosadas Jerico Baylon Claire Greiller Adine Adonis Divya Dhasmana Nicholas W. S. Davies Graham P. Taylor Graham P. Taylor |
| author_facet | Carolina Rosadas Jerico Baylon Claire Greiller Adine Adonis Divya Dhasmana Nicholas W. S. Davies Graham P. Taylor Graham P. Taylor |
| author_sort | Carolina Rosadas |
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| description | IntroductionHuman T-cell lymphotropic virus type 1 (HTLV-1) may cause spinal cord inflammation, leading to HTLV-1-associated myelopathy (HAM). HAM is a chronic and progressive neurological disorder that is associated with increased mortality and impaired quality of life. There are limited data on the incidence of HAM, with higher rates seen in Latin America and the Caribbean compared to Japan. We investigated the incidence of HAM in a cohort of initially asymptomatic people with HTLV-1 in the United Kingdom (UK).MethodsThis is a longitudinal retrospective observational study of people with confirmed HTLV-1 infection who first attended the National Centre for Human Retrovirology in London, UK, between 1st March 1991 and 31st March 2024. Clinical records were analysed to calculate the incidence rate and cumulative incidence of HAM. A secondary analysis was conducted to assess HAM incidence in people living with HTLV-1 and HIV coinfection. At the first visit, the HTLV-1 proviral load was compared between incident cases and those who remained asymptomatic during follow-up.ResultsIn a cohort with up to 33 years of follow-up of individuals living with HTLV-1 in the UK, the cumulative incidence of HTLV-1-associated myelopathy (HAM) was found to be 1.35% (4/297), with an incidence rate of 1.98 per 1,000 person-years. All people who developed HAM had a high proviral load at the first clinic visit. No cases of incident HAM were observed among individuals who had HIV-HTLV-1 coinfection during the study period.DiscussionThe incidence of HAM in the UK cohort is comparable to the rates reported in Latin America and the Caribbean and is higher than reported in other high-income countries. High proviral load of HTLV-1 predates the development of HAM. |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-8a551677891443f4b541e0203ec92b482025-01-07T06:41:29ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.15197501519750Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort studyCarolina Rosadas0Jerico Baylon1Claire Greiller2Adine Adonis3Divya Dhasmana4Nicholas W. S. Davies5Graham P. Taylor6Graham P. Taylor7Section of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United KingdomNational Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United KingdomSection of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United KingdomNational Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United KingdomNational Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United KingdomNational Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United KingdomSection of Virology, Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, United KingdomNational Centre for Human Retrovirology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United KingdomIntroductionHuman T-cell lymphotropic virus type 1 (HTLV-1) may cause spinal cord inflammation, leading to HTLV-1-associated myelopathy (HAM). HAM is a chronic and progressive neurological disorder that is associated with increased mortality and impaired quality of life. There are limited data on the incidence of HAM, with higher rates seen in Latin America and the Caribbean compared to Japan. We investigated the incidence of HAM in a cohort of initially asymptomatic people with HTLV-1 in the United Kingdom (UK).MethodsThis is a longitudinal retrospective observational study of people with confirmed HTLV-1 infection who first attended the National Centre for Human Retrovirology in London, UK, between 1st March 1991 and 31st March 2024. Clinical records were analysed to calculate the incidence rate and cumulative incidence of HAM. A secondary analysis was conducted to assess HAM incidence in people living with HTLV-1 and HIV coinfection. At the first visit, the HTLV-1 proviral load was compared between incident cases and those who remained asymptomatic during follow-up.ResultsIn a cohort with up to 33 years of follow-up of individuals living with HTLV-1 in the UK, the cumulative incidence of HTLV-1-associated myelopathy (HAM) was found to be 1.35% (4/297), with an incidence rate of 1.98 per 1,000 person-years. All people who developed HAM had a high proviral load at the first clinic visit. No cases of incident HAM were observed among individuals who had HIV-HTLV-1 coinfection during the study period.DiscussionThe incidence of HAM in the UK cohort is comparable to the rates reported in Latin America and the Caribbean and is higher than reported in other high-income countries. High proviral load of HTLV-1 predates the development of HAM.https://www.frontiersin.org/articles/10.3389/fmed.2024.1519750/fullHTLV-1incidenceHAMepidemiologyHTLV-1 associated myelopathytropical spastic paraparesis |
| spellingShingle | Carolina Rosadas Jerico Baylon Claire Greiller Adine Adonis Divya Dhasmana Nicholas W. S. Davies Graham P. Taylor Graham P. Taylor Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study Frontiers in Medicine HTLV-1 incidence HAM epidemiology HTLV-1 associated myelopathy tropical spastic paraparesis |
| title | Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study |
| title_full | Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study |
| title_fullStr | Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study |
| title_full_unstemmed | Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study |
| title_short | Incidence of HTLV-1-associated myelopathy in the UK from 1991 to 2024: a longitudinal observational cohort study |
| title_sort | incidence of htlv 1 associated myelopathy in the uk from 1991 to 2024 a longitudinal observational cohort study |
| topic | HTLV-1 incidence HAM epidemiology HTLV-1 associated myelopathy tropical spastic paraparesis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1519750/full |
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