Quantitative assessment of subclinical spasticity in human T-cell lymphotropic virus type I infection
Abstract
Objective: To compare human T-cell lymphotrophic virus type I (HTLV-I) seropositive and seronegative women for symptoms and signs of spasticity.
Background: Infection with HTLV-I causes tropical spastic paraparesis/HTLV-I–associated myelopathy (TSP/HAM). Certain populations, including female commercial sex workers (FSW), are at increased risk of developing this infection. Fewer than 5% of HTLV-I–seropositive persons develop TSP/HAM, which is typically associated with spasticity.
Methods: Cross-sectional study of 255 registered FSW in Callao, Perú, involving a questionnaire detailing demographics and neurologic symptoms, standard neurologic examination, quantitative assessment of spasticity (QSA) of muscle tone, and serologic testing for HTLV-I. Participants and examiners were blinded to serology results.
Results: On the questionnaire and neurologic examination, none of the 32 HTLV-I–seropositive or 223 seronegative women had signs or symptoms of spasticity. However, mean values on QSA were significantly higher among seropositive women (27.1 Newton-meters/radian [N-m/r]) than among seronegative women (21.6 N-m/r, p = 0.01), indicating a subclinical increase in lower extremity tone. With values of QSA divided into tertiles, and the first tertile serving as the comparison group, the odds ratio for seropositivity was 1.4 (95% confidence interval [CI] 1.0 to 2.0) in the second and 3.1 (95% CI 2.2 to 4.3) in the third tertile, after adjusting for age and place of birth.
Conclusions: Although a standard neurologic evaluation could not distinguish between women with and without HTLV-I infection, QSA indicated significantly increased lower extremity tone in those with infection. Long-term follow-up will determine whether these subclinical findings in asymptomatic women progress to overt TSP/HAM.
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References
1.
Román GC, Román LN. Tropical spastic paraparesis. A clinical study of 50 patients from Tumaco (Colombia) and review of the worldwide features of the syndrome. J Neurol Sci 1988;87:121–138.
2.
Vernant JC, Maurs L, Gessain A, et al. Endemic spastic paraparesis associated with human T-cell lymphotrophic virus type I : a clinical and seroepidemiological study of 25 cases. Ann Neurol 1987;21:123–130.
3.
Murphy EL, Wilks R, Morgan OSC, et al. Health effects of human T-lymphotropic virus type I (HTLV-I) in a Jamaican cohort. Int J Epidemiol 1996;25:1090–1097.
4.
Kaplan JE, Osame M, Kubota H, et al. The risk of development of HTLV-I–associated myelopathy/tropical spastic paraparesis among persons infected with HTLV-I. J Acquir Immune Defic Syndr 1990;3:1096–1101.
5.
Murphy EL, Fridley J, Smith LW, et al. HTLV-associated myelopathy in a cohort of HTLV-I and HTLV-II–infected blood donors. Neurology 1997;48:315–320.
6.
Khabbaz RF, Darrow WW, Hartley TM, et al. Seroprevalence and risk factors for HTLV-I/II infection among female prostitutes in the United States. JAMA 1990;263:60–64.
7.
Gotuzzo E, Sánchez J, Escamilla J, et al. Human T-cell lymphotrophic virus type I infection among female sex workers in Peru. J Infect Dis 1994;169:754–759.
8.
Wignall FS, Hyams KC, Phillips IA, et al. Sexual transmission of human T-lymphotropic virus type I in Peruvian prostitutes. J Med Virol 1992;38:44–48.
9.
Wiktor SZ, Piot P, Mann JM, et al. Human T-cell lymphotrophic virus type I (HTLV-I) among female prostitutes in Kinshasa, Zaire. J Infect Dis 1990;161:1073–1077.
10.
Nakashima K, Kashiwaga S, Kajiyama W, et al. Sexual transmission of human T-lymphotropic virus type I among female prostitutes and among patients with sexually transmitted diseases in Fukuoka, Kyushu, Japan. Am J Epidemiol 1995;141:305–311.
11.
Lehmann JF, Price R, deLateur BJ, Hinderer S, Traynor C. Spasticity : quantitative measurements as a basis for assessing effectiveness of therapeutic intervention. Arch Phys Med Rehabil 1989;70:6–15.
12.
Price R, Bjornson KF, Lehmann JF, McLaughlin JF, Hays RM. Quantitative measurement of spasticity in children with cerebral palsy. Dev Med Child Neurol 1993;33:585–595.
13.
SPSS for Macintosh. Advanced Statistics, Release 6.0. Chicago, IL: SPSS, 1993.
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Received: November 13, 1998
Accepted: February 26, 1999
Published online: July 1, 1999
Published in print: July 1, 1999
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