Mendoza, Carmen dePérez, LeireRando, AriadnaReina, GabrielAguilera, AntonioBenito, RafaelEirós, José MaríaRodríguez-Avial, ItziarOrtega, DiegoPena, María JoséSoriano, VicenteHTLV Spanish NetworkPozuelo de Felipe, María JoséUniversidad San Pablo-CEU. Facultad de Farmacia. Departamento de Ciencias Farmacéuticas y de la SaludGrupo: Parasitología e Inmunología molecular con aplicación biotecnológica, diagnóstica y terapéutica (PARINM)2024-01-192024-01-192023-11-21de-Mendoza C, Pérez L, Rando A, Reina G, Aguilera A, Benito R, Eirós JM, Rodríguez-Avial I, Ortega D, Pozuelo MJ, Pena MJ, Soriano V; Spanish HTLV Network. HTLV-1-associated myelopathy in Spain. J Clin Virol. 2023 Dec;169:105619. doi: 10.1016/j.jcv.2023.105619. Epub 2023 Nov 21. PMID: 38000189.1386-6532http://hdl.handle.net/10637/15027Acceso al texto completo del artículo, disponible desde el sitio de la revista usando DOI: https://doi.org/10.1016/j.jcv.2023.105619Este artículo está en acceso abierto siguiendo la política de la revistaBackground: HTLV-1 infection is a neglected disease. Over 10 million people are infected worldwide, with hot spots of high endemicity across all continents. Roughly 5% of HTLV-1 carriers develop HTLV-1-associated myelopathy (HAM), a progressive subacute neurological disabling disease. Methods: We report the main features of patients diagnosed with HAM up to date in Spain, a non-endemic country with a relatively high migrant flow from Latin America and Equatorial Africa, where HTLV-1 is endemic. Results: A total of 451 cases of HTLV-1 had been recorded in Spain until the end of year 2022. HAM had been diagnosed in 58 (12.9%). The current incidence is of 2-3 new cases per year. Women represent 76%. Mean age at diagnosis is 49 years-old. Nearly 60% are Latin Americans. Although sexual transmission is the most likely route of HTLV-1 acquisition, up to 6 individuals had been infected following solid organ transplantation. Rapid onset myelopathy developed in all but one of these transplant recipients from three HTLV-1-positive donors. HTLV-1 subtype 1a transcontinental was the only variant recognized in HAM patients. HTLV-1 proviral load was significantly greater in HAM patients than in asymptomatic HTLV-1 carriers (677 vs 104 HTLV-1 DNA copies/104 PBMC; p = 0.012). Symptom relief medications and physiotherapy have been the only treatment providing some benefit to HAM patients. Neither significant clinical nor virological efficacy was noticed using antiretrovirals in at least 9 HAM patients. Two thirds of HAM patients ended up in a wheelchair and with urinary/fecal sphincter incontinence. Conclusion: HAM is the most frequent clinical manifestation of HTLV-1 infection in Spain, a non-endemic country. Middle aged women migrants from Latin America are the most frequently affected. Two thirds end up in a wheelchair despite using antiretroviral therapy.enopen accessEpidemiologyHTLV-1MyelopathyPrenatal screeningSexually transmitted infectionsTestingArtículo10.1016/j.jcv.2023.105619https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es