Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Aug 21:6:2049936119868028.
doi: 10.1177/2049936119868028. eCollection 2019 Jan-Dec.

Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals

Lourdes Roc  1 , Carmen de Mendoza  2 , Miriam Fernández-Alonso  3 , Gabriel Reina  3 , Vicente Soriano  4 ; Spanish HTLV Network
Collaborators, Affiliations
Case Reports

Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals

Lourdes Roc et al. Ther Adv Infect Dis. .

Abstract

Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor-recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain.

Keywords: HTLV-1; antiretroviral drugs; myelopathy; screening; transplantation.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: The author(s) declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Model for HTLV-1 disease development in transplant recipients.
See this image and copyright information in PMC

References

    1. Hlela C, Shepperd S, Khumalo Net al. The prevalence of HTLV type 1 in the general population is unknown. AIDS Rev 2009; 11: 205–214. - PubMed
    1. Gessain A, Cassar O. Epidemiological aspects and world distribution of HTLV-1 infection. Front Microbiol 2012; 3: 388. - PMC - PubMed
    1. Gessain A, Barin F, Vernant Jet al. Antibodies to human T-lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet 1985; 2: 407–410. - PubMed
    1. Yoshida M, Seiki M, Yamaguchi Ket al. Monoclonal integration of HTLV provirus in all primary tumors of adult T-cell leukemia suggests causative role of human T-cell leukemia virus in the disease. Proc Natl Acad Sci USA 1984; 81: 2534–2537. - PMC - PubMed
    1. Martins M, Guimarães J, Ribas Jet al. Long-term follow-up of HTLV-1 proviral load in asymptomatic carriers and in incident cases of HAM/TSP: what is its relevance as a prognostic marker for neurologic disease? J Neurovirol 2017; 23: 125–133. - PubMed

Publication types

LinkOut - more resources