Clinical, Radiological and Functional Characteristics of Pulmonary Diseases among HTLV-1 Infected Patients without Prior Active Tuberculosis Infection

Abstract

The lifelong infection with the human T lymphotropic virus type 1 (HTLV-1) has been associated with a variety of clinical manifestations; one of the less-explored is HTLV-1-associated pulmonary disease. Imaging of lung damage caused by the HTLV-1 hyperinflammatory cascade can be similar to sequelae from TB infection. Our study aims to describe the pulmonary lesions of HTLV-1-positive patients without past or current active TB and evaluate pulmonary function. We found that nine out of fourteen patients with no known TB disease history presented bronchiectasis, mainly found bilaterally while five presented pulmonary fibrosis. A normal pattern was found in most patients with a pulmonary functional test. Furthermore, there was no association between the PVL and the chest-CT scan findings, nor with spirometry results. However, the sample size was insufficient to conclude it.

Keywords: HTLV-1; epidemiology; pulmonary disease; pulmonary function.

Figure A1

Flow chart of participants in the study.

Figure 1

Images of an 85 years-old female patient with multiple HTLV-1 associated disorders (infective dermatitis, TSP/HAM, Sjögren’s syndrome). (a) Coronal CT scan shows peripheral images of ground-glass pattern in the lower lobes (arrowheads) and apical pleural thickening (arrows). (b) Transverse CT scan shows bilateral saccular bronchiectasis in the lower lobes (asterisks), thickening of bronchovascular bundles, and presence of ground-glass pattern (arrowheads) with pleural thickening (arrow).

Figure 2

Images of an 86 years-old male patient with TSP/HAM and neurogenic bladder. (a) Coronal CT scan shows diffuse ground-glass pattern (arrowheads) in the right paramediastinal region, elevation of the left hemidiaphragm and presence of bronchiectasis (arrows). (b) Transverse CT scan shows diffuse ground-glass pattern, bronchiectasis (arrows), and presence of a nodular image (asterisk).