Urinary Symptoms Associated with Human T-Cell Lymphotropic Virus Type I Infection: Evidence of Urinary Manifestations in Large Group of HTLV-I Carriers

• Published in: Urology (Ridgewood, N.J.) N.J.), 2007-05, Vol.69 (5), p.813-818
• Main Authors: Castro, Néviton M, Rodrigues, Waldyr, Freitas, Daniel M, Muniz, André, Oliveira, Paulo, Carvalho, Edgar M
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Blotting, Western; Brazil - epidemiology; Carrier State - diagnosis; Carrier State - epidemiology; Carrier State - virology; Cohort Studies; Comorbidity; Dysuria - epidemiology; Dysuria - virology; Female; HTLV-I Infections - diagnosis; HTLV-I Infections - epidemiology; Human T-lymphotropic virus 1 - isolation & purification; Humans; Incidence; Male; Middle Aged; Nocturia - epidemiology; Nocturia - virology; Odds Ratio; Probability; Prognosis; Retrospective Studies; Serologic Tests; Severity of Illness Index; Sex Distribution; Urination Disorders - diagnosis; Urination Disorders - epidemiology; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2007.01.052

Objectives To describe the frequency of urologic manifestations in human T-cell lymphotropic virus type I (HTLV-I) seropositive individuals from Salvador and other cities in Bahia, Brazil, with or without clinical HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Methods A total of 218 HTLV-I seropositive subjects referred from blood banks or neurologic clinics were admitted to the HTLV-I multidisciplinary outpatient clinic from January 2001 to April 2004. They were assessed using a standardized questionnaire to determine urinary complaints and quality of life. Neurologic impairment was established using the Expanded Disability Status Scale (EDSS). HAM/TSP was considered as an EDSS score of 2 or greater. Results Nocturia (35.8%) was the most frequent finding, followed by incontinence (29.8%), urgency (25.2%), frequency (22.0%), and dysuria (15.6%). Differences were found between individuals with an EDSS score of 0 and those with an EDSS score greater than 0 but less than 2 regarding frequency, nocturia, urgency, urinary loss of any degree, and quality of life. Dysuria and great or total urinary loss were more frequent among those with severe HAM/TSP (EDSS score greater than 6). Conclusions Even HTLV-I subjects considered not to have HAM/TSP may have prominent urinary findings already present. Urologic manifestations, including nocturia and urinary loss, might be early manifestations of neurologic disease in those with HTLV-I.