Rapid development of subacute myelopathy in three organ transplant recipients after transmission of human T-cell lymphotropic virus type I from a single donor

TitleRapid development of subacute myelopathy in three organ transplant recipients after transmission of human T-cell lymphotropic virus type I from a single donor
Publication TypeJournal Article
Year of Publication2003
AuthorsToro C, Rodes B, Poveda E, Soriano V
JournalTransplantation
Volume75
Issue1
Pagination102 - 4
Date PublishedJan 15
ISSN0041-1337 (Print) 0041-1337 (Linking)
Accession Number12544880
Keywords*Tissue Donors, Adult, Base Sequence, Female, HTLV-I Infections / *transmission / virology, Human T-lymphotropic virus 1 / classification / isolation & purification, Humans, Kidney Transplantation / *adverse effects, Liver Transplantation / *adverse effects, Male, Middle Aged, Molecular Sequence Data, Paraparesis, Tropical Spastic / *etiology, Viral Load
Abstract

BACKGROUND: Human T-cell lymphotropic virus type I (HTLV-I) causes a subacute myelopathy in less than 5% of chronic carriers. However, the risk of neurologic disease appears to increase in persons infected through blood transfusion. METHODS: We report three recipients of solid organ transplants who developed a subacute myelopathy within 2 years after becoming infected with HTLV-I from a single asymptomatic HTLV-I donor. Genetic studies were performed in and sequences in proviral DNA, and HTLV-I proviral load was measured by real-time quantitative polymerase chain reaction. RESULTS: HTLV-I sequences were obtained in two of these individuals, and they were almost identical and clustered within the Cosmopolitan A HTLV-I subtype, which indicates a common source. All typical changes in Tax amino acid sequence of the HTLV-I Cosmopolitan A were identified, plus two additional changes were noted. Although A has been associated with a greater risk of neurologic disease, both patients were positive for human leukocyte antigen-A*02, which is considered a protective factor. CONCLUSION: Rapid development of subacute myelopathy may occur in recipients of organ transplants from asymptomatic HTLV-I donors. A particular virulence of the virus strain, the large size of the virus inoculum, and the immunosuppressed condition after transplantation may have contributed to produce this unusual rapid development of HTLV-I associated myelopathy.

DOI10.1097/01.TP.0000040428.36030.FC
Notify Library Reference ID1551

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