An infectious disease expert describes the situation with the HTLV-1 virus, for which there is no vaccine or drug to treat: “It’s a silent epidemic because 90% are asymptomatic.”

An infectionologist describes the status of the HTLV-1 virus as a ‘silent epidemic’ with no vaccine or drug to treat it

Vicente Soriano is Vice Dean of Research at the Faculty of Health of the International University of La Rioja (UNIR) and expert in infectious diseases. The doctor is the master of ceremonies of an event organized on September 15 by the Madrid College of Physicians (ICOMEM) around the HTLV-1 virus, which has been branded as the protagonist of the “silent epidemic” because it is difficult to track and Is searched. However, its symptoms can be very serious.

is one strange disease And it is less widespread in Europe, but with the globalization of the 21st century, small incidents have already occurred in the country. Spain is one of the few countries in the world where the national number of cases has barely reached 500 since 1989, the year surveillance began. However, the scientific community is practically convinced that there are many cases that go undetected, since the number of people without symptoms is 90% and, therefore, they are simply carriers of the virus.

Question: What are the characteristics of this virus?

Answer: There are two types of viruses, the genetic material of which is DNA or RNA. RNAs are the protagonists of the pandemics of the last fifty years: the AIDS virus, Hepatitis C, Ebola or SARS (COVID virus). The AIDS virus appeared in 1981, but HTLV-1 had been described two years earlier, hence its name. AIDS is HTLV-3. The media influence was about HIV, but it is a virus that has been in the human species for a long time.

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Q:What symptoms does HTLV-1 cause?

It causes two diseases: T-leukemia, which is the rarest and has the worst prognosis because most people diagnosed die; The second disease is myelopathy, in which the strength of the lower limbs is lost. HTLV-1 first occurred in tropical, sub-Saharan Africa and Latin America. There it is known as tropical spastic paraparesis.

Like the AIDS virus, it is spread from mothers to children during sexual transmission, blood transfusion or breastfeeding. We have not had cases in Europe, but some cases have already emerged with 21st century migrant movements. About 20 cases are diagnosed every year in Spain, but we call it a silent epidemic because there are many cases that are not diagnosed, because 90% are asymptomatic. Unlike the HIV virus, which develops AIDS after ten years, not with this disease. Only 10% of infected people develop symptoms such as blood cancer or paralysis. The other 90% die from the virus, but not from the virus itself. They are carriers. Since they don’t know they are infected, they can spread it to others.

HTLV-1 virus (CDC, Wikimedia Commons).

Question: Can it be detected? What’s wrong?

It can be detected, but one of our conclusions is that it is advisable to include it in prenatal tests or sexual transmission screening tests, which do not currently exist. This is not because there is no awareness that this is a virus that is transmitted sexually. We are at that stage, making doctors and public administration aware that it is much cheaper to keep it under control.

But the second big issue is that there is no vaccine or medicine for it. We already have things in place for AIDS and hepatitis, but the only prevention mechanism is to avoid exposure. People who develop leukemia are usually prescribed monoclonal antibodies, but they have a poor prognosis and we attempt bone marrow transplantation, which is a risky intervention. For prevention through sexual or maternal-fetal routes, anti-HIV fat inhibitors such as cabotegravir have been used experimentally, but results are poor in the absence of clinical trials.

Question: Is the mortality rate from this disease high?

Answer: The mortality rate for T-leukemia is more than 80% after three years. Myelopathy does not cause death, but people who suffer from it remain in wheelchairs and cause autoimmune diseases. Spain is one of the only countries with a national registry of cases since 1989. There are in other countries, but not national. Since then we have accumulated about 500 cases.

Q: Are such cases identified because they have developed symptoms?

Answer: A large part of the cases registered are because they have developed symptoms, but when we check family members we find some others infected. Also in blood banks, because in Madrid, Catalonia and other communities they look for HTLV-1 in donated blood and the diagnosis is found there.

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