Stanford University School of Medicine, Medical School Office Building Room 323, Stanford, CA 94305-5404, USA.
J Clin Virol. 2012 Mar;53(3):251-5. doi: 10.1016/j.jcv.2011.12.018. Epub 2012 Jan 10.
Infection with the human T-cell lymphotropic virus, type 1 (HTLV-1) has been associated with an increased Th1 response. Interestingly, a higher prevalence of helminthic coinfection has been observed among infected individuals, and subsequent modulation of the immune response typically associated with helminths may influence clinical outcomes among HTLV-1 coinfected individuals.
This study was conducted to elucidate the association between helminthic coinfection and the development of clinically characterized neurologic disease that occurs in HTLV-1 infection.
In a cohort analysis, incidence of HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP) was recorded. Incidence of clinical outcomes and disease-free survival of several neurologic outcomes associated with HTLV-1 were estimated using the Kaplan-Meier method with log-rank tests. The relationships between helminthic infection and risk of HTLV-1 neurologic outcomes were assessed by Cox proportional hazard modeling.
Seventy-four coinfected and 79 non-coinfected patients were followed, with 92 helminthic infections observed in the coinfected group. One patient per group developed HAM/TSP and the risk of progression to neurologic disease outcomes did not differ among those with and without helminthic coinfection (p>0.45). A significant difference was noted in the prevalence of neurologic disease outcomes among all patients at the conclusion of the study (p<0.01).
These data suggest that treated helminthic infection does not affect risk of development of neurologic disease in HTLV-1 infection, and reinforce that treatment of helminths does not adversely affect patients with HTLV-1. Importantly, among all patients, an overall progression of neurologic disease was observed.
人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）感染与 Th1 反应增强有关。有趣的是，感染人群中观察到寄生虫合并感染的患病率较高，而寄生虫通常会影响免疫反应的后续调节，这可能会影响 HTLV-1 合并感染个体的临床结局。
本研究旨在阐明寄生虫合并感染与 HTLV-1 感染中发生的具有临床特征的神经疾病发展之间的关联。
在队列分析中，记录了 HTLV 相关性脊髓病/热带痉挛性截瘫（HAM/TSP）的发生率。使用 Kaplan-Meier 方法和对数秩检验估计与 HTLV-1 相关的几种神经系统结局的无临床结局和无疾病生存的发生率。通过 Cox 比例风险模型评估寄生虫感染与 HTLV-1 神经结局风险之间的关系。
对 74 例合并感染和 79 例非合并感染患者进行了随访，在合并感染组中观察到 92 例寄生虫感染。每组中有 1 例患者发展为 HAM/TSP，且寄生虫合并感染与无寄生虫合并感染患者的神经疾病结局进展风险无差异（p>0.45）。在研究结束时，所有患者的神经疾病结局的患病率存在显著差异（p<0.01）。
这些数据表明，经治疗的寄生虫感染不会影响 HTLV-1 感染中神经疾病的发展风险，并且强化了治疗寄生虫不会对 HTLV-1 患者产生不利影响。重要的是，在所有患者中，观察到神经系统疾病的总体进展。
