Lopes Martins Adenilda Lima, Rios Grassi Maria Fernanda, de Aquino Firmino Alisson, Lacerda Araujo Jean Paulo, Paixao Taiane Silva, Galvão-Castro Bernardo, Boa-Sorte Ney
Universidade Estadual de Feira de Santana, Feira de Santana, Brazil; Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas (HTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas (HTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil; Laboratório Avançado de Saúde Pública, Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.
Sex Med. 2018 Dec;6(4):324-331. doi: 10.1016/j.esxm.2018.07.002. Epub 2018 Sep 1.
Human T-lymphotropic virus (HTLV)-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurological disorder that mostly affects women. This disease is characterized by a progressive loss of motor function and disruptions in sensory function in the lower limbs. HTLV-1 is also associated with isolated neurologic dysfunctions, overactive bladder, and erectile dysfunction. The occurrence of sexual dysfunction in HTLV-1-infected women remain unclear.
To investigate associations between HTLV-1 infection and sexual dysfunction in both asymptomatic infected women and those diagnosed with HAM/TSP compared with uninfected women.
HTLV-1-infected and uninfected women were assessed for sexual dysfunction using the Female Sexual Function Index instrument. Sexual dysfunction was considered if global Female Sexual Function Index scores were <26.5. Crude and adjusted prevalence ratios (PR) with 95% CI were calculated to identify associations between sexual dysfunction (outcome) and HTLV infection status-asymptomatic or HAM/TSP (main exposure), compared with uninfected women, and adjusted by sociodemographic and/or clinical characteristics (covariables).
HTLV-1-infected women (n = 72; 57 asymptomatic; 15 HAM/TSP) and HTLV-1 uninfected women (n = 49) were evaluated. The overall sexual dysfunction prevalence was 53.7% (65/121), which was higher in the HAM/TSP group (80.0%; adjusted PR 1.89; 95% CI 1.23-2.90) when compared with non-infected individuals (44.9%). Sexual dysfunction was found in 54.4% of the HTLV-1-infected asymptomatic women (PR 1.21; 95% CI 0.82-1.79). Sexual dysfunction was associated with income lower than 1 minimal wage (∼US $300, October 2017) and number of previous birthday.
The obtained results indicate that sexual dysfunction is associated with HAM/TSP in women infected with HTLV-1 of reproductive age. Lima Lopes Martins A, Rios Grassi MF, de Aquino Firmino A, et al. Human T-Lymphotropic Virus-1-Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age. Sex Med 2018;6:324-331.
人类嗜T淋巴细胞病毒1型（HTLV-1）相关脊髓病/热带痉挛性截瘫（HAM/TSP）是一种主要影响女性的神经系统疾病。该疾病的特征是运动功能逐渐丧失以及下肢感觉功能紊乱。HTLV-1还与孤立性神经功能障碍、膀胱过度活动症和勃起功能障碍有关。HTLV-1感染女性性功能障碍的发生情况尚不清楚。
调查无症状感染女性和被诊断为HAM/TSP的女性中HTLV-1感染与性功能障碍之间的关联，并与未感染女性进行比较。
使用女性性功能指数工具对HTLV-1感染和未感染的女性进行性功能障碍评估。如果女性性功能指数总得分<26.5，则认为存在性功能障碍。计算粗患病率和调整患病率比（PR）及95%置信区间（CI），以确定性功能障碍（结果）与HTLV感染状态（无症状或HAM/TSP，主要暴露因素）之间的关联，并与未感染女性进行比较，同时根据社会人口统计学和/或临床特征（协变量）进行调整。
对72名HTLV-1感染女性（57名无症状；15名HAM/TSP）和49名未感染HTLV-1的女性进行了评估。总体性功能障碍患病率为53.7%（65/121），与未感染个体（44.9%）相比，HAM/TSP组的患病率更高（80.0%；调整后的PR为1.89；95%CI为1.23 - 2.90）。在54.4%的HTLV-1感染无症状女性中发现了性功能障碍（PR为1.21；95%CI为0.82 - 1.79）。性功能障碍与收入低于1个最低工资（约300美元，2017年10月）以及既往生日次数有关。
所得结果表明，性功能障碍与感染HTLV-1的育龄期女性的HAM/TSP有关。利马·洛佩斯·马丁斯A、里奥斯·格拉西MF、德阿基诺·菲尔米诺A等。人类嗜T淋巴细胞病毒1型相关脊髓病/热带痉挛性截瘫与感染HTLV-1的育龄期女性性功能障碍有关。《性医学杂志》2018年；6：324 - 331。
