Gracia F, Castillo L C, Larreategui M, Roberts B, Cedeño V, Heneine W, Blattner W, Kaplan J E, Levine P H
Laboratorio Conmemorativo Gorgas, Panama City, Panama.
J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Oct 1;10(2):192-7. doi: 10.1097/00042560-199510020-00013.
Human T-cell lymphotropic virus type I (HTLV-I) is endemic in the Caribbean basin and in Japan. HTLV-II, a closely related virus, is endemic in several groups of native Americans, including Panamanian Guaymi. In Panama, a nationwide HTLV-I/II seroprevalence of 1-2% has been reported. We evaluated the frequency of HTLV-I/II infection in patients with neurologic diseases admitted to state tertiary hospitals in Panama City between 1985 and 1990. Nineteen of 322 patients with eligible diagnoses had antibodies to HTLV-I/II, 17 with HTLV-I and 2 with HTLV-II. HTLV-I was associated with spastic paraparesis (13 of 23, 56.5% versus 4 of 299, 1.3%, p < 0.001) and with cerebellar syndrome (2 of 13, 15.4%) and multiple sclerosis (2 of 54, 3.7%) (p < 0.05 for both diseases compared with subject with none of these diagnoses). The two HTLV-I infected patients with cerebellar syndrome later developed spastic paraparesis. HTLV-II infection was noted in one patient with cerebellar syndrome and one with amyotrophic lateral sclerosis. All patients with other diagnoses were seronegative. Among patients with spastic paraparesis, HTLV-I-infected patients were clinically indistinguishable from seronegative subjects. There is apparently an overlapping clinical spectrum of neurologic diseases associated with HTLV-I and HTLV-II infection.
人类嗜T淋巴细胞病毒I型（HTLV-I）在加勒比海地区和日本呈地方性流行。HTLV-II是一种与之密切相关的病毒，在包括巴拿马瓜伊米族在内的几支美洲原住民群体中呈地方性流行。在巴拿马，据报道全国HTLV-I/II血清阳性率为1%-2%。我们评估了1985年至1990年间入住巴拿马城国立三级医院的神经系统疾病患者中HTLV-I/II感染的频率。322例符合诊断标准的患者中有19例对HTLV-I/II呈抗体阳性，其中17例为HTLV-I阳性，2例为HTLV-II阳性。HTLV-I与痉挛性截瘫相关（23例中有13例，56.5%，而299例中有4例，1.3%，p<0.001），与小脑综合征相关（13例中有2例，15.4%）以及与多发性硬化症相关（54例中有2例，3.7%）（与无这些诊断的受试者相比，这两种疾病的p值均<0.05）。两名感染HTLV-I且患有小脑综合征的患者后来发展为痉挛性截瘫。在一名患有小脑综合征的患者和一名患有肌萎缩侧索硬化症的患者中发现了HTLV-II感染。所有患有其他诊断的患者血清学均为阴性。在痉挛性截瘫患者中，感染HTLV-I的患者在临床上与血清学阴性的受试者无法区分。显然，与HTLV-I和HTLV-II感染相关的神经系统疾病存在重叠的临床谱。
