EVER HEARD OF HTLV-1?

Usually, when we think of sexually transmitted infections, we think about infections like HIV, gonorrhoea, herpes, chlamydia, and so on. There are others that we don't know about that can cause major problems as well, and as the saying goes, 'knowledge is power'. For example, HTLV-1 is a virus (a 'cousin' to HIV) that is not often discussed.

HTLV-1 (human T-cell lymphotrophic virus type 1) was discovered around 1980, which is, incidentally, around the time that HIV was discovered. Like HIV, it attacks the T-cells (one of the types of white cells which make up the immune system) of the body. It has the opposite effect to HIV though, initially at least, in that it brings about an increase in the numbers of T-cells, but the ones produced are abnormal and do not function properly. This eventually leads to some weakening of the immune system.

Three to six per cent of Jamaicans have HTLV-1, so it not a rare infection. It is more common among women and older age groups.

HTLV-1 can be transmitted sexually, from mother to child (especially by breastfeeding), through blood transfusion, through organ transplants, and intravenous drug abuse. It is easier for a woman to get HTLV-1 than to give it, which is why women have higher rates of infection. Fortunately, it is not transmitted easily. In fact, in a five-year relationship, the rate of transmission seems to be about seven per cent. Blood for transfusion in Jamaica is tested for HTLV-1. Breastfeeding is discouraged in HTLV-1 positive mothers.

HTLV-1 is important because it may lead to several illnesses. Adult T-cell lymphoma/leukaemia (ATL), a cancer which can kill in a matter of months, develops in two to four per cent of infected persons, but it seems it is unlikely to develop in persons who contract it in adult life. ATL is not always aggressive, and one may live with it for many years.

COULD AFFECT NERVES

Tropical spastic paraparesis develops in one to two per cent of persons infected. This is a chronic illness affecting the nerves of the lower parts of the body, especially the pelvis and lower limbs. It manifests as weakness and stiffness of the lower limbs, urinary symptoms (such as loss of bladder control), and lower back pain.

HTLV-1 may also lead to inflammation of the eyes, joints, skin (infectious dermatitis), lungs, and muscles.

Anyone who wants to know his/her status can find out by doing a blood test at a reputable lab.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.