Human T-Cell Lymphotropic Viruses (HTLV) Treatment & Management

Updated: Aug 20, 2019
  • Author: Joseph M Yabes, Jr, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Treatment

Medical Care

No treatments exist for acute or chronic HTLV infection.

Antiretroviral agents have demonstrated the ability to inhibit HTLV replication, but there has been limited research in asymptomatic carriers of HTLV-1, in whom the proviral load is already typically low. [65] In patients with HAM/TSP, who typically have high HTLV-1 viremia, 6-12 months of zidovudine plus lamivudine failed to show clinical benefit. [47]

Thorough neurologic and ophthalmologic examinations, in addition to a complete physical examination, should be performed in patients with HTLV infection.

Additional blood work should also be performed (see Lab Studies).

Good oral care and routine dental follow-up are recommended.

All patients with HTLV-1 or HTLV-2 infection should be counseled extensively on the lifelong implications of infection (see Patient Education). [45]

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Consultations

Consultation with an infectious disease specialist is advisable to diagnose HTLV infection.

A hematologist/oncologist should be consulted for patients with ATL.

A neurologist should be consulted for patients with HAM/TSP.

An ophthalmologist should be consulted for patients with ocular symptoms and for routine examinations.

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Activity

Use of barrier protection during intercourse is important to prevent the sexual spread of HTLV. In addition, intravenous drug users should avoid sharing needles.

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Prevention

Strategies for HTLV infection prevention should include education regarding transmission on a global and individual basis. Both HTLV-1 and HTLV-2 can be transmitted through breastfeeding, sexual contact, and direct blood-to-blood contact.

Women diagnosed with HTLV infection should not breastfeed. In Japan, HTLV screening is a standard procedure in pregnant women, and seropositive women are discouraged from breastfeeding. One caveat is that infant malnutrition results from breastfeeding avoidance in endemic developing nations.

The routine use of latex condoms should be recommended, as well as limiting the number of sexual partners.

Parenteral transmission of HTLV is prevented through abstaining from needle sharing and through blood-donor screening.

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