Sections

Human T-Cell Lymphotropic Viruses (HTLV)

Sections Human T-Cell Lymphotropic Viruses (HTLV)
Overview
Presentation
- History
- Physical
- Causes
- Complications
- Show All
DDx
Workup
Treatment
Medication
References

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.^[67]In patients with HAM/TSP, who typically have high HTLV-1 viremia, 6-12 months of zidovudine plus lamivudine failed to show clinical benefit.^[49]

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).^[47]

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.

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.

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 human milk, 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.

Medication

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Author

Joseph M Yabes, Jr, MD Deputy Director, USAF HIV Medical Evaluation Unit, Officer in Charge, Infectious Disease Clinic, Brooke Army Medical Center; Core Faculty, Infectious Disease Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC); Assistant Professor, Department of Medicine, Uniformed Services University of the Health Sciences

Joseph M Yabes, Jr, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Joseph R Masci, MD, FACP, FCCP Professor of Medicine, Professor of Preventive Medicine, Icahn School of Medicine at Mount Sinai; Director of Medicine, Elmhurst Hospital Center

Joseph R Masci, MD, FACP, FCCP is a member of the following medical societies: American Academy of HIV Medicine, American Association for the Advancement of Science, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Association of Professors of Medicine, Association of Program Directors in Internal Medicine, Association of Specialty Professors, Federation of American Scientists, HIV Medicine Association, Infectious Diseases Society of America, International AIDS Society, International Association of Providers of AIDS Care, International Society for Infectious Diseases, New York Academy of Medicine, New York Academy of Sciences, Physicians for Human Rights, Physicians for Social Responsibility, Royal Society of Medicine

Disclosure: Nothing to disclose.

Mark R Wallace, MD, FACP, FIDSA Infectious Disease Physician, Skagit Valley Hospital, Skagit Regional Health

Disclosure: Nothing to disclose.

Josiah D Rich, MD, MPH Professor of Medicine and Epidemiology, Brown University Medical School

Josiah D Rich, MD, MPH is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Medical Association, American Public Health Association, Infectious Diseases Society of America, Massachusetts Medical Society, Rhode Island Medical Society

Disclosure: Received ownership interest from alkermes stockholder for none; Received ownership interest from isis stockholder for none; Received ownership interest from repligen for none.

Christopher Mark Salas, MD Fellow, Department of Infectious Diseases, Lifespan, The Warren Alpert Medical School of Brown University

Disclosure: Nothing to disclose.

Booth Wainscoat, DO Assistant Director, Division of Infectious Disease, Hartford Hospital; Assistant Professor of Clinical Medicine, University of Connecticut School of Medicine

Booth Wainscoat, DO is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Received consulting fee from Gilead for consulting.

Ewa Maria Szczypinska, MD Fellow, Department of Infectious Diseases, Orlando Health

Ewa Maria Szczypinska, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Sections Human T-Cell Lymphotropic Viruses (HTLV)
Overview
Presentation
- History
- Physical
- Causes
- Complications
- Show All
DDx
Workup
Treatment
Medication
References

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

Medical Care

Consultations

Activity

Prevention

References

Tables

Contributor Information and Disclosures

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