Human T-cell lymphotropic virus type 1 in Adult
Alerts and Notices
Synopsis

HTLV-1 virus is associated with ATL, a proliferation of CD4+ T-cells that can present in various forms. The lifetime risk of developing ATL after infection with HTLV-1 is approximately 2%-5%, and development occurs about 20-30 years after initial infection. The acute form is seen in most cases and has an aggressive course (approximate 6-month survival) presenting with skin lesions, hypercalcemia, bone lesions, and pulmonary infiltrates. Central nervous system (CNS) involvement can also occur. The lymphomatous form presents with lymphadenopathy, hepatosplenomegaly, and skin lesions. The chronic form has a slightly longer prognosis (approximately 2-year survival) and presents without hypercalcemia, CNS involvement, or gastrointestinal involvement. The smoldering form is the least common and has the best prognosis (survival of approximately 5 years); it is limited to skin and lung involvement only.
HTLV-1 is also associated with HAM. It is characterized by slow-onset weakness and spasticity in the lower extremities, hyperreflexia, back pain, urinary frequency / incontinence, paresthesias, and sensory changes. The upper limbs are spared. HAM occurs more commonly in women, and its severity is related to the proviral load found in the CNS.
Related topic: Human T-cell lymphotropic virus type 2
Codes
ICD10CM:B97.33 – Human T-cell lymphotrophic virus, type I [HTLV-I] as the cause of diseases classified elsewhere
SNOMEDCT:
429659006 – Human T-cell lymphotropic virus 1 infection
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
For ATL:- Acute leukemia (see, eg, acute lymphoid leukemia, acute myeloid leukemia)
- Lymphomas (T-cell or B-cell)
- Viral infections (human immunodeficiency virus [HIV], Epstein-Barr virus [EBV], cytomegalovirus [CMV], herpes simplex virus)
- Autoimmune disease
- Acute inflammatory demyelinating polyneuropathy
- Myasthenia gravis
- Other autoimmune disease
- CNS lymphoma
- Viral infections (HIV, EBV, CMV, herpes simplex)
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:04/24/2019
Last Updated:02/04/2020
Last Updated:02/04/2020