Imperial College London
Alternate

Dr Peter Kelleher

Faculty of Medicine, Department of Infectious Disease

Reader in Immunology
 
 
 
//

Contact

 

+44 (0)20 3315 8251p.kelleher

 
 
//

Location

 

J.2.10Chelsea and Westminster HospitalChelsea and Westminster Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Harding:2022:10.1007/s13365-022-01088-x,
author = {Harding, D and Rosadas, C and Tsoti, S and Heslegrave, A and Stewart, M and Kelleher, W and Zetterberg, H and Taylor, G and Dhasmana, D},
doi = {10.1007/s13365-022-01088-x},
journal = {Journal of NeuroVirology},
pages = {473--482},
title = {Refining the risk of HTLV-1-associated myelopathy in people living with HTLV-1: Identification of a HAM-like phenotype in a proportion of asymptomatic carriers},
url = {http://dx.doi.org/10.1007/s13365-022-01088-x},
volume = {28},
year = {2022}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Up to 3.8% of human T-lymphotropic virus type-1 (HTLV-1)-infected asymptomatic carriers (AC) eventually develop HTLV-1-associated myelopathy (HAM). HAM occurs in patients with high (>1%) HTLV proviral load (PVL). However, this cut-off includes more than 50% of ACs and therefore the risk needs to be refined. As HAM is additionally characterised by an inflammatory response to HTLV-1, markers of T cell activation (TCA), β 2 -microglobulin (β 2 M) and neuronal damage were accessed for the identification of ACs at high risk of HAM.  Methods: Retrospective analysis ofcross-sectional and longitudinal routine clinical data examining differences in TCA (CD4/CD25, CD4/HLA-DR, CD8/CD25 & CD8/HLA-DR), β 2 M and neurofilament light (NfL) in plasma in ACs with high or low PVL and patients with HAM. Results: Comparison between 74 low PVL ACs, 84 high PVL ACs and 58 patients with HAM revealed a significant, stepwise, increase in TCA and β 2 M.  Construction of receiver operating characteristic (ROC) curves for each of these blood tests generated a profile that correctly identifies 88% of patients with HAM along with 6% of ACs. The 10 ACs with this ‘HAM-like’ profile had increased levels of NfL in plasma and two developed myelopathy during follow-up, compared to none of the 148 without this viral-immune-phenotype. Conclusions: A viral-immuno-phenotype resembling that seen in patients with HAM identifies asymptomatic carriers who are at increased risk of developing HAM and have markers of subclinical neuronal damage.
AU  - Harding,D
AU  - Rosadas,C
AU  - Tsoti,S
AU  - Heslegrave,A
AU  - Stewart,M
AU  - Kelleher,W
AU  - Zetterberg,H
AU  - Taylor,G
AU  - Dhasmana,D
DO  - 10.1007/s13365-022-01088-x
EP  - 482
PY  - 2022///
SN  - 1355-0284
SP  - 473
TI  - Refining the risk of HTLV-1-associated myelopathy in people living with HTLV-1: Identification of a HAM-like phenotype in a proportion of asymptomatic carriers
T2  - Journal of NeuroVirology
UR  - http://dx.doi.org/10.1007/s13365-022-01088-x
UR  - http://hdl.handle.net/10044/1/98326
VL  - 28
ER  -
Download