Htlv-1 Infection in Patients With Neurological Manifestations in Northeast Brazil

Human T-lymphotropic virus (HTLV) infection is associated with a broad spectrum of neurological manifestations, including conditions that may precede the development of HTLV-1–associated myelopathy/tropical spastic paraparesis. This analytical cross-sectional study aimed to estimate the prevalence of HTLV-1 infection and describe associated sociodemographic, socioeconomic, behavioral, and clinical characteristics among patients with neurological disorders followed at a tertiary public hospital in Northeast Brazil between 2024 and 2025. A total of 300 patients underwent serological screening using an immunoenzymatic assay with a commercial kit (Murex HTLV-I + II-Diasorin UK), and molecular confirmation by polymerase chain reaction for positive or indeterminate samples using a commercial kit (HiPurA Blood Genomic DNA Miniprep Purification). Three patients tested positive for HTLV-1 infection, resulting in an overall prevalence of 1.0%. All individuals who tested positive for HTLV-1 were women aged 43 to 72 years, with low educational level and income. Univariate analyses identified significant associations with injection drug use, history of blood transfusion, and family history of HTLV-1/2. Clinically, HTLV-1 positive patients presented heterogeneous neurological manifestations, ranging from urinary dysfunction and lower limb sensory and motor impairment to musculoskeletal and inflammatory symptoms, compatible with early or intermediate neurological syndrome. These findings highlight the presence of HTLV-1 infection among neurological patients and reinforce the importance of targeted screening in this population. Early identification of HTLV-1 may contribute to improved clinical management and support public health strategies aimed at preventing disease progression and reducing underdiagnosis in endemic regions.