NEUROLOGIC/IMMUNOLOGIC MANIFESTATION OF HTLV-I INFECTION

描述（改编自申请摘要）：人类T细胞 嗜淋巴细胞病毒I型（HTLV-I）感染引起热带痉挛性 轻瘫/HTLV-I相关的脊髓病（TSP/HAM），通过性传播， 胃肠外，或围产期，是一个主要的公共卫生问题，在许多国家， 世界各地。性获得性HTLV-I的早期自然史 青年人的感染情况基本上仍不明确。 候选人的前 对秘鲁的女性性工作者（FSW）的研究得出了两个重要的发现。 首先，在有性行为的女性中，HTLV-I DNA的频繁宫颈脱落 获得性HTLV-I感染，以及宫颈癌的强相关性， 在性传播疾病的存在下HTLV-I DNA脱落，以及 第二，一个盲法的计算机辅助定量分析， 痉挛状态评估显示平均痉挛状态显著更高 HTLV-I感染的无症状FSW的评分高于未感染者 对照 拟议研究的具体目的是（1）确定临床 和早期HTLV-I感染的病毒学特征，（2）确定决定因素 子宫颈阴道HTLV-I脱落的可能性以及脱落在 性传播，以及（3）定义病毒学和免疫学 与亚临床痉挛和TSP/HAM相关。

DESCRIPTION (adapted from the application's abstract): Human T-cell lymphotropic virus type I (HTLV-I) infection causes tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM), is transmitted sexually, parenterally, or perinatally, and is a major public health problem in many parts of the world. The early natural history of sexually acquired HTLV-I infection in young adults remains largely undefined. The candidate's previous studies of female sex workers (FSW) in Peru yielded 2 important findings. First, frequent cervical shedding of HTLV-I DNA among women with sexually acquired HTLV-I infection, as well as a strong association of cervical shedding of HTLV-I DNA with the presence of sexually transmitted diseases, and with young age were found. Second, a blinded, computer assisted quantitative spasticity assessment demonstrated a significantly higher mean spasticity score among asymptomatic FSW with HTLV-I infection, than among uninfected controls. The specific aims of the proposed study are to (1) define clinical and virological features of early HTLV-I infection, (2) to define determinants of cervico-vaginal HTLV-I shedding and the potential role of shedding in sexual transmission, and (3) to define virological and immunological correlates associated with subclinical spasticity and TSP/HAM.