EXPERIENCE OF HUMAN LYMPHOTROPIC VIRUS TYPE-I (HTLV-I) IN AN EAST LONDON HOSPITAL

We describe the experience of The Royal London Hospital with human T-c ell lymphotropic virus type 1 (HTLV-1) related disease. Twelve patient s presented from 1988-1993, nine of them in 1993. None were born in th e U.K. and 11 were of West Indian origin. Ten had overt lymphomas, one tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM) a nd one atypical lymphocytosis and Strongyloidiasis. Five presented acu tely ill to Casualty and three died shortly after presentation. Four h ad been referred to rheumatologists and five had predominantly gastroi ntestinal symptoms. The population of Caribbean origin served by the h ospital is 23 700 and one would only expect one or two cases of lympho ma and one or two cases of TSP/HAM per year. Overall the spectrum of c linical disease at presentation was varied. Suspicion of HTLV-1 infect ion is merited in patients of West Indian origin between the ages 30-6 5 yeas, who present with a sarcoid-like illness, gastrointestinal symp toms, leukaemia/lymphoma, myelopathy or myositis like-illness.