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Abstract

Objectives:
Analyze risk factors for progression towards total gait disability in patients with HAM/TSP.
Methods:
Cohort for investigation of clinical-epidemiological characteristics. The outcome variable of the study was total incapacity to walk. The analysis was conducted using the Kaplan-Meier curve and Cox regression model.
Results:
206 patients were included, with an average time of total gait disability of 22.3 years. The following variables did not have an influence on the prognosis: sex, marital status, educational level, presence of neuropathic pain, diabetes, hypertension, alcoholism and tabagism, blood transfusions, HTLV-1 seropositive partner or mother and spinal medulla atrophy in the MRI. After performing Cox regression, a higher age at onset, the presence of articular limitations in the lower limbs and the level of thoracic neurological lesion are kept as clinical predictors of total gait disability.
Conclusions:
It is necessary to prevent and improve articular limitations in the lower limbs. Patients over the age of sixty had the worst prognosis, probably related to senescence. Few clinical and epidemiological factors explain the different prognoses for the patients with HAM/TSP and the patients who had an initial neurological profile of greater severity presented total gait disabilities in a shorter time.

Keywords: Epidemiology, Human T-cell lymphotropic virus type 1 (HTLV-I), Tropical spastic Paraparesis, Prognosis, Risk factors, Cohort studies