Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age

• Main Authors: Adenilda Lima Lopes Martins, MD, PhD, Maria Fernanda Rios Grassi, MD, PhD, Alisson de Aquino Firmino, MSc, Jean Paulo Lacerda Araujo, UGS, Taiane Silva Paixao, UGS, Bernardo Galvão-Castro, MD, PhD, Ney Boa-Sorte, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2018-12-01
• Series: Sexual Medicine
• Online Access: http://www.sciencedirect.com/science/article/pii/S2050116118300758
• ISSN: 2050-1161

Introduction: Human T-lymphotropic virus (HTLV)-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurological disorder that mostly affects women. This disease is characterized by a progressive loss of motor function and disruptions in sensory function in the lower limbs. HTLV-1 is also associated with isolated neurologic dysfunctions, overactive bladder, and erectile dysfunction. The occurrence of sexual dysfunction in HTLV-1–infected women remain unclear. Aim: To investigate associations between HTLV-1 infection and sexual dysfunction in both asymptomatic infected women and those diagnosed with HAM/TSP compared with uninfected women. Methods: HTLV-1–infected and uninfected women were assessed for sexual dysfunction using the Female Sexual Function Index instrument. Sexual dysfunction was considered if global Female Sexual Function Index scores were <26.5. Crude and adjusted prevalence ratios (PR) with 95% CI were calculated to identify associations between sexual dysfunction (outcome) and HTLV infection status–asymptomatic or HAM/TSP (main exposure), compared with uninfected women, and adjusted by sociodemographic and/or clinical characteristics (covariables). Results: HTLV-1–infected women (n = 72; 57 asymptomatic; 15 HAM/TSP) and HTLV-1 uninfected women (n = 49) were evaluated. The overall sexual dysfunction prevalence was 53.7% (65/121), which was higher in the HAM/TSP group (80.0%; adjusted PR 1.89; 95% CI 1.23–2.90) when compared with non-infected individuals (44.9%). Sexual dysfunction was found in 54.4% of the HTLV-1–infected asymptomatic women (PR 1.21; 95% CI 0.82–1.79). Sexual dysfunction was associated with income lower than 1 minimal wage (∼US $300, October 2017) and number of previous birthday. Conclusion: The obtained results indicate that sexual dysfunction is associated with HAM/TSP in women infected with HTLV-1 of reproductive age.Lima Lopes Martins A, Rios Grassi MF, de Aquino Firmino A, et al. Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis Is Associated With Sexual Dysfunction in Infected Women of Reproductive Age. Sex Med 2018;6:324–331. Key Words: Sexual Dysfunction, Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis, Female Sexual Function Index, Human T-Lymphotropic Virus-1, Prevalence