Background
Study subjects
Major
|
Minor
|
---|---|
1. Eczema of scalp, axillae and groin external ear and retro-auricular areas, eyelid margins, paranasal skin and/or neck | 1. Positive cultures for Staphylococcus aureus and/or Beta-haemolytic streptococcus from the skin or anterior nares |
2. Chronic watery nasal discharge without other signs of rhinitis and/or crusting of the anterior nares | 2. Generalized fine papular rash (in most severe cases) |
3. Chronic relapsing dermatitis with prompt response to appropriate therapy but prompt recurrence on withdrawal of use of antibiotic | 3. Generalized lymphadenopathy with dermatopathic lymphadenitis |
4. Usual onset in early childhood | 4. Anaemia |
5. Human T cell lymphotropic virus type 1 antibody seropositivity | 5. Elevated erythrocyte sedimentation rate |
6. Hyperimmunoglobulinaemia (IgD and IgE ) | |
7. Elevated CD4 count, CD8 count, and CD4/CD8 ratio |
Methods
Results
Total enrolled |
n = 60* | ||
HTLV-1 + |
n = 33 | ||
IDH confirmed |
n = 19 | ||
HTLV-1/HIV + |
n = 9 | ||
(of n = 33) | |||
Ethnicity | all black african | ||
HTLV-1 subtype | Cosmopolitan (1a) | ||
Age | mean | 8 years | |
range | 8 months −15 years (IQR 7–11) | ||
Gender distribution | male | 68.40% | |
female | 52.60% | ||
Microbiology | Staph Aureus | 55.60% | |
Streptococcal spp | 33.60% | ||
Clinical examination | dermatological | scalp (78.9%) and axilla (73.7%) commonest sites of involvement | |
neurological | no evidence for HAM/TSP | ||
opthalmological | corneal opacities 3(15.6%) | ||
Immunologic parameters | mean (normals) g/l | ||
IgA | 3.52 (0.65-2.9) | ||
IgG | 22.6 (5.2-15.6) | ||
IgM | 1.38 (0.28-2.4) | ||
SPEP | mean (normals) g/l | ||
Albumin | 32.5 (32–50) | ||
Alpha 1 globulin | 4.0 (1.72-3.30) | ||
Alpha 2 globulin | 11.1 (4.2-8.7) | ||
Beta globulin | 11.4 (5.2-10.5) | ||
Gamma globulin | 26.7 (7.1-14.5) | ||
Blood counts | mean (normals) | ||
Hb | 12.3 (11.5-13.5) g/dl | ||
WBCC | 10.1 (4-11x10^9) | ||
Platelets | 405 (150-450x10^9) | ||
ESR | 40 (3–9 mm/hr) | ||
CD4 count | 1958 (500–1500) cells/mm3 | ||
CD8 count | 1150 (436–2278) cells/mm3 | ||
CD4 : CD8 ratio | 1.7:1 | ||
HTLV-1 proviral load | mean (range%) | ||
10.5 (1.8-29.8) |