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

Adenilda Lima Lopes Martins; Maria Fernanda Rios Grassi; Alisson de Aquino Firmino; Jean Paulo Lacerda Araujo; Taiane Silva Paixao; Bernardo Galvão-Castro; Ney Boa-Sorte

doi:10.1016/j.esxm.2018.07.002

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

Sex Med. 2018 Dec;6(4):324-331. doi: 10.1016/j.esxm.2018.07.002. Epub 2018 Sep 1.

Authors

Adenilda Lima Lopes Martins¹, Maria Fernanda Rios Grassi², Alisson de Aquino Firmino³, Jean Paulo Lacerda Araujo³, Taiane Silva Paixao³, Bernardo Galvão-Castro², Ney Boa-Sorte³

Affiliations

¹ Universidade Estadual de Feira de Santana, Feira de Santana, Brazil; Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas (HTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil. Electronic address: adenildamartins@hotmail.com.
² Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas (HTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil; Laboratório Avançado de Saúde Pública, Instituto de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil.
³ Centro Integrativo e Interdisciplinar de Centro Integrativo e Interdisciplinar para Atendimento de Portadores do Vírus Linfotrópico de Células T Humanas (HTLV), Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.

Abstract

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.

Keywords: Female Sexual Function Index; Human T-Lymphotropic Virus-1; Human T-Lymphotropic Virus-1–Associated Myelopathy/Tropical Spastic Paraparesis; Prevalence; Sexual Dysfunction.