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-cell lymphotropic virus type 1 (HTLV-1) related disease. Twelve patients presented from 1988-1993, nine of them in 1993. None were born in the U.K. and 11 were of West Indian origin. Ten had overt lymphomas, one tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM) and one atypical lymphocytosis and Strongyloidiasis. Five presented acutely ill to Casualty and three died shortly after presentation. Four had been referred to rheumatologists and five had predominantly gastrointestinal symptoms. The population of Caribbean origin served by the hospital is 23,700 and one would only expect one or two cases of lymphoma and one or two cases of TSP/HAM per year. Overall the spectrum of clinical disease at presentation was varied. Suspicion of HTLV-1 infection is merited in patients of West Indian origin between the ages of 30-65 years, who present with a sarcoid-like illness, gastrointestinal symptoms, leukaemia/lymphoma, myelopathy or myositis like-illness.