Multidimensional effects of HTLV-1 on well-being: depression, functional capacity, and quality of life

INTRODUCTION: Human T-cell lymphotropic virus 1 (HTLV-1) is associated with significant health challenges, including a high prevalence of depression and a reduced quality of life (QoL). We aimed to investigate associations between HTLV-1 infection status (uninfected, asymptomatic, or HAM/TSP), depression, and different QoL domains across the QoL. METHODS: This cross-sectional study included 171 participants: 26 uninfected controls, 91 HTLV-1-infected asymptomatic individuals, and 54 individuals diagnosed with HAM/TSP. Depression and QoL were assessed using the Mini-International Neuropsychiatric Interview and the WHOQOL-BREF, respectively. Functional capacity was determined using the Expanded Disability Status Scale (EDSS) and Osame’s Motor Disability Score (OMDS). RESULTS: The overall prevalence of depression was 33.9%, varying significantly according to infection status (19.2% - uninfected individuals, 29.7% - asymptomatic HTLV-1, 48.1% - HAM/TSP). Multivariate analysis revealed that depression had a profoundly negative impact across all QoL domains, particularly the psychological health domain (average -3.58 - point reduction). Individuals with HAM/TSP reported the lowest QoL scores, while asymptomatic individuals also exhibited reduced scores in the physical health domain compared to uninfected controls. CONCLUSIONS: Our findings highlight the urgent need for comprehensive mental health and QoL interventions tailored to HTLV-1-infected populations. This study provides novel insights into the multidimensional effects of HTLV-1 on well-being, emphasizing the importance of addressing both physical and psychological dimensions to improve outcomes for this neglected tropical disease.