{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T12:18:05Z","timestamp":1753359485559},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T00:00:00Z","timestamp":1675814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Virtually all patients with human T-lymphotropic virus 1 (HTLV-1)\u2013associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) have some degree of erectile dysfunction (ED), but ED is also found in a large percentage of HTLV-1 carriers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the evolution of ED in individuals infected with HTLV-1 who were followed for up to 15\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cohort study included men infected with HTLV-1 who had ED, were aged 18 to 70\u00a0years, and were followed from January 2004 to December 2019. We used the International Index of Erectile Function\u20135 (IIEF-5), the Expanded Disability Status Scale and Osame Motor Disability Scale, and the Overactive Bladder Symptom Score (OABSS) to define and stratify ED, neurologic disability, and bladder dysfunction, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>Time to development of severe ED was the main outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 90 men with ED (mean \u00b1 SD age, 52.8\u2009\u00b1 9.78\u00a0years). At baseline, 42 were carriers, 16 had probable HAM\/TSP, and 32 had definite HAM\/TSP. IIEF-5 was highest among carriers and lowest in patients with definite HAM\/TSP, whereas OABSS was lowest in carriers and highest in patients with definite HAM\/TSP. Median (IQR) follow-up was 8.50 years (3.00-12.00). IIEF-5 fell significantly from baseline to last follow-up among carriers and patients with probable and definite HAM\/TSP. There was an inverse correlation between the IIEF-5 and the OABSS at last follow-up (r\u2009=\u2009\u22120.62, P\u2009&amp;lt;\u2009.001). In survival analysis, the time to development of severe ED was significantly shorter in patients with definite HAM\/TSP when compared with carriers (P\u2009=\u2009.001) and those with probable HAM\/TSP (P\u2009=\u2009.014). The presence of definite HAM\/TSP at baseline was independently associated with the development of severe ED, after adjustment for baseline age and proviral load (hazard ratio, 6.74; P\u2009=\u2009.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Implications<\/jats:title><jats:p>Formal assessment of erectile function should be part of the routine clinical assessment of individuals infected with HTLV-1; worsening erectile function should alert clinicians to the possibility of neurologic deterioration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Strengths and Limitations<\/jats:title><jats:p>This is the first prospective cohort study to describe the course of ED in men infected with HTLV-1. The small sample size and absence of seronegative controls are limitations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ED is a slowly progressive clinical manifestation of HTLV-1 infection, and the degree of neurologic compromise at baseline is the main predictor of time to progression to severe ED.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jsxmed\/qdac050","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T08:44:46Z","timestamp":1675845886000},"page":"269-276","source":"Crossref","is-referenced-by-count":4,"title":["Evolution of erectile dysfunction in individuals infected with human T-lymphotropic virus 1: a prospective cohort study"],"prefix":"10.1093","volume":"20","author":[{"given":"Cassius J V","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Post Graduate Program of Health Sciences, Federal University of Bahia , Salvador, Bahia, CEP 40026-010 , Brazil"},{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Abra\u00e3o Carneiro","family":"Neto","sequence":"additional","affiliation":[{"name":"Post Graduate Program of Health Sciences, Federal University of Bahia , Salvador, Bahia, CEP 40026-010 , Brazil"},{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila N F","family":"Liberato de Matos","sequence":"additional","affiliation":[{"name":"Post Graduate Program of Health Sciences, Federal University of Bahia , Salvador, Bahia, CEP 40026-010 , Brazil"},{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matheus","family":"Tannus","sequence":"additional","affiliation":[{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00e9viton","family":"Castro","sequence":"additional","affiliation":[{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo N","family":"Rocha","sequence":"additional","affiliation":[{"name":"Post Graduate Program of Health Sciences, Federal University of Bahia , Salvador, Bahia, CEP 40026-010 , Brazil"},{"name":"School of Medicine of Bahia, Federal University of Bahia , Salvador, Bahia, CEP 40110-100 , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar M","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Ambulat\u00f3rio Multidisciplinar de HTLV-1 , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Federal University of Bahia , Hospital Universit\u00e1rio Professor Edgard Santos, , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"Gon\u00e7alo Moniz Institute , Fiocruz, Salvador, Bahia, CEP 40296-710 , Brazil"},{"name":"Immunology Service of University Hospital Professor Edgard Santos, Federal University of Bahia , Salvador, Bahia, CEP 40110-060 , Brazil"},{"name":"National Institute of Science and Technology of Tropical Diseases , Salvador, Bahia, CEP 40296-710 , 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