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               <mods:name>
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                  <mods:namePart>de Mendoza, Carmen</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Piron, Maria</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Gonzalez, Rocio</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Jimenez, Ana</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Caballero, Estrella</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Roc, Lourdes</mods:namePart>
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               <mods:name>
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                  <mods:namePart>Benito, Rafael</mods:namePart>
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               <mods:name>
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                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>Ramos, Jose Manuel</mods:namePart>
               </mods:name>
               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
                  </mods:role>
                  <mods:namePart>Soriano, Vicente</mods:namePart>
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               <mods:name>
                  <mods:role>
                     <mods:roleTerm type="text">author</mods:roleTerm>
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                  <mods:namePart>HTLV Spanish Study Group</mods:namePart>
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                  <mods:dateAccessioned encoding="iso8601">2024-09-10T13:09:52Z</mods:dateAccessioned>
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                  <mods:dateAvailable encoding="iso8601">2024-09-10T13:09:52Z</mods:dateAvailable>
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               <mods:originInfo>
                  <mods:dateIssued encoding="iso8601">2019-02</mods:dateIssued>
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               <mods:identifier type="citation">De Mendoza C, Piron M, Gonzalez R, Jimenez A, Caballero E, Roc L, et al. Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain. Open Forum Infect Dis. 2019 Feb;6(2):ofz036.</mods:identifier>
               <mods:identifier type="doi">10.1093/ofid/ofz036</mods:identifier>
               <mods:identifier type="issn">2328-8957</mods:identifier>
               <mods:identifier type="journal">Open Forum Infectious Diseases</mods:identifier>
               <mods:identifier type="other">http://hdl.handle.net/20.500.13003/10108</mods:identifier>
               <mods:identifier type="pubmedID">30815504</mods:identifier>
               <mods:identifier type="pui">L628039583</mods:identifier>
               <mods:identifier type="scopus">2-s2.0-85064261083</mods:identifier>
               <mods:identifier type="uri">https://hdl.handle.net/20.500.12105/22786</mods:identifier>
               <mods:identifier type="wos">461522500028</mods:identifier>
               <mods:abstract>Background. Although only 8%-10% of persons infected with human T-cell leukemia virus type 1 (HTLV-1) may develop virus-associated diseases lifelong, misdiagnosis of asymptomatic infected carriers frequently leads to late diagnoses. Methods. A nationwide HTLV-1 register was created in Spain in 1989. A total of 351 infected persons had been reported by the end of 2017. We examined all new HTLV-1 diagnoses during the last decade and compared their clinical presentation. Results. A total of 247 individuals with HTLV-1 infection had been reported in Spain since year 2008. The incidence has remained stable with 20-25 new diagnoses yearly. Women represented 62%. Only 12% were native Spaniards, most of whom were foreigners from Latin America (72.5%). Up to 57 (23%) individuals presented clinically with HTLV-1-associated conditions, including subacute myelopathy (n = 24; 42.1%), T-cell lymphoma (n = 19; 33.3%), or Strongyloides stercoralis infestation (n = 8; 14%). Human T-cell leukemia virus type 1 diagnosis had been made either at blood banks (n = 109; 44%) or at clinics (n = 138; 56%). It is interesting to note that Spaniards and especially Africans were overrepresented among patients presenting with HTLV-1-associated illnesses, suggesting that misdiagnosis and late presentation are more frequent in these populations compared to Latin Americans. Conclusions. Given that 23% of new HTLV-1 diagnoses in Spain are symptomatic, underdiagnosis must be common. Although screening in blood banks mostly identifies asymptomatic Latin American carriers, a disproportionately high number of Spaniards and Africans are unveiled too late, that is, they already suffer from classic HTLV-1 illnesses.</mods:abstract>
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                  <mods:languageTerm authority="rfc3066">eng</mods:languageTerm>
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               <mods:subject>
                  <mods:topic>Adult T-cell leukemia</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Epidemiology</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>HTLV-1</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Myelopathy</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Screening</mods:topic>
               </mods:subject>
               <mods:titleInfo>
                  <mods:title>Clinical Presentation of Individuals With Human T-Cell Leukemia Virus Type-1 Infection in Spain</mods:title>
               </mods:titleInfo>
               <mods:genre>research article</mods:genre>
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