AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 72(6), 2005, pp. 855-857
Copyright © 2005 by The American Society of Tropical Medicine and Hygiene

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NORWEGIAN SCABIES IN PERU: THE IMPACT OF HUMAN T CELL LYMPHOTROPIC VIRUS TYPE I INFECTION

MAGALY BLAS, FRANCISCO BRAVO, WENCESLAO CASTILLO, WENCESLAO J. CASTILLO, ROSALÍA BALLONA, PEDRO NAVARRO, JOSÉ CATACORA, ROSARIO CAIRAMPOMA, AND EDUARDO GOTUZZO
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Hospital Nacional Cayetano Heredia, Lima, Peru; Hospital Nacional Arzobispo Loayza Lima, Peru; Hospital Daniel Alcides Carrión, Lima, Peru; Instituto de Salud del Niño, Lima, Peru; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru

Isolates cases and groups of patients co-infected with human T cell lymphotropic virus type I (HTLV-I) and Norwegian scabies have been previously reported. Peru is considered to be endemic for HTLV-I. Between June 1999 and December 2000, 23 patients with Norwegian scabies were enrolled in this study after written informed consent was obtained. Antibodies against HTLV-I were detected by an enzyme-linked immunosorbent assay and confirmatory Western blot. Patients ranged in age from 3 months to 84 years; 15 (65.2%) were female. Infection with HTLV-I was found in 16 (69.6%) patients. Comorbid features included corticosteroid therapy (8.6%), malnutrition (8.6%), and Down’s syndrome (4.3%). Among those who consented to be tested for human immunodeficiency virus (n = 13, 56.5%), no one had a positive result. The three patients that reported one or more prior episodes of Norwegian scabies were infected with HTLV-I and two of these HTLV-I-positive patients died. Infection with HTLV-I is an important co-factor related to Norwegian scabies in Peru. In our setting, the evaluation for HTLV-I in all Norwegian scabies cases is highly recommended, especially when no other risk factors are apparent.

Received September 15, 2004. Accepted for publication November 25, 2004.

Acknowledgments: We thank Dr. Joseph Vinetz (Division of Infectious Diseases, Department of Medicine, University of California at San Diego School of Medicine, La Jolla, CA) for critically reading the manuscript, Dr. Elsa González (Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia) for her support in preparing the manuscript, and to our health workers (Afilio Tello and Juana Huerta) for help in this study.

Financial support: This study was supported in part by the Directorate-General for Development Co-operation of the Belgian Government (DGDC – Framework Agreement 01).

Authors’ addresses: Magaly Blas, Francisco Bravo, Rosario Cairampoma, and Eduardo Gotuzzo, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru, Telephone: 51-1-425-8493, Fax: 51-1-482-3404, E-mails: magalyblas{at}yahoo.com, fbravo{at}terra.com.pe, rcairampoma{at}Blufsteinlab.com, and egh{at}upch.edu.pe. Wenceslao J. Castillo, Hospital Nacional Arzobispo Loayza, Av. Alfonso Ugarte 848, Lima 1, Peru, Telephone: 51-1-9503-4770, Fax: 51-1-482-3404. Wenceslao Castillo, Hospital Daniel Alcides Carrión, Av. Guardia Chalaca 2176, Callao 2, Peru, Telephone: 51-1-476-4079, Fax: 51-1-482-3404. Rosalía Ballona, Instituto de Salud del Niño, Av. Brasil 600, Lima 5, Peru, Telephone: 51-1-9935-2357, Fax: 51-1-386-0141, E-mail: ballona{at}terra.com.pe. Pedro Navarro, Hospital Nacional Edgardo Rebagliati Martins, Jr. Rebagliatti y Av. Salaverry, Lima 11, Peru, Telephone: 51-1-433-0212, Fax: 51-1-482-3404, E-mail: crpnh2002{at}yahoo.com. José Catacora, Hospital Nacional Guillermo Almenara Yrigoren, Av. Grau Cdra 8, Lima 13, Peru, Telephone 51-1-497-2713, Fax: 51-1-221-8271, E-mail: jose.catacora{at}essalud.sld.pe.

Reprint requests: Francisco Bravo, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru.






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