Factors associated with pain in individuals infected by human T-cell lymphotropic virus type 1 (HTLV-1)

IntroductionDespite the high prevalence of chronic pain in individuals infected with HTLV-1, predictive and protective factors for its development are still unclear.ObjectiveTo identify factors associated with chronic pain in individuals with HTLV-1.MethodsThis cross-sectional study was conducted in a reference center for treatment of patients infected with HTLV-1 in Salvador, Bahia, Brazil. The study included individuals infected with HTLV-1, over 18 years, and excluded those with difficulty to respond the pain protocol. Data on sociodemographic, health behavior, and clinical characteristics were collected in a standardized way. The prevalence ratio (PR) of pain is described, as well as the factors independently associated with the presence of pain, which were assessed by multiple logistic regression.ResultsA total of 142 individuals were included in the study, mostly female (62.7%), aged 20-64 years (73.2%), married (61.3%), with less than eight years of education (54.2%), and with a steady income (79.6%). Multivariate analysis showed that being symptomatic for HTLV-1 - sensory manifestations, erectile dysfunction, overactive bladder, and/or HAM/TSP (PR = 1.21, 95% CI: 1.05 to 1.38), self-medication (PR = 1.29, 95% CI: 1.08-1.53), physiotherapy (PR = 1.15, 95% CI: 1.02-1.28), and depression (PR = 1.14, 95% CI: 1.01-1.29) were associated with an increased likelihood of presenting pain. On the other hand, physical activity (PR = 0.79, 95% CI: 0.67-0.93) and religious practice (PR = 0.83, 95% CI: 0.72-0.95) were associated with a decreased likelihood of having pain.ConclusionThe use of self-medication, physiotherapy and the presence of depression are independently associated with neurological symptoms in HTLV-1 infected patients. Religious practice and physical activity are both protective for the development of pain.