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Tackling HTLV-1 infection in ophthalmology: a nationwide survey of ophthalmic care in an endemic country, Japan
  1. Koju Kamoi1,2,
  2. Akihiko Okayama3,
  3. Shuji Izumo4,
  4. Isao Hamaguchi5,
  5. Kaoru Uchimaru2,6,
  6. Arinobu Tojo2,
  7. Toshiki Watanabe2,
  8. Kyoko Ohno-Matsui1
  1. 1 Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo, Japan
  2. 2 Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Bunkyo, Tokyo, Japan
  3. 3 Department of Rheumatology, Infectious Diseases and Laboratory Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Miyazaki, Japan
  4. 4 Division of Molecular Pathology, Center for Chronic Viral Diseases, Kagoshima University, Kagoshima, Kagoshima, Japan
  5. 5 Department of Safety Research on Blood and Biological Products, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
  6. 6 Laboratory of Tumor Cell Biology, Department of Medical Genome Sciences, The University of Tokyo Graduate School of Frontier Sciences, Kashiwa, Chiba, Japan
  1. Correspondence to Dr Koju Kamoi, Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Bunkyo-ku, Tokyo 113-8519, Japan; koju.oph{at}


Introduction Japan is the most endemic of the developed nations in terms of human T-lymphotropic virus type 1 (HTLV-1) infection. Japan has been tackling HTLV-1 infection and has made remarkable progress. In ophthalmology, awareness of the association between HTLV-1 infection and uveitis has been increasing since the 1990s, when the relationship was first established. Here, we describe a nationwide survey and analysis of the current state of medical care for HTLV-1-associated uveitis (HAU) at ophthalmic facilities in Japan.

Methods A questionnaire survey covered all university hospitals in Japan that were members of the Japanese Ophthalmological Society and all regional core facilities that were members of the Japanese Ocular Inflammation Society. Survey data were collected, and nationwide data on the state of medical care for HAU were tallied and analysed.

Results Of the 115 facilities, 69 (60.0%) responded. HAU was most commonly diagnosed ‘based on blood tests and characteristic ophthalmic findings’. Overall, 86.8% of facilities perform testing for HTLV-1 antibodies during medical care for diagnosing uveitis, with 58.3% routinely performing testing. Facilities with experience in providing medical care for HAU accounted for 67.6%. The survey also revealed that 85.5% of facilities had seen no decrease in the number of patients with HAU.

Conclusions In the two decades since the establishment of HAU as a pathological entity, the majority of facilities in Japan have started performing testing for HTLV-1 antibodies when considering differential diagnoses for uveitis. Our data suggest that providing information on HTLV-1 infection to ophthalmologists in Japan has been successfully implemented.

  • infection
  • inflammation
  • public health
  • diagnostic tests/investigation
  • microbiology

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  • Contributors KK designed the study and wrote the draft of the manuscript. AO designed the study. SI, IH, KU, AT, TW and KOM contributed to analysis and interpretation of data, and assisted in the preparation of the manuscript. All authors critically reviewed and approved the final manuscript.

  • Funding This study was supported by grants from the Research Program on Emerging and Re-emerging Infectious Diseases from the Japan Agency for Medical Research and Development (AMED) (ID: 15652551, 15652670, JP18fk0108037), and Health and Labour Sciences Research Grants from the Ministry of Health, Labour and Welfare, Japan (ID: 14427084).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This cross-sectional study was performed in Japan after obtaining ethics approval from both Tokyo Medical and Dental University and the Institute of Medical Science at the University of Tokyo, in accordance with the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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