HTLV-associated myelopathy in a cohort of HTLV-I and HTLV-II-infected blood donors. The REDS investigators

Neurology. 1997 Feb;48(2):315-20. doi: 10.1212/wnl.48.2.315.

Abstract

Objective: HTLV-I-associated myelopathy (HAM) is a slowly progressive spastic paraparesis caused by infection with human T-lymphotropic virus type I (HTLV-I). The prevalence of HAM among those infected with HTLV-I is poorly defined, and the association of a similar myelopathy with HTLV-II infection has not been confirmed.

Design: Cross-sectional examination of HTLV-I, HTLV-II, and control subjects from the baseline visit of a cohort study. SETTING/ SUBJECTS: Persons testing HTLV seropositive at the time of blood donation at five U.S. blood centers, their seropositive sex partners, and a matched control group of HTLV seronegative blood donors.

Measurements: HTLV-I and HTLV-II were differentiated by serology and/or polymerase chain reaction. All subjects received systematic neurologic screening examinations.

Results: A diagnosis of myelopathy was confirmed in four of 166 HTLV-I subjects (2.4%, 95% confidence interval 0.7%, 6.1%) and in one of 404 HTLV-II subjects (0.25%, 95% confidence interval 0.0%, 0.6%). None of the 798 controls had a similar myelopathy, although one had longstanding typical multiple sclerosis.

Conclusions: Our data also suggest that HAM occurs more frequently among HTLV-I-infected subjects than reported by previous studies. The HTLV-II infected myelopathy patient identified in this cohort, together with three other case reports in the literature, implies a pathogenic role for this human retrovirus. The diagnosis of HTLV-associated myelopathy should be considered in cases of spastic paraparesis or neurogenic bladder when risk factors for HTLV-I or HTLV-II infection are present.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis
  • Adult
  • Blood Donors
  • Cohort Studies
  • Epidemiologic Methods
  • Female
  • HTLV-I Infections / complications*
  • HTLV-I Infections / epidemiology*
  • HTLV-II Infections / complications*
  • HTLV-II Infections / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Neurologic Examination
  • Paraparesis, Tropical Spastic / diagnosis
  • Paraparesis, Tropical Spastic / epidemiology*
  • Risk Factors
  • Sexual Partners
  • Urinary Incontinence / complications