HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE II-ASSOCIATED MYELOPATHY - CLINICAL AND IMMUNOLOGICAL PROFILES

Human T-cell lymphotropic virus type II (HTLV-II) is endemic in severa l ethnic tribes and among intravenous drug users in metropolitan areas . Despite the presence of HTLV-II in these various populations, the as sociation of HTLV-II with disease is sparse and mainly limited to isol ated case reports. This study is an extension of an earlier descriptio n of an HTLV-II-infected patient with neurologic disease and presents the clinical and immunologic findings of 4 patients with HTLV-II serop ositivity and spastic paraparesis. The patients are of African-America n origin with 3 of the patients being of Amerindian descent. All of th e patients are seronegative for the human immunodeficiency virus (HIV) . The patients progressed to a nonambulatory state in less than 5 year s. Magnetic resonance imaging studies obtained from 3 of the patients demonstrated white matter disease in the cerebrum and spinal cord. The cerebrospinal fluid and serum contained antibodies to HTLV-II. The pr esence of proviral HTLV-II was confirmed by polymerase chain reaction analysis of peripheral blood lymphocytes (PBLs). A spinal cord biopsy from I patient demonstrated HTLV RNA within a lesion. Immunologic stud ies on 2 patients demonstrated that spontaneous lymphoproliferation of PBLs was present but decreased relative to HTLV-I-infected patients. The clinical and immunologic findings from these HTLV-II-infected pati ent resemble those found in HTLV-I-associated myelopathy/tropical spas tic paraparesis.