Tj. Lehky et al., HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE II-ASSOCIATED MYELOPATHY - CLINICAL AND IMMUNOLOGICAL PROFILES, Annals of neurology, 40(5), 1996, pp. 714-723
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.