Presence of tropical spastic paraparesis/human T‐cell lymphotropic virus type 1‐associated myelopathy (TSP/HAM)‐like among HIV‐1‐infected patients

Abstract

A total of 38 HIV-1/HTLV-1 co-infected subjects were identified in this cohort: Twenty-six had already been diagnosed with AIDS and 12 remained asymptomatic. Six of 38 co-infected subjects (18%) were diagnosed as having TSP/HAM and also AIDS, and for 5 of them TSP/HAM was their first illness. One additional incident case was diagnosed after 2 years of follow-up. No modifications on HIV-1 viral load was seen. In contrast, the co-infected with TSP/HAM-like group showed higher HTLV-1 proviral load (505 +/- 380 vs. 97 +/- 149 copies/10(4) PBMC, P = 0.012) than asymptomatic co-infected subjects, respectively. The incidence of myelopathy among HIV-1/HTLV-1 co-infected subjects is probably higher than among patients infected only with HTLV-1, and related to a higher HTLV-1 proviral load. Thus, HTLV-1/2 screening should be done for all HIV-1-infected patients in areas where HTLV-1 infection is endemic.

A comparative study of human T-cell lymphotropic virus-associated myelopathy in HIV-positive and HIV-negative patients in KwaZulu-Natal

“…19 Casseb et al diagnosed HAM/TSP in six out of 38 (18%) dually infected patients and found that HTLV-1 proviral loads were significantly higher in patients with HAM/TSP compared to asymptomatic co-infected patients (p = 0.012). 20 Our study confirms a high frequency of HIV co-infection in patients with HAM/TSP in KwaZulu-Natal. Dual infection is associated with a younger age of clinical presentation and shorter duration of symptoms prior to presentation.…”

Neurological morbidity among human T-lymphotropic-virus-type-1-infected individuals in a rural West African population

“…A higher incidence of myelopathy among HIV1/HTLV-1 coinfected subjects has been previously reported21 but was not a feature here. Coinfection with HIV-2 was found in only 2/8.…”

Leukemia and Retroviral Disease

“…The results indicated that 73% of the coinfected patients and 16% of the patients infected with only HIV-1 developed myelopathy [100]. Another group reported that the prevalence of HAM/TSP among HTLV-1/HIV-1-coinfected patients in Brazil was 8% [101]. Schutte and coworkers [102] observed in a cohort of patients in Pretoria, South Africa, that HTLV-1/HIV-1-coinfected individuals were prone to developing HAM/TSP at an earlier age than when infected with HTLV-1.…”

“…Furthermore, the period of time in which the coinfected patients remained asymptomatic was shorter than the monoinfected patients (less than 3 years) [102]. Furthermore, Casseb and colleagues [101] demonstrated that the levels of HTLV-1 proviral DNA load in coinfected patients with HAM/TSP were five times higher than in asymptomatic coinfected individuals. HTLV-1 proviral DNA levels in PBMCs varied during the course of HTLV-1 infection [103].…”