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Biswas HH, Engstrom JW, Kaidarova Z, et al. Neurologic abnormalities in HTLV-I- and HTLV-II-infected individuals without overt myelopathy. Neurology. 2009;73(10):781-9doi: 10.1212/WNL.0b013e3181b6bba9.
Biswas, H. H., Engstrom, J. W., Kaidarova, Z., Garratty, G., Gibble, J. W., Newman, B. H., Smith, J. W., Ziman, A., Fridey, J. L., Sacher, R. A., & Murphy, E. L. (2009). Neurologic abnormalities in HTLV-I- and HTLV-II-infected individuals without overt myelopathy. Neurology, 73(10), 781-9. https://doi.org/10.1212/WNL.0b013e3181b6bba9
Biswas, H H, et al. "Neurologic abnormalities in HTLV-I- and HTLV-II-infected individuals without overt myelopathy." Neurology vol. 73,10 (2009): 781-9. doi: https://doi.org/10.1212/WNL.0b013e3181b6bba9
Biswas HH, Engstrom JW, Kaidarova Z, Garratty G, Gibble JW, Newman BH, Smith JW, Ziman A, Fridey JL, Sacher RA, Murphy EL. Neurologic abnormalities in HTLV-I- and HTLV-II-infected individuals without overt myelopathy. Neurology. 2009 Sep 08;73(10):781-9. doi: 10.1212/WNL.0b013e3181b6bba9. PMID: 19738173; PMCID: PMC2739606.
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Neurology. 2009 Sep 08;73(10):781-9. doi: 10.1212/WNL.0b013e3181b6bba9.

Neurologic abnormalities in HTLV-I- and HTLV-II-infected individuals without overt myelopathy.

Neurology

H H Biswas, J W Engstrom, Z Kaidarova, G Garratty, J W Gibble, B H Newman, J W Smith, A Ziman, J L Fridey, R A Sacher, E L Murphy

Affiliations

  1. Blood Systems Research Institute, San Francisco, CA, USA.

PMID: 19738173 PMCID: PMC2739606 DOI: 10.1212/WNL.0b013e3181b6bba9

Abstract

BACKGROUND: Human T-lymphotropic virus (HTLV) type I is the causative agent of HTLV-associated myelopathy (HAM)/tropical spastic paraparesis, and a number of HAM cases with HTLV-II infection have also been reported. However, despite some reports, it is unclear whether HTLV-I or -II infection is associated with other neurologic manifestations.

METHODS: An analysis of medical histories and screening neurologic examinations from a prospective cohort of 153 HTLV-I, 388 HTLV-II, and 810 HTLV-seronegative individuals followed up for means of 11.5, 12.0, and 12.2 years was performed. Participants diagnosed with HAM were excluded. We calculated odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, race or ethnicity, income, educational attainment, body mass index, alcohol and cigarette consumption, injection drug use, diabetes, and hepatitis C virus status, using generalized estimating equations for repeated measures.

RESULTS: HTLV-I and -II participants were more likely than seronegative participants to have leg weakness (ORs 1.67 [95% CI 1.28-2.18] and 1.44 [1.16-1.78]), impaired tandem gait (ORs 1.25 [95% CI 1.07-1.47] and 1.45 [1.27-1.64]), Babinski sign (ORs 1.54 [95% CI 1.13-2.08] and 1.51 [1.18-1.93]), impaired vibration sense (ORs 1.16 [95% CI 1.01-1.33] and 1.27 [1.14-1.42]), and urinary incontinence (ORs 1.45 [95% CI 1.23-1.72] and 1.70 [1.50-1.93]). For both HTLV-I and -II participants, higher odds of sensory neuropathy by monofilament examination were no longer significant after adjustment for confounding.

CONCLUSIONS: These results provide strong evidence that human T-lymphotropic virus (HTLV)-I and -II are associated with a spectrum of predominantly motor abnormalities in patients without overt HTLV-associated myelopathy. Further investigation of the clinical course and etiology of these abnormalities is warranted.

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