Human T‐cell lymphotropic virus type II–associated myelopathy: Clinical and immunologic profiles

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Abstract
Human T‐cell lymphotropic virus type II (HTLV‐II) is endemic in several ethnic tribes and among intravenous drug users in metorpolitan areas. Despite the presence of HTLV‐II in these various populations, the association of HTLV‐II with disease is sparse and mainly limited to isolated case reports. This study is an extension of an earlier description of an HTLV‐II‐infected patient with neurologic disease and presents the clinical and immunologic findings of 4 patients with HTLV‐II seropositivity and spastic paraparesis. The patients are of African‐American orgin with 3 of the patients with HTLV‐II seropositivity and spastic paraparesis. The patients are of African‐American origin with 3 of the patients being of Amerindian descent. All of the patients are seronegative for the human immunodeficiency virus (HIV). The patients progressed to a nonambulatory state in less than 5 years. Magnetic resonacne imaging studies obtained jfrom 3 of the patients demonstratd white matter disease in the cerebrum and spinal cord. The cerebrospinal fluid and serum contained antibodies to HTLV‐II. Ther presence of proviral HTLV‐II was confirmed by polymerase chain reaction analysis of peripheral blood lymphocytes (PBLs). A spinal cord biopsy from 1 patient demonstratd HTLV RNA within a lesion. Immunolgic studies 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 patient resemble those found in HTLV‐I‐associated myelopathy/tropical spastic paraparesis.