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July 2007

Other Important Aspects of Human T-Lymphotropic Virus 1–Associated Myelopathy

Arch Neurol. 2007;64(7):1059. doi:10.1001/archneur.64.7.1059-a

We read with great interest the study of Olindo et al1 about the natural history of human T-lymphotropic virus 1 (HTLV-1)–associated myelopathy/tropical spastic paraparesis (HAM/TSP). The authors followed up a cohort of patients for 14 years and recorded important landmarks in the disease evolution, such as the ability to walk with unilateral or bilateral support, restriction to a wheelchair, and death related to the disease. They also measured the HTLV-1 proviral load in peripheral blood mononuclear cells at time of diagnosis. It was shown that the progression of the motor disability continues throughout the course of disease and that a high HTLV-1 proviral load and an older age at onset adversely affect the outcome. Sex had no influence on the progression of the motor complaints.

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