title: HTLV-I proviral load correlates with progression of motor disability in HAM/TSP: analysis of 239 HAM/TSP patients including 64 patients followed up for 10 years.
abstract: To clarify clinical and laboratory findings that may be related to the pathomechanism of HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), we analyzed these findings in 239 patients with HAM/TSP, including 64 patients followed up for 10 years after their first examinations, with special interest in the HTLV-I proviral load in peripheral blood mononuclear cells (PBMCs). The proviral load in PBMCs did not differ in terms of modes of HTLV-I transmission. However, the proviral load in patients with age of disease onset greater than 65 years tended to be higher than those with a younger age of onset. In the 64 patients followed up for 10 years, the clinical symptoms deteriorated in 36 patients (56%), unchanged in 26 patients (41%), and improved in 2 patients (3%). HTLV-I proviral load also appeared to be related to the deterioration of motor disability in these patients. To our knowledge, the present study is the first longitudinal study concerning the relationship between the clinical course of HAM/TSP and HTLV-I proviral load. It is suggested that HTLV-I proviral load is related to the progression of motor disability and is an important factor to predict prognosis of patients with HAM/TSP.
authors.affiliation: Third Department of Internal Medicine, Kagoshima University Faculty of Medicine, Sakuragaoka, Kagoshima City, Kagoshima, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: M
authors.initials: M
authors.lastname: Nakagawa
authors.forename: M
authors.initials: M
authors.lastname: Nagai
authors.forename: K
authors.initials: K
authors.lastname: Usuku
authors.forename: I
authors.initials: I
authors.lastname: Higuchi
authors.forename: K
authors.initials: K
authors.lastname: Arimura
authors.forename: H
authors.initials: H
authors.lastname: Kubota
authors.forename: S
authors.initials: S
authors.lastname: Izumo
authors.forename: S
authors.initials: S
authors.lastname: Akiba
authors.forename: M
authors.initials: M
authors.lastname: Osame
mesh_terms: D017668:Age of Onset; D000368:Aged; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000453:epidemiology / Q000821:virology; D015368:Human T-lymphotropic virus 1; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000453:epidemiology / Q000821:virology*; D015493:Paraparesis, Tropical Spastic / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D012189:Retrospective Studies; D019562:Viral Load