title: HTLV-1-associated myelopathy/tropical spastic paraparesis.
abstract: Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive disease of the CNS that causes weakness or paralysis of the legs, lower back pain and urinary symptoms. HAM/TSP was first described in Jamaica in the nineteenth century, but the aetiology of the condition, infection with the retrovirus HTLV-1, was only identified in the 1980s. HAM/TSP causes chronic disability and, accordingly, imposes a substantial health burden in areas where HTLV-1 infection is endemic. Since the discovery of the cause of HAM/TSP, considerable advances have been made in the understanding of the virology, immunology, cell biology and pathology of HTLV-1 infection and its associated diseases. However, progress has been limited by the lack of accurate animal models of the disease. Moreover, the treatment of HAM/TSP remains highly unsatisfactory: antiretroviral drugs have little impact on the infection and, although potential disease-modifying therapies are widely used, their value is unproved. At present, clinical management is focused on symptomatic treatment and counselling. Here, we summarize current knowledge on the epidemiology, pathogenesis and treatment of HAM/TSP and identify areas in which further research is needed. For an illustrated summary of this Primer, visit: http://go.nature.com/tjZCFM.
authors.affiliation: Section of Virology, Department of Medicine, Imperial College, London W2 1PG, UK.
authors.forename: Charles R M
authors.initials: CR
authors.lastname: Bangham
authors.affiliation: Laboratory for Clinical Research in Neuroinfections, Evandro Chagas National Institute of Infectious Diseases, FIOCRUZ, Rio de Janeiro, Brazil.
authors.forename: Abelardo
authors.initials: A
authors.lastname: Araujo
authors.affiliation: Department of Rare Diseases Research, Institute of Medical Science, St Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamano
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Imperial College, London W2 1PG, UK.
authors.forename: Graham P
authors.initials: GP
authors.lastname: Taylor
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology; D015490:HTLV-I Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000187:drug effects; D006801:Humans; D015493:Paraparesis, Tropical Spastic / Q000188:drug therapy / Q000821:virology*
chemical_list: D000998:Antiviral Agents