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Human T-cell lymphotrophic virus–I (HTLV-I)–associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive neurologic illness caused by HTLV-I. HAM/TSP is endemic in Brazil1 and, although there are some interregional differences in neurologic manifestations, the main clinical findings are similar to those previously described.1,2
The lifetime risk among HTLV-I carriers to develop HAM/TSP is less than 2%.2 As in several other chronic inflammatory or neurodegenerative diseases, it would be helpful to identify sensitive or specific clinical or complementary tests to detect early pathologic lesions, to follow up disease progression, or to predict which asymptomatic HTLV-I–positive patients will develop HAM/TSP. Recently, a quantitative assessment of muscle spasticity showed subclinical increased lower extremity tone in female commercial sex workers positive for HTLV-I.3 The relevance of this finding to HAM/TSP development remains unknown.3
Viral mRNA of HTLV-I was found in astrocytes of patients with HAM/TSP …
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