Rapid development of subacute myelopathy in three organ transplant recipients after transmission of human T-cell lymphotropic virus type I from a single donor

Transplantation. 2003 Jan 15;75(1):102-4. doi: 10.1097/00007890-200301150-00019.


Background: Human T-cell lymphotropic virus type I (HTLV-I) causes a subacute myelopathy in less than 5% of chronic carriers. However, the risk of neurologic disease appears to increase in persons infected through blood transfusion.

Methods: We report three recipients of solid organ transplants who developed a subacute myelopathy within 2 years after becoming infected with HTLV-I from a single asymptomatic HTLV-I donor. Genetic studies were performed in and sequences in proviral DNA, and HTLV-I proviral load was measured by real-time quantitative polymerase chain reaction.

Results: HTLV-I sequences were obtained in two of these individuals, and they were almost identical and clustered within the Cosmopolitan A HTLV-I subtype, which indicates a common source. All typical changes in Tax amino acid sequence of the HTLV-I Cosmopolitan A were identified, plus two additional changes were noted. Although A has been associated with a greater risk of neurologic disease, both patients were positive for human leukocyte antigen-A*02, which is considered a protective factor.

Conclusion: Rapid development of subacute myelopathy may occur in recipients of organ transplants from asymptomatic HTLV-I donors. A particular virulence of the virus strain, the large size of the virus inoculum, and the immunosuppressed condition after transplantation may have contributed to produce this unusual rapid development of HTLV-I associated myelopathy.

Publication types

  • Case Reports
  • Comment
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Base Sequence
  • Female
  • HTLV-I Infections / transmission*
  • HTLV-I Infections / virology
  • Human T-lymphotropic virus 1 / classification
  • Human T-lymphotropic virus 1 / isolation & purification
  • Humans
  • Kidney Transplantation / adverse effects*
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Paraparesis, Tropical Spastic / etiology*
  • Tissue Donors*
  • Viral Load

Associated data

  • GENBANK/AF485380
  • GENBANK/AF485383