Human T-lymphotropic virus type I-associated myelopathy in patients with the acquired immunodeficiency syndrome

Hum Pathol. 1992 May;23(5):513-9. doi: 10.1016/0046-8177(92)90128-p.


We describe two cases of serologically confirmed human T-lymphotropic virus type I (HTLV-I)-associated myelopathy involving North American men coinfected by the human immunodeficiency virus type 1. Our first patient suffered from a gradually progressive spastic paraparesis for 10 years prior to presenting with Kaposi's sarcoma, while our second patient developed subacutely progressive spastic paraparesis in the setting of full-blown acquired immunodeficiency syndrome. Autopsy examination of the spinal cords from these two cases revealed widespread axonal loss and demyelination principally involving the lateral columns of case no. 1 and the lateral and anterior columns of case no. 2. Vascular sclerosis and hyalinization were prominent in both cases, but in neither was there a conspicuous inflammatory component. In case no. 2, HTLV-I mRNA was not detected by in situ hybridization, but HTLV-I proviral DNA sequences were detected in this case by polymerase chain reaction. Neither case exhibited multinucleated cell (human immunodeficiency virus type 1) myelitis, vacuolar myelopathy, or evidence of HTLV-II infection by polymerase chain reaction assay.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • Autopsy
  • Base Sequence
  • HIV-1 / isolation & purification*
  • Human T-lymphotropic virus 1 / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Molecular Sequence Data
  • Paraparesis, Tropical Spastic / complications*
  • Paraparesis, Tropical Spastic / pathology
  • Spinal Cord Diseases / microbiology*
  • Spinal Cord Diseases / pathology