Isolated bladder dysfunction in human T lymphotropic virus type 1 infection: 10 years of follow-up

Dear Editor , Human T lymphotropic virus type 1 (HTLV-1) is the aetiological agent of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP), a neurological disease characterised by a slowly progressive paraparesis and bladder dysfunction. Most HTLV-1-infected individuals remain asymptomatic throughout their lives, and the factors that play a role to conversion from asymptomatic to symptomatic status are still a matter of discussion. It is believed that <1% of HTLV-1-infected individuals will develop HAM/TSP. Host genetic factors and the immunological response against HTLV-1 are pivotal to HTLV-1 proviral load (PVL), and there are evidences that a high PVL is associated with HAM/TSP and with other HTLV-1-associated diseases such as peripheral neuropathy and amyotrophic lateral sclerosis.1 In addition, some aspects …