HTLV-myelopathy

  Hi.
  My understanding is that this disease is mostly found in the Caribbean and Japan, but the virus is now thougt to be much more common other places than earlier thougt. Am I correct?
  1. How is this disorder best diagnosed?
  2. Are serologic tests specific?
  3. How will an infected spine appear on MRI (T1/T2) ?
  4. Which of the HTLVs is causing the disease?
  5.The virus beeing related to HIV (??), could the so called ''HIV-coctail'' (or
     med. of similar strategic approach) be effective in HTLV-myelopathy? If    not, why?
  Thank you very much for your time!  Atle
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Dear Atle,
Thank you for your questions,
You are correct in that the disease has now been reported not only
from the Caribbean islands and Japan, but also
in southern USA, South America, and Africa.
The disease is called HTLV-1 associated myelopathy (HAM)
or Tropical Spastic Paraparesis.
1. We now can check for the presence of the virus responsible for
the disease using PCR (very sensitive test like the one used in OJ and
Lewinsky's dress) specifically for the HTLV-1 virus on the spinal fluid.
2. The test utilizes cerebrospinal fluid not blood/serum because
the disease/virus affects the spinal cord, see #1.
3. No specific changes on MRI. But usually a high signal on T2.
The spinal cord may look thin.
4. HTLV-1
5. To my knowledge no form of treatment has proved effective in
reversing HAM/TSP or slowing down the progression of the disease.
Thanks again for very good question.