Laboratory Diagnosis of HTLV-1-Associated Myelopathy

Human T-lymphotropic virus type 1 (HTLV-1), a human retrovirus, is endemic in certain regions of the world and affects millions of people worldwide. Infected individuals are at risk of developing adult T-cell leukemia/lymphoma and HTLV-1-associated myelopathy/tropical spastic paraparesis. Vertical and parenteral transmission are the main routes of infection. Diagnosis of HTLV-1 infection can be made by detection of HTLV-1-specific antibodies in plasma, serum, or cerebrospinal fluid using a combination of initial and supplemental serologic assays. In contrast, quantitative proviral DNA in peripheral blood mononuclear cells has been used to predict and monitor disease progression. This review provides an overview of the virology, epidemiology, transmission, pathophysiology, clinical manifestations, and laboratory testing methods for HTLV-1 infection.