Sections

Human T-Cell Lymphotropic Viruses (HTLV)

Sections Human T-Cell Lymphotropic Viruses (HTLV)
Overview
Presentation
- History
- Physical
- Causes
- Complications
- Show All
DDx
Workup
Treatment
Medication
References

Workup

Laboratory Studies

Multiple serologic methodologies are commercially available for the diagnosis of HTLV-1 and HTLV-2 infections. Included in the diagnostic armamentarium are enzyme-linked immunosorbent assays (ELISA), chemiluminescence assays, and particle agglutination assays.

Any positive result in the aforementioned diagnostic studies should be followed by confirmatory western blot, immunofluorescence assay (IFA), or polymerase chain reaction (PCR).

Only individuals with risk factors for HTLV infection should undergo testing.

HTLV ELISA yields very high false-positive rates in areas of low prevalence.^[65]In patients in whom testing is deemed to be appropriate, recent test comparisons have found that those widely available perform with similar diagnostic accuracy.^[66]

Positive ELISA results in combination with indeterminate western blot findings can be interpreted as follows:

Cross-reactivity with Plasmodium falciparum infection
HTLV-3 or HTLV-4 infection
Delayed seroconversion with low antibody titers
False-positive ELISA result

In this setting, western blot testing may be repeated, and, if possible, a different confirmatory laboratory test (ie, HTLV PCR testing) should be performed. In a US-based study including more than 400 patients with indeterminate western blot results, only 1.4% had positive PCR results for HTLV infection.^[48]

PCR testing has additional uses. PCR or EIA with virus-specific synthetic peptides is necessary to distinguish between HTLV-1 and HTLV-2. PCR is also required in infants whose results may be false-positive because of circulating maternal anti-HTLV antibodies. PCR also quantifies the proviral load, which is frequently used as a marker for progression, especially in HAM/TSP. It is expressed as “the number of HTLV-1 DNA copies per fixed number of peripheral blood mononuclear cells.”^[49]

Patients diagnosed with HTLV-1 or HTLV-2 infection should also undergo the following tests:

Complete blood count with differential and peripheral blood smear
Complete chemistry with calcium level
Liver function tests
Lactate dehydrogenase testing
HIV screening
Viral hepatitis serology (A, B, C)
Rapid plasma reagin (RPR)
Purified protein derivative (PPD)
Strongyloides stercoralis serology and stool examination for ova and parasites (if the appropriate risk factors exist)

Imaging Studies

No specific imaging studies are recommended for asymptomatic HTLV infections. However, imaging studies may be considered in aiding in diagnoses/evaluation of HAM/TSP or ATL.

HAM/TSP

Brain MRI reveals nonspecific periventricular and subcortical white matter lesions in 50%-80% of patients with HAM/TSP; however, these lesions also occur in patients with asymptomatic HTLV-1 infections, and comparisons with controls have not been adequate.^[49]

ATL

Chest radiography is important, particularly in patients with ATL, to assess for pulmonary complications, opportunistic infections, and lytic bone lesions.

CT scanning of the neck, thorax, abdomen, and pelvis is crucial in assessing for nodal involvement.^[50]It can also aid in further assessment for opportunistic infections (ie, abscess formation, pneumonia, intestinal infections).

Procedures

No specific procedures are recommended for asymptomatic HTLV infections.

Lumbar puncture to evaluate CSF for anti–HTLV-1 antibodies (and/or HTLV-1 proviral load) might be beneficial in establishing a diagnosis of HAM/TSP. The laboratory results often show a mild lymphocyte pleocytosis and increased protein levels. A proviral load ratio of CSF to peripheral blood that exceeds 1 supports a diagnosis of HAM/TSP.^[49]

Lymph node biopsy may aid in the diagnosis of ATL.

Histologic Findings

No characteristic histologic findings are associated with asymptomatic HTLV infections.

HAM/TSP histopathology of the spinal cord shows perivascular and parenchymal infiltration of T cells, which worsens with the development of atrophy during disease progression.^[49]

Peripheral blood smear is required for definitive diagnosis and categorization of ATL. ATL peripheral blood lymphocytes are found to have convoluted nuclei (cloverleaf or flower lymphocytes); provirus can be detected within these malignant cells.

Treatment & Management

Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Natl Acad Sci U S A. 1980 Dec. 77(12):7415-9. [QxMD MEDLINE Link]. [Full Text].
Kalyanaraman VS, Sarngadharan MG, Robert-Guroff M, Miyoshi I, Golde D, Gallo RC. A new subtype of human T-cell leukemia virus (HTLV-II) associated with a T-cell variant of hairy cell leukemia. Science. 1982 Nov 5. 218(4572):571-3. [QxMD MEDLINE Link].
Rosenblatt JD, Giorgi JV, Golde DW, et al. Integrated human T-cell leukemia virus II genome in CD8 + T cells from a patient with "atypical" hairy cell leukemia: evidence for distinct T and B cell lymphoproliferative disorders. Blood. 1988 Feb. 71(2):363-9. [QxMD MEDLINE Link].
Calattini S, Chevalier SA, Duprez R, Bassot S, Froment A, Mahieux R. Discovery of a new human T-cell lymphotropic virus (HTLV-3) in Central Africa. Retrovirology. 2005. 2:30. [QxMD MEDLINE Link].
Mahieux R, Gessain A. HTLV-3/STLV-3 and HTLV-4 viruses: discovery, epidemiology, serology and molecular aspects. Viruses. 2011 Jul. 3 (7):1074-90. [QxMD MEDLINE Link].
Murata M, Mizusawa H, Kanazawa I, Yazawa T, Uchida Y. [An autopsy case of HTLV-I associated myelopathy (HAM) with adult T-cell leukemia (ATL)]. Rinsho Shinkeigaku. 1990 Jul. 30(7):754-9. [QxMD MEDLINE Link].
Furukawa Y, Okadome T, Tara M, Niina K, Izumo S, Osame M. Human T-cell lymphotropic virus type-I (HTLV-I)-associated myelopathy/tropical spastic paraparesis with acute type of adult T-cell leukemia. Intern Med. 1995 Nov. 34(11):1130-3. [QxMD MEDLINE Link].
Primo J, Siqueira I, Nascimento MC, et al. High HTLV-1 proviral load, a marker for HTLV-1 associated myelopathy/tropical spastic paraparesis, is also detected in patients with infective dermatitis associated with HTLV-1. Braz J Med Biol Res. 2009 Aug. 42(8):761-4. [QxMD MEDLINE Link].
Vine AM, Witkover AD, Lloyd AL, Jeffery KJ, Siddiqui A, Marshall SE. Polygenic control of human T lymphotropic virus type I (HTLV-I) provirus load and the risk of HTLV-I-associated myelopathy/tropical spastic paraparesis. J Infect Dis. 2002 Oct 1. 186(7):932-9. [QxMD MEDLINE Link].
Murphy EL, Biswas HH. Human T-cell lymphotropic virus types I and II. Mandell G, Bennett J, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Churchill Livingston / Elsevier; 2010. Ch 168.
Murphy EL, Wang B, Sacher RA, Fridey J, Smith JW, Nass CC. Respiratory and urinary tract infections, arthritis, and asthma associated with HTLV-I and HTLV-II infection. Emerg Infect Dis. 2004 Jan. 10(1):109-16. [QxMD MEDLINE Link].
Buggage RR. Ocular manifestations of human T-cell lymphotropic virus type 1 infection. Curr Opin Ophthalmol. 2003 Dec. 14(6):420-5. [QxMD MEDLINE Link].
Maruyama K, Nagata K, Kojima K, Inaba T, Sugita S, Mochizuki M, et al. Intraocular Invasion of Adult T-Cell Leukemia Cells without Systemic Symptoms after Cataract Surgery. Case Rep Ophthalmol. 2013. 4(3):252-6. [QxMD MEDLINE Link]. [Full Text].
Yazdanpanah MJ, Maleki M, Joneidi N, Khalighi AR, Azarpazhooh MR, Khajedaluee M, et al. Cutaneous Manifestations in HTLV-I Positive Blood Donors. Iran J Basic Med Sci. 2013 Mar. 16(3):273-7. [QxMD MEDLINE Link]. [Full Text].
Safaeian M, Wilson LE, Taylor E, Thomas DL, Vlahov D. HTLV-II and bacterial infections among injection drug users. J Acquir Immune Defic Syndr. 2000 Aug 15. 24(5):483-7. [QxMD MEDLINE Link].
Nishioka K, Maruyama I, Sato K, Kitajima I, Nakajima Y, Osame M. Chronic inflammatory arthropathy associated with HTLV-I. Lancet. 1989 Feb 25. 1(8635):441. [QxMD MEDLINE Link].
LaGrenade L, Hanchard B, Fletcher V, Cranston B, Blattner W. Infective dermatitis of Jamaican children: a marker for HTLV-I infection. Lancet. 1990 Dec 1. 336(8727):1345-7. [QxMD MEDLINE Link].
Primo JR, Brites C, Oliveira Mde F, Moreno-Carvalho O, Machado M, Bittencourt AL. Infective dermatitis and human T cell lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis in childhood and adolescence. Clin Infect Dis. 2005 Aug 15. 41(4):535-41. [QxMD MEDLINE Link].
Martins FM, Casseb J, Penalva-de-Oliveira AC, de Paiva MF, Watanuki F, Ortega KL. Oral manifestations of human T-cell lymphotropic virus infection in adult patients from Brazil. Oral Dis. 2010 Mar. 16(2):167-71. [QxMD MEDLINE Link].
Lins L, de Carvalho VJ, de Almeida Rego FF, Azevedo R, Kashima S, Gallazi VN, et al. Oral health profile in patients infected with HTLV-1: clinical findings, proviral load, and molecular analysis from HTLV-1 in saliva. J Med Virol. 2012 Sep. 84(9):1428-36. [QxMD MEDLINE Link].
Garlet GP, Giozza SP, Silveira EM, Claudino M, Santos SB, Avila-Campos MJ, et al. Association of human T lymphotropic virus 1 amplification of periodontitis severity with altered cytokine expression in response to a standard periodontopathogen infection. Clin Infect Dis. 2010 Feb 1. 50(3):e11-8. [QxMD MEDLINE Link].
Biswas HH, Engstrom JW, Kaidarova Z, et al. Neurologic abnormalities in HTLV-I- and HTLV-II-infected individuals without overt myelopathy. Neurology. 2009 Sep 8. 73(10):781-9. [QxMD MEDLINE Link]. [Full Text].
Dooneief G, Marlink R, Bell K, et al. Neurologic consequences of HTLV-II infection in injection-drug users. Neurology. 1996 Jun. 46(6):1556-60. [QxMD MEDLINE Link].
Zunt JR, Tapia K, Thiede H, Lee R, Hagan H. HTLV-2 infection in injection drug users in King County, Washington. Scand J Infect Dis. 2006. 38(8):654-63. [QxMD MEDLINE Link]. [Full Text].
Bryan ES, Tadi P. Human T Cell Lymphotropic Virus. StatPearls. 2022 Jan. [QxMD MEDLINE Link]. [Full Text].
Kalinichenko S, Komkov D, Mazurov D. HIV-1 and HTLV-1 Transmission Modes: Mechanisms and Importance for Virus Spread. Viruses. 2022 Jan 14. 14 (1):[QxMD MEDLINE Link].
Futsch N, Mahieux R, Dutartre H. HTLV-1, the Other Pathogenic Yet Neglected Human Retrovirus: From Transmission to Therapeutic Treatment. Viruses. 2017 Dec 21. 10 (1):[QxMD MEDLINE Link].
Proietti FA, Carneiro-Proietti AB, Catalan-Soares BC, Murphy EL. Global epidemiology of HTLV-I infection and associated diseases. Oncogene. 2005 Sep 5. 24(39):6058-68. [QxMD MEDLINE Link].
Perzova R, Benz P, Abbott L, Welch C, Thomas A, El Ghoul R, et al. Short communication: no evidence of HTLV-3 and HTLV-4 infection in New York State subjects at risk for retroviral infection. AIDS Res Hum Retroviruses. 2010 Nov. 26(11):1229-31. [QxMD MEDLINE Link].
Chang YB, Kaidarova Z, Hindes D, Bravo M, Kiely N, Kamel H, et al. Seroprevalence and demographic determinants of human T-lymphotropic virus type 1 and 2 infections among first-time blood donors--United States, 2000-2009. J Infect Dis. 2014 Feb 15. 209(4):523-31. [QxMD MEDLINE Link]. [Full Text].
Andrade TM, Dourado I, Galvao-Castro B. Associations among HTLV-I, HTLV-II, and HIV in injecting drug users in Salvador, Brazil. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Jun 1. 18(2):186-7. [QxMD MEDLINE Link].
Lee HH, Weiss SH, Brown LS, Mildvan D, Shorty V, Saravolatz L. Patterns of HIV-1 and HTLV-I/II in intravenous drug abusers from the middle atlantic and central regions of the USA. J Infect Dis. 1990 Aug. 162(2):347-52. [QxMD MEDLINE Link].
Murphy EL, Mahieux R, de The G, et al. Molecular epidemiology of HTLV-II among United States blood donors and intravenous drug users: an age-cohort effect for HTLV-II RFLP type aO. Virology. 1998 Mar 15. 242(2):425-34. [QxMD MEDLINE Link].
Murphy EL, Watanabe K, Nass CC, Ownby H, Williams A, Nemo G. Evidence among blood donors for a 30-year-old epidemic of human T lymphotropic virus type II infection in the United States. J Infect Dis. 1999 Dec. 180(6):1777-83. [QxMD MEDLINE Link].
Castilla J, Pachon I, Gonzalez MP, et al. Seroprevalence of HIV and HTLV in a representative sample of the Spanish population. Epidemiol Infect. 2000 Aug. 125(1):159-62. [QxMD MEDLINE Link].
Tajima K. Worldwide distribution of HTLV. Jpn J Cancer Res. 1998 Jan. 89(1):inside front cover. [QxMD MEDLINE Link].
Edlich RF, Arnette JA, Williams FM. Global epidemic of human T-cell lymphotropic virus type-I (HTLV-I). J Emerg Med. 2000 Jan. 18(1):109-19. [QxMD MEDLINE Link].
Willems L, Hasegawa H, Accolla R, et al. Reducing the global burden of HTLV-1 infection: An agenda for research and action. Antiviral Res. 2017 Jan. 137:41-48. [QxMD MEDLINE Link].
Roucoux DF, Murphy EL. The epidemiology and disease outcomes of human T-lymphotropic virus type II. AIDS Rev. 2004 Jul-Sep. 6(3):144-54. [QxMD MEDLINE Link].
Cook LB, Taylor GP. HTLV-1 and HTLV-2 prevalence in the United States. J Infect Dis. 2014 Feb 15. 209(4):486-7. [QxMD MEDLINE Link].
Telzak EE, Hershow R, Kalish LA, et al. Seroprevalence of HTLV-I and HTLV-II among a cohort of HIV-infected women and women at risk for HIV infection. Women's Interagency HIV Study. J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Dec 15. 19(5):513-8. [QxMD MEDLINE Link].
Melo J, Beby-Defaux A, Faria C, et al. HIV and HTLV prevalences among women seen for sexually transmitted diseases or pregnancy follow-up in Maputo, Mozambique. J Acquir Immune Defic Syndr. 2000 Feb 1. 23(2):203-4. [QxMD MEDLINE Link].
Eshima N, Iwata O, Iwata S, et al. Age and gender specific prevalence of HTLV-1. J Clin Virol. 2009 Jun. 45(2):135-8. [QxMD MEDLINE Link].
Stuver SO, Tachibana N, Okayama A, Shioiri S, Tsunetoshi Y, Tsuda K, et al. Heterosexual transmission of human T cell leukemia/lymphoma virus type I among married couples in southwestern Japan: an initial report from the Miyazaki Cohort Study. J Infect Dis. 1993 Jan. 167 (1):57-65. [QxMD MEDLINE Link].
Melbye M, Poulsen AG, Gallo D, Pedersen JB, Biggar RJ, Larsen O, et al. HTLV-1 infection in a population-based cohort of older persons in Guinea-Bissau, West Africa: risk factors and impact on survival. Int J Cancer. 1998 May 4. 76 (3):293-8. [QxMD MEDLINE Link].
Roucoux DF, Wang B, Smith D, et al. A prospective study of sexual transmission of human T lymphotropic virus (HTLV)-I and HTLV-II. J Infect Dis. 2005 May 1. 191(9):1490-7. [QxMD MEDLINE Link].
[Guideline] Khabbaz RF, Fukuda K, Kaplan JE. Guidelines for counseling human T-lymphotropic virus type I (HTLV-I)- and HTLV type II-infected persons. Transfusion. 1993 Aug. 33(8):694. [QxMD MEDLINE Link].
Busch MP, Laycock M, Kleinman SH, Wages JW Jr, Calabro M, Kaplan JE, et al. Accuracy of supplementary serologic testing for human T-lymphotropic virus types I and II in US blood donors. Retrovirus Epidemiology Donor Study. Blood. 1994 Feb 15. 83 (4):1143-8. [QxMD MEDLINE Link].
Cooper SA, van der Loeff MS, Taylor GP. The neurology of HTLV-1 infection. Pract Neurol. 2009 Feb. 9(1):16-26. [QxMD MEDLINE Link].
Shimoyama M. Diagnostic criteria and classification of clinical subtypes of adult T-cell leukaemia-lymphoma. A report from the Lymphoma Study Group (1984-87). Br J Haematol. 1991 Nov. 79(3):428-37. [QxMD MEDLINE Link].
Wolfe ND, Heneine W, Carr JK, Garcia AD, Shanmugam V, Tamoufe U. Emergence of unique primate T-lymphotropic viruses among central African bushmeat hunters. Proc Natl Acad Sci U S A. 2005 May 31. 102(22):7994-9. [QxMD MEDLINE Link].
Li HC, Biggar RJ, Miley WJ, Maloney EM, Cranston B, Hanchard B. Provirus load in breast milk and risk of mother-to-child transmission of human T lymphotropic virus type I. J Infect Dis. 2004 Oct 1. 190(7):1275-8. [QxMD MEDLINE Link].
Wiktor SZ, Pate EJ, Rosenberg PS, Barnett M, Palmer P, Medeiros D. Mother-to-child transmission of human T-cell lymphotropic virus type I associated with prolonged breast-feeding. J Hum Virol. 1997 Nov-Dec. 1(1):37-44. [QxMD MEDLINE Link].
Kinoshita K, Amagasaki T, Hino S, et al. Milk-borne transmission of HTLV-I from carrier mothers to their children. Jpn J Cancer Res. 1987 Jul. 78(7):674-80. [QxMD MEDLINE Link].
Iga M, Okayama A, Stuver S, Matsuoka M, Mueller N, Aoki M. Genetic evidence of transmission of human T cell lymphotropic virus type 1 between spouses. J Infect Dis. 2002 Mar 1. 185(5):691-5. [QxMD MEDLINE Link].
Manns A, Wilks RJ, Murphy EL, et al. A prospective study of transmission by transfusion of HTLV-I and risk factors associated with seroconversion. Int J Cancer. 1992 Jul 30. 51(6):886-91. [QxMD MEDLINE Link].
Yara S, Fujita J, Date H. Transmission of human T-lymphotropic virus type I by bilateral living-donor lobar lung transplantation. J Thorac Cardiovasc Surg. 2009 Jul. 138(1):255-6. [QxMD MEDLINE Link].
Gout O, Baulac M, Gessain A, et al. Rapid development of myelopathy after HTLV-I infection acquired by transfusion during cardiac transplantation. N Engl J Med. 1990 Feb 8. 322(6):383-8. [QxMD MEDLINE Link].
Tang AR, Taylor GP, Dhasmana D. Self-Flagellation as Possible Route of Human T-Cell Lymphotropic Virus Type-1 Transmission. Emerg Infect Dis. 2019 Apr. 25 (4):811-813. [QxMD MEDLINE Link].
Carvalho EM, Da Fonseca Porto A. Epidemiological and clinical interaction between HTLV-1 and Strongyloides stercoralis. Parasite Immunol. 2004 Nov-Dec. 26(11-12):487-97. [QxMD MEDLINE Link].
Marcos LA, Terashima A, Dupont HL, Gotuzzo E. Strongyloides hyperinfection syndrome: an emerging global infectious disease. Trans R Soc Trop Med Hyg. 2008 Apr. 102(4):314-8. [QxMD MEDLINE Link].
Collins JA, Hernandez AV, Hidalgo JA, Salazar R. HTLV-I infection is not associated with a higher risk of death in Peruvian HIV-infected patients. Rev Inst Med Trop Sao Paulo. 2009 Jul-Aug. 51(4):197-201. [QxMD MEDLINE Link].
Brites C, Sampalo J, Oliveira A. HIV/human T-cell lymphotropic virus coinfection revisited: impact on AIDS progression. AIDS Rev. 2009 Jan-Mar. 11(1):8-16. [QxMD MEDLINE Link].
Hershow RC, Galai N, Fukuda K, Graber J, Vlahov D, Rezza G. An international collaborative study of the effects of coinfection with human T-lymphotropic virus type II on human immunodeficiency virus type 1 disease progression in injection drug users. J Infect Dis. 1996 Aug. 174(2):309-17. [QxMD MEDLINE Link].
Laperche S, Sauleda S, Piron M, Mühlbacher A, Schennach H, Schottstedt V, et al. Evaluation of Sensitivity and Specificity Performance of Elecsys HTLV-I/II Assay in a Multicenter Study in Europe and Japan. J Clin Microbiol. 2017 Jul. 55 (7):2180-2187. [QxMD MEDLINE Link].
da Silva Brito V, Santos FLN, Gonçalves NLS, Araujo THA, Nascimento DSV, Pereira FM, et al. Performance of Commercially Available Serological Screening Tests for Human T-Cell Lymphotropic Virus Infection in Brazil. J Clin Microbiol. 2018 Dec. 56 (12):[QxMD MEDLINE Link].
Macchi B, Balestrieri E, Mastino A. Effects of nucleoside-based antiretroviral chemotherapy on human T cell leukaemia/lymphotropic virus type 1 (HTLV-1) infection in vitro. J Antimicrob Chemother. 2003 Jun. 51(6):1327-30. [QxMD MEDLINE Link].
Poiesz B, Dube D, Dube S, et al. HTLV-II-associated cutaneous T-cell lymphoma in a patient with HIV-1 infection. N Engl J Med. 2000 Mar 30. 342(13):930-6. [QxMD MEDLINE Link].
Salemi M, Lewis M, Egan JF, Hall WW, Desmyter J, Vandamme AM. Different population dynamics of human T cell lymphotropic virus type II in intravenous drug users compared with endemically infected tribes. Proc Natl Acad Sci U S A. 1999 Nov 9. 96(23):13253-8. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

of 0

Author

Joseph M Yabes, Jr, MD Deputy Director, USAF HIV Medical Evaluation Unit, Officer in Charge, Infectious Disease Clinic, Brooke Army Medical Center; Core Faculty, Infectious Disease Fellowship, San Antonio Uniformed Services Health Education Consortium (SAUSHEC); Assistant Professor, Department of Medicine, Uniformed Services University of the Health Sciences

Joseph M Yabes, Jr, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Joseph R Masci, MD, FACP, FCCP Professor of Medicine, Professor of Preventive Medicine, Icahn School of Medicine at Mount Sinai; Director of Medicine, Elmhurst Hospital Center

Joseph R Masci, MD, FACP, FCCP is a member of the following medical societies: American Association for the Advancement of Science, American College of Chest Physicians, American College of Physicians, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, International AIDS Society, International Society for Infectious Diseases, New York Academy of Medicine, New York Academy of Sciences, Physicians for Social Responsibility, Royal Society of Medicine, Association of Program Directors in Internal Medicine, Physicians for Human Rights, Association of Professors of Medicine, HIV Medicine Association, American Academy of HIV Medicine, Association of Specialty Professors, International Association of Providers of AIDS Care, Federation of American Scientists, American Society of Tropical Medicine and Hygiene

Disclosure: Nothing to disclose.

Mark R Wallace, MD, FACP, FIDSA Infectious Disease Physician, Skagit Valley Hospital, Skagit Regional Health

Disclosure: Nothing to disclose.

Josiah D Rich, MD, MPH Professor of Medicine and Epidemiology, Brown University Medical School

Josiah D Rich, MD, MPH is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Medical Association, American Public Health Association, Infectious Diseases Society of America, Massachusetts Medical Society, Rhode Island Medical Society

Disclosure: Received ownership interest from alkermes stockholder for none; Received ownership interest from isis stockholder for none; Received ownership interest from repligen for none.

Christopher Mark Salas, MD Fellow, Department of Infectious Diseases, Lifespan, The Warren Alpert Medical School of Brown University

Disclosure: Nothing to disclose.

Booth Wainscoat, DO Assistant Director, Division of Infectious Disease, Hartford Hospital; Assistant Professor of Clinical Medicine, University of Connecticut School of Medicine

Booth Wainscoat, DO is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Received consulting fee from Gilead for consulting.

Ewa Maria Szczypinska, MD Fellow, Department of Infectious Diseases, Orlando Health

Ewa Maria Szczypinska, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Sections Human T-Cell Lymphotropic Viruses (HTLV)
Overview
Presentation
- History
- Physical
- Causes
- Complications
- Show All
DDx
Workup
Treatment
Medication
References

Human T-Cell Lymphotropic Viruses (HTLV) Workup

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

References

Tables

Contributor Information and Disclosures

What would you like to print?