Comparison of HTLV-associated myelopathy (HAM) in HIV-positive and HIV-negative patients at a tertiary South African hospital
Aim. We aimed to compare clinical and radiological findings in HIV-positive and -negative patients with HAM.
Methods. Adult patients who presented to the Neurology Unit at the Steve Biko Academic Hospital from May 2005 to June 2012 with a progressive myelopathy and HTLV seropositivity were retrospectively identified and their clinical and radiological data were collected and reviewed.
Results. 21 patients with HAM were identified, of whom 9 were HIV-positive and 11 HIV-negative. One patient, whose HIV status had not been established, was not included in the study. Although the trend did not reach statistical significance, co-infected patients tended to present at an earlier age (HHAM 6/9 (66%) <40 years old; HAM 2/11 (18%) <40 years old) and presented to hospital earlier (HHAM 6/9 (66%) < 3 years symptomatic; HAM 7/11 (63%) > 3 years symptomatic). Cord atrophy occurred in 7/8 dually infected patients and 8/10 HIV-negative patients.
Conclusion. Although the study is limited by the small number of patients, co-infected patients tended to have a younger age of onset and to present to hospital sooner, and thoracic cord atrophy was very common.
Clara Maria Schutte, Department of Neurology, Steve Biko Academic Hospital, Pretoria
T Townsend, Department of Neurology, Steve Biko Academic Hospital, Pretoria
R van Coller, Department of Neurology, Steve Biko Academic Hospital, Pretoria
S Olorunju, Medical Research Council, Pretoria
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Date published: 2012-11-08
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