Abstract
Different human retroviruses, such as Human Immunodeficiency Virus (HIV) and Human T-cell Lymphotropic Virus (HTLV), can cause neurologic infection. However, a definitive diagnosis may be hampered by several factors. Quantification of the viral or proviral load in cerebrospinal fluid (CSF) may be helpful in the diagnosis of nervous system disorders due to retroviral infection and may influence the treatment approach. The present work discusses retrovirus infection and neurologic impairment, as well as the usefulness of the determination of the HIV and HTLV proviral or viral load in cerebrospinal fluid in cases of neurologic disorder, in light of recent advances in this field. This study also discusses the different molecular techniques for quantifying the proviral load (real-time quantitative PCR, droplet digital PCR, and semi-nested real-time reverse transcription PCR) that are currently available.
Highlights
The Retroviridae family comprises enveloped RNA viruses that can infect several hosts
Human T-cell Lymphotropic Virus (HTLV) proviral load in cerebrospinal fluid (CSF) According to WHO guidelines for HTLV-1–associated myelopathy/tropical spastic paraparesis (HAM/TSP) diagnosis, a patient can be classified under definitive HAM/TSP in the presence of chronic progressive spastic paraparesis associated with antibodies detection in both blood and CSF
The HTLV-1 proviral load (PVL) in blood is higher in HAM/TSP patients than in asymptomatic carriers
Summary
The Retroviridae family comprises enveloped RNA viruses that can infect several hosts. In cases of CNS impairment, such as HTLV1–associated myelopathy and HIV-associated dementia, viral quantification in cerebrospinal fluid (CSF) may clarify the diagnosis [8, 13, 17,18,19,20,21,22]. We discuss the usefulness of HIV and HTLV-1 quantification in CSF among patients with neurologic disorders due to retrovirus infection, on the basis of the recent knowledge achieved in this field.
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