htlv-1 proviral load absolute rt-qpcr development for assessing on clinical outcomes in ham/tsp patients

Background: the significance of htlv-1 proviral load as a prognostic biomarker in htlv-1-associated myelopathy/tropical spastic paraparesis (ham/tsp) has been a subject of controversy. this study aims to assess the impact of htlv-1 proviral load (pvl) on the clinical outcome in patients with ham/tsp.methods: an absolute quantitative htlv-1 pvl rt-qpcr, taqman method was developed with 100% sensitivity and specificity. then, from 2005-2018, the htlv-1 pvl of 90 eligible newly diagnosed ham/tsp patients were assessed for demographic, clinical symptoms and their associations with htlv-1-pvl.results: the quality control of the designed rt-qpcr showed a sensitivity and specificity of 100%. spasticity in lower limbs in 58.9% and urinary symptoms in 17.8% of ham/tsps were observed. using this designed rt-qpcr, the htlv-1-pvl strongly affected spasticity and sphincter disturbance (p=0.05). the multivariate logistic test showed that only the beginning of lower limb weakness along with tremor was associated with pvl (or: 2.78. 95% ci (0.99-1.02) and p=0.05). urinary incontinence was prevalent among these patients; however, no association was identified with the htlv-1 proviral load (pvl).conclusion: the absolute rt-qpcr developed for measuring htlv-1 proviral load (pvl) demonstrated reliable results. despite a high prevalence of urinary incontinence in these patients, no association was observed with the pvl. consequently, it appears that htlv-1 proviral load is specifically associated with developing spasticity in ham/tsp.