HTLV-1 and HIV infections of the central nervous system in tropical areas.

In tropical areas, the human T lymphotropic virus type 1 (HTLV-1) infection is often superimposed on the human immunodeficiency virus (HIV) endemic. However, from a clinical point of view, the neurological consequences of HTLV-1 infection are not as prevalent as those of HIV infection. Only 0.25% of the HTLV-1 carriers develop a progressive myelopathy. By contrast, CNS complications of HIV infection are frequent and often lethal. Most (89%) of the 30.6 million HIV infected people are estimated to live in sub-Saharan Africa and developing countries of Asia, but the neurological complications have been well described in other populations. By contrast, HTLV-1 infection is mostly confined to tropical areas. This review highlights the diVerences in the neurological complications of HIV infection, and the management of these complications in tropical countries from other parts of the world, and discusses HTLV-1 infections.