- Spread sexually, vertically, via transfusion
- Most prevalent in Caribbean, Central/South America, Japan
- No problems w/opportunistic infxn like HIV
- Long term risks include: T-cell leukemia-lymphoma
- Spastic paraparesis/myelopathy→ unremitting, progressive neuro syndrome characterized by lower extrem weakness, spasticity, hyper-reflexia, gait probs, incontinence, neruopathic pain
- No cognitive or cranial nerve involvement