- Spread sexually, vertically, via transfusion
- Most prevalent in Caribbean, Central/South America, Japan
- Most are asx, no problems w/opportunistic infxn like HIV
- Long term risks include: T-cell leukemia-lymphoma; increased risk for strongyloidiasis
- Also spastic paraparesis/myelopathy→ unremitting, progressive neuro syndrome characterized by lower extreme weakness
- Gait probs, incontinence, neruopathic pain; no cognitive or cranial nerve involvement
- Also spastic paraparesis/myelopathy→ lower extrem weakness, spasticity