In addition, a previous report from the United States suggested that the level of HTLV-1 tax mRNA expression in HTLV-1-infected cells (mRNA/DNA ratio) was significantly higher in HAM/TSP patients than HCs, and this finding correlated with the HTLV-1 proviral load, Tax-specific CD8+ T cell frequency and disease severity of the patients [17]. Here, CD8A is linked to tropical spastic paraparesis.