Given that CD8+ T cells in HTLV-1 infection may paradoxically contribute to the immunopathology and the clinical manifestation of HAM/TSP through an inflammatory state (25, 26), it is conceivable that the timing and the dynamics of events of inflammation vs. immune exhaustion co-exist in the evolution of immune failure in controlling infection and exacerbated pathology. Here, CD8A is linked to tropical spastic paraparesis.