Abstract
Human T-lymphotropic virus (HTLV) is a member of the RNA virus Retroviridae family, genus Deltaretrovirus, that causes chronic infections of humans and is divided into four currently recognized genotypes and serotypes (HTLV-1 through HTLV-4). These retroviruses are derived from simian retroviruses, to which they bear close genetic similarity, and phylogenetic analyses support ancient interspecies transmission from monkeys and apes to humans. Viral replication is by means of a DNA provirus intermediate which is integrated into the genome of host lymphocytes, and proliferation of the provirus in vivo is predominantly via clonal proliferation of infected lymphocytes. HTLV-1 is endemic in sub-Saharan Africa, the Caribbean, parts of South America, southwestern Japan and Australian aboriginal populations. HTLV-2 is endemic in Amerindian tribes in North, Central, and South America and hyperendemic among injection drug users in North America and Europe. HTLV-3 and HTLV-4 are more recent discoveries and have been isolated to date from only a handful of humans in Central Africa with hunting or other exposure to nonhuman primates. Both HTLV-1 and HTLV-2 are transmitted from mother to child predominantly by breast-feeding, by sexual transmission, and by parenteral transmission including blood transfusion and injection drug use. In a small proportion of those infected, HTLV-1 causes a malignancy of mature T lymphocytes known as adult T-cell leukemia/lymphoma or ATL, as well as an inflammatory myelopathy known as HTLV-associated myelopathy or tropical spastic or paraparesis (HAM/TSP). HTLV-2 does not cause lymphoma or leukemia, but has been associated with an inflammatory myelopathy similar to HAM/TSP. Both HTLV-1 and HTLV-2 are associated with a spectrum of other immunologic and infectious conditions. Prevention of infection with HTLV viruses may be accomplished by (1) the interruption of breast-feeding by seropositive mothers, at least in countries with adequate socioeconomic conditions to support safe formula feeding; (2) the use of condoms by sexually active individuals; (3) testing of blood products for HTLV antibodies; and (4) interruption of needle sharing among injection drug users. Although the epidemiology of HTLV-1 and HTLV-2 is generally well described, a number of problems remain, including a better understanding of HTLV prevalence in parts of Asia and Africa and the prognostic factors for ATL and HAM/TSP. In developed countries including Japan and the USA, the prevalence of HTLV-1 and HTLV-2 infection is waning due to declining transmission. However, better monitoring of secular trends of HTLV infection is warranted in a number of endemic countries that have or have not implemented prevention measures.
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Murphy, E.L., Bruhn, R.L. (2023). Human T-Cell Leukemia Viruses Types 1 and 2. In: Kaslow, R.A., Stanberry, L.R., Powers, A.M. (eds) Viral Infections of Humans. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-9544-8_45-2
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Human T-Cell Leukemia Viruses Types 1 and 2- Published:
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