Résumé
Le rétrovirus HTLV-1 (Human T cell leukemia/lymphoma virus type 1) est le premier rétrovirus oncogène découvert chez l’Homme. On estime qu’il infecte 10 à 20 millions de sujets dans le monde. Cependant, l’HTLV-1 n’est pas un virus ubiquitaire. En effet, il existe des zones de forte endémie virale (sud du Japon, Afrique intertropicale, les Caraïbes, certaines régions d’Amérique centrale et du Sud, du Moyen-Orient et d’Australie). Dans ces régions, de 0,5 à 50 % des sujets, selon le sexe et l’âge, possèdent des anticorps dirigés contre les antigènes viraux d’HTLV-1. La séroprévalence HTLV-1 augmente avec l’âge, en particulier chez la femme. Le virus se transmet de la mère à l’enfant par un allaitement prolongé (> 6 mois), mais aussi par contact sexuel, surtout dans le sens homme-femme et, enfin, par voie sanguine, lors de la transmission de cellules lymphoïdes infectées. L’HTLV-1 est principalement l’agent étiologique de deux maladies très sévères : une lymphoprolifération maligne de cellules T, la leucémie/lymphome T de l’adulte, et une neuromyélopathie chronique, invalidante, la paraplégie spastique tropicale (TSP) ou myélopathie associée à HTLV-1 (TSP/HAM). Il est aussi associé à des maladies plus rares, telles des uvéites antérieures, des dermatites infectieuses et des myosites. La répartition des différents sous-types moléculaires d’HTLV-1 ou génotypes est liée à l’origine géographique des populations infectées et non pas à la pathologie associée. La très grande stabilité génétique d’HTLV-1 est utilisée comme un outil moléculaire pour mieux comprendre l’origine, l’évolution et les voies de dissémination de ce rétrovirus et des populations infectées.
Abstract
Human T-cell leukemia/lymphoma virus type 1 (HTLV-1) was the first oncogenic human retrovirus discovered in 1980. It is estimated that around 10–20 million people are infected with HTLV-1 worldwide. However, HTLV-1 is not a ubiquitous virus. Indeed, HTLV-1 is present throughout the world with clusters of high endemicity including mainly southern Japan, the Caribbean region, parts of South America and intertropical Africa, with foci in the Middle East and Australia. The origin of this puzzling geographical repartition is probably linked to a founder effect in certain human groups. In the high endemic areas, 0.5 to 50% of the people have antibodies against HTLV-1 antigens. HTLV-1 seroprevalence increases with age, especially in women. HTLV-1 has 3 modes of transmission: mother to child, mainly through prolonged breastfeeding (> 6 months); sexual, mainly but not exclusively occurring from male to female; and by blood products contaminated by infected lymphocytes. HTLV-1 is mainly the etiological agent of two very severe diseases: a malignant T CD4+ cell lymphoproliferation of very poor prognosis, named adult T-cell leukemia/lymphoma (ATLL), and a chronic neuro-myelopathy named tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM). HTLV-1 is also associated with rare anterior uveitis, infective dermatitis and myositis in some high HTLV-1 endemic areas. The repartition of the different molecular subtypes or genotypes is mainly linked to the geographical origin of the infected persons but not to the associated pathology. HTLV-1 possesses a remarkable genetic stability probably linked to viral amplification via clonal expansion of infected cells rather than by reverse transcription. This stability can be used as a molecular tool to gain better insights into the origin, evolution and modes of dissemination of HTLV-1 and infected populations. HTLV-1 originated in humans through interspecies transmission from STLV-1, a very closely related retrovirus, highly endemic in several populations of apes and Old World monkeys.
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Gessain, A. Le rétrovirus humain oncogène HTLV-1 : épidémiologie descriptive et moléculaire, origine, évolution et aspects diagnostiques et maladies associées. Bull. Soc. Pathol. Exot. 104, 167–180 (2011). https://doi.org/10.1007/s13149-011-0174-4
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DOI: https://doi.org/10.1007/s13149-011-0174-4