Human T-Cell Lymphotropic Virus Types 1 and 2

Abstract

Human T-cell leukemia virus type 1 (HTLV-1) was reported in 1980 by Bernard Poiesz and Robert Gallo as the first retrovirus shown to be pathogenic to humans. As can be surmised from the description of some mechanisms of pathogenesis, the diseases associated with human T-cell leukemia virus (HTLV) infection have inflammatory and/or proliferative attributes. HTLV-1 and HTLV-2 diseases are usually classified as malignant or nonmalignant clinical presentations. Diagnosis of uveitis is based on clinical presentation and the presence of antibodies to HTLV-1 as well as the confirmation of proviral DNA by PCR. Sjogren’s syndrome is an autoimmune disorder complete with the expression of anticentromere antibodies, while the antibodies expressed with sicca syndrome are to HTLV-1. Skin lesions constitute the most common initial clinical presentation of disease and can appear as papules, nodules, infiltrated plaques, tumors, or erythroderma. The treatment of adult T-cell leukemia/lymphoma (ATL) consists of chemotherapy, alpha interferon, and zidovudine. The main cause of death is disease progression combined with hypercalcemia and septicemia. The detection of HTLV-1 and -2 relies on the presence of serum or plasma antibodies and proviral DNA. Enzyme-linked immunosorbent assays (ELISAs), Western immunoblots, and radioimmunoprecipitation assays (RIPAs) are used to confirm repeatedly reactive or inconclusive findings. The interpretation of PCR-restriction fragment length polymorphism findings is based on the comparison to the banding patterns of known standards. HTLV-1- and HTLV-2-seropositive patients should be counseled about prevention of transmission. Patients are advised to use condoms during sexual intercourse and are prohibited from donating blood or blood products.