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HTLV-1, HTLV-2, and associated diseases 

HTLV-1, HTLV-2, and associated diseases

HTLV-1, HTLV-2, and associated diseases

Kristien Verdonck

and Eduardo Gotuzzo



More emphasis on infectious complications of HTLV-1; additional detail of occurrence and disease outcomes of HTLV-2.

Addition of recent information on HTLV-1 receptor, virological synapse, the regulatory protein HBZ, and FoxP3+CD4+ T cells.

Discussion on reliability of prevalence estimates.

Particle agglutination tests have gone out of use and are no longer mentioned.

The proposal of a fifth category of ATL has not been adopted widely and is no longer mentioned.

Addition of bronchiectasis to table.

Addition of potential treatment strategies proposed in the literature.

Enhanced discussion of infectious complications and non-HAM/TSP inflammatory conditions.

More detail on HTLV-2 disease outcomes.

Recent references have been added.

Updated on 31 May 2012. The previous version of this content can be found here.
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date: 29 April 2017

Human T-lymphotropic virus (HTLV)-1 and HTLV-2 belong to the genus Deltaretrovirus of the family Retroviridae. They only infect humans, produce a lifelong infection, and can be transmitted from mother to child, through sexual intercourse, and via cellular blood components. Both viruses are present in all continents. The highest HTLV-1 prevalence in the general population (10%) has been found in southern Japan. There are endemic foci of HTLV-2 among native Amerindians and Central African pygmy tribes. HTLV-2 is also frequent among injecting drug users. It is unclear why some infected people develop associated diseases while others remain asymptomatic.

Clinical features—(1) HTLV-1—up to 10% of carriers develop clinical manifestations, including adult T-cell leukaemia/lymphoma, HTLV-associated myelopathy/tropical spastic paraparesis, and infectious diseases such as strongyloidiasis, scabies, and tuberculosis. (2) HTLV-2—causes a milder form of HTLV-associated myelopathy/tropical spastic paraparesis, arthritis, bronchitis, and pneumonia.

Diagnosis and prevention—HTLV enzyme immunosorbent assays are used for screening, followed by confirmatory testing of positive results. Mother-to-child transmission of HTLV-1 can be reduced by avoiding breast-feeding; condom use protects against sexually transmitted infection; screening of blood donors is performed in many countries. No vaccine is available and there are no effective antiviral drugs.

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