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The human T‐cell leukemia virus type 1 (HTLV‐1): New insights into the clinical aspects and molecular pathogenesis of adult t‐cell leukemia/lymphoma (ATLL) and tropical spastic paraparesis/HTLV‐associated myelopathy (TSP/HAM)

Human T‐cell leukemia virus type 1 (HTLV‐1) was the first human retrovirus to be identified in the early 1980s. The isolation and identification of a related virus, HTLV‐2, and the distantly related human immunodeficiency virus (HIV) immediately followed. Of the three retroviruses, two are associated definitively with specific diseases, HIV, with acquired immune deficiency syndrome (AIDS) and HTLV‐1, with adult T‐cell leukemia/lymphoma (ATLL) and tropical spastic paraparesis/HTLV‐1–associated myelopathy (TSP/HAM). While an estimated 10–20 million people worldwide are infected with HTLV‐I, infection is endemic in the Caribbean, parts of Africa, southwestern Japan, and Italy. Approximately 4% of HTLV‐I infected individuals develop ATLL, a disease with a poor prognosis. The clinical manifestations of infection and the current biology of HTLV viruses with emphasis on HTLV‐1 are discussed in detail. The implications for improvements in diagnosis, treatment, intervention, and vaccination are included, as well as a discussion of the emergence of HTLV‐1 and ‐2 as copathogens among HIV‐1‐infected individuals. Microsc. Res. Tech. 68:176–196, 2005. © 2005 Wiley‐Liss, Inc.