Chapter 89 : Human T-Cell Lymphotropic Virus Types 1 and 2

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Human T-Cell Lymphotropic Virus Types 1 and 2, Page 1 of 2

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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. Sjögren’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.

Citation: Nyland S, Loughran T, Ugen K. 2006. Human T-Cell Lymphotropic Virus Types 1 and 2, p 798-802. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch89

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Restriction Fragment Length Polymorphism
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Flowchart for HTLV-1 and -2 detection and discrimination. For patients with combined clinical presentation and risk factors, detection of HTLV-1 and -2 infection begins with ELISA testing. When both ELISA results are negative (—), it is recommended that follow-up include documentation of other possible causes for the clinical presentation, as well as additional testing if other causes are ruled out. Repeatedly reactive (+) results must be confirmed by Western blot analysis and then analyzed by PCR if indicated. Indeterminate (?) or reactive ELISA results that are nonreactive on Western blotting should be confirmed by RIPA. Repeatedly indeterminate results can be clarified by PCR-related methods. RFLP, restriction fragment length polymorphism.

Citation: Nyland S, Loughran T, Ugen K. 2006. Human T-Cell Lymphotropic Virus Types 1 and 2, p 798-802. In Detrick B, Hamilton R, Folds J (ed), Manual of Molecular and Clinical Laboratory Immunology, 7th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815905.ch89
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