An HTLV-I vaccine: why, how, for whom?
Endemic infection with the human T cell leukemia/lymphoma viruses I and II (HTLV-I/II) is now recognized to be worldwide, and is becoming epidemic among intravenous drug abusers (IVDAs) in the United States and Europe. The number of people around the world infected with HTLV-I can be estimated as between 10 and 20 million (Table 1). HTLV-I causes a rapidly progressing adult T cell leukemia/lymphoma (ATLL), and an incurable progressive neuromyelopathy named tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM), as well as a number of less well-studied syndromes. There is evidence that coinfection with HTLV-I or -II accelerates progression to AIDS. The cumulative lifetime risk of developing ATLL or TSP/HAM is around 5%, which, in terms of the induction of serious diseases, places HTLV-I in the same category of viruses for which efficient vaccines are made and used. Furthermore, there are factors favoring the feasibility of a vaccine against HTLV-I, in that the virus displays relatively low antigenic variability, natural immunity occurs in humans, and experimental vaccination with the envelope (Env) antigen is successful in animal models. A vaccine against HTLV-I would be of significant public health value in the fields of oncology, neurology, and AIDS, and it would serve as a pathfinder for a vaccine against HIV.
de Thé
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Unité d'Epidémiologie des Virus Oncogènes, Institut Pasteur, Paris, France.
Bomford
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D016915:AIDS Vaccines / Q000302:isolation & purification; D000328:Adult; D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D015490:HTLV-I Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D015368:Human T-lymphotropic virus 1 / Q000276:immunology*; D015367:Human T-lymphotropic virus 2 / Q000276:immunology; D006801:Humans; D011247:Pregnancy; D014765:Viral Vaccines / Q000302:isolation & purification / Q000494:pharmacology*
D016915:AIDS Vaccines; D014765:Viral Vaccines