title: Genetic control and dynamics of the cellular immune response to the human T-cell leukaemia virus, HTLV-I.
abstract: About 1% of people infected with the human T-cell leukaemia virus, type 1 (HTLV-I) develop a disabling chronic inflammatory disease of the central nervous system known as HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Patients with HAM/TSP have a vigorous immune response to HTLV-I, and it has been widely suggested that this immune response, particularly the HTLV-I-specific cytotoxic T-lymphocyte (CTL) response, causes the tissue damage that is seen in HAM/TSP. In this paper we summarize recent evidence that a strong CTL response to HTLV-I does in fact protect against HAM/TSP by reducing the proviral load of HTLV-I. We conclude that HTLV-I is persistently replicating at a high level, despite the relative constancy of its genome sequence. These results imply that antiretroviral drugs could reduce the risk of HAM/TSP by reducing the viral load, and that an effective anti-HTLV-I vaccine should elicit a strong CTL response to the virus. The dynamic nature of the infection also has implications for the epidemiology and the evolution of HTLV-I.
authors.affiliation: Department of Immunology, Imperial College School of Medicine, London, UK. c.bangham@ic.ac.uk
authors.forename: C R
authors.initials: CR
authors.lastname: Bangham
authors.forename: S E
authors.initials: SE
authors.lastname: Hall
authors.forename: K J
authors.initials: KJ
authors.lastname: Jeffery
authors.forename: A M
authors.initials: AM
authors.lastname: Vine
authors.forename: A
authors.initials: A
authors.lastname: Witkover
authors.forename: M A
authors.initials: MA
authors.lastname: Nowak
authors.forename: D
authors.initials: D
authors.lastname: Wodarz
authors.forename: K
authors.initials: K
authors.lastname: Usuku
authors.forename: M
authors.initials: M
authors.lastname: Osame
mesh_terms: D015368:Human T-lymphotropic virus 1 / Q000235:genetics* / Q000276:immunology* / Q000502:physiology; D006801:Humans; D015493:Paraparesis, Tropical Spastic / Q000453:epidemiology / Q000276:immunology*; D012307:Risk Factors; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*; D019562:Viral Load; D014779:Virus Replication