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The immune control and cell-to-cell spread of human T-lymphotropic virus type 1 Bangham CRMJ Gen Virol 2003[Dec]; 84 (Pt 12): 3177-3189Human T-lymphotropic virus type 1 (HTLV-1) varies little in sequence compared with human immunodeficiency virus type 1 (HIV) and it is difficult to detect HTLV-1 mRNA, proteins or virions in fresh blood. But the strong and chronically activated T cell response to the virus indicates that HTLV-1 proteins are expressed persistently. It now appears that the efficiency of an individual's cytotoxic T cell (CTL) response to HTLV-1 is the chief single determinant of that person's provirus load, which can differ between HTLV-1-infected people by more than 10 000-fold. Progress is now being made towards defining this CTL 'efficiency' in terms of host genetics, T cell function, T cell gene expression and mathematical dynamics. Lymphocytes that are naturally infected with HTLV-1 do not produce enveloped extracellular virions in short-term culture and this has reinforced the erroneous conclusion that the virus is latent. But recent evidence shows that HTLV-1 can spread directly between lymphocytes across a specialized, virus-induced cell-cell contact - a 'viral synapse'. Instead of making extracellular virions, HTLV-1 uses the mobility of the host cell to spread within and between hosts. In this review the evidence is summarized on the persistent gene expression of HTLV-1 in vivo, the role of the immune system in protection and pathogenesis in HTLV-1 infection, and the mechanism of cell-to-cell spread of HTLV-1.|CD4-Positive T-Lymphocytes/immunology[MESH]|CD8-Positive T-Lymphocytes/immunology[MESH]|Gene Products, env/analysis[MESH]|Gene Products, gag/analysis[MESH]|Human T-lymphotropic virus 1/*pathogenicity/physiology[MESH]|Humans[MESH]|Immunity, Cellular[MESH]|Intercellular Junctions/virology[MESH]|Logistic Models[MESH]|Lymphocyte Count[MESH]|Paraparesis, Tropical Spastic/etiology/*immunology/virology[MESH]|Proviruses/pathogenicity[MESH]|RNA-Directed DNA Polymerase/immunology[MESH]|T-Lymphocytes/*immunology/*virology[MESH]|Viral Load[MESH]|Virus Latency[MESH] |
