Weber T, Hunsmann G, Stevens W, Fleming A F
Baillieres Clin Haematol. 1992 Apr;5(2):273-314. doi: 10.1016/s0950-3536(11)80021-1.
It was only in 1980 that the first human retrovirus, HTLV-1, was isolated. Since then, HTLV-2, HIV-1 and HIV-2 have been identified. All four viruses are transmitted with varying efficiency sexually, vertically from mother to infant, and through blood by transfusion or contamination. HTLV-1 is endemic in populations in south-west Japan, Taiwan, sub-Saharan Africa, the Caribbean, southern USA, central and south America, Australia, Papua New Guinea, Solomon Islands and western Asia. There is now epidemic spread amongst IVDUs in north and south America and southern Europe. HTLV-1 is the aetiological agent of adult T-cell leukaemia/lymphoma (ATL) and tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM). Other associations which may be causative are with polymyositis, infective dermatitis, gastrointestinal malignant lymphoma and chronic lymphatic leukaemia. ATL appears to be due to malignant transformation of HTLV-1 infected cells, and TSP/HAM to chronic activation of these cells. The epidemiology of HTLV-2 is being separated only recently from HTLV-1 through the application of PCR. It has a low level of endemicity in populations of central Africa, and central and south America. It is being spread epidemically amongst IVDUs in north America and southern Europe. Its association with any pathology in man remains uncertain. HIV-1 is epidemic and spreading rapidly throughout the world. In areas where homosexual contact was the predominant mode of transmission, heterosexual spread is becoming increasingly important. The areas where heterosexual contact is the predominant mode of transmission include the worst affected populations in the world, for example sub-Saharan Africa and some of the Caribbean. There have been recent and explosive increases of HIV-1 seroprevalence in IVDUs and female prostitutes in Asia, especially Thailand and India. Of the diverse pathology following infection, only the haematological consequences are reviewed in detail: these include anaemia, leucopenia, thrombocytopenia, disorders of coagulation and lymphomas. HIV-2, compared to HIV-1, is less infectious and causes less immunosuppression with more slowly progressive disease. It is prevalent in west Africa, but is spreading, albeit slowly, far beyond.
直到1980年，第一种人类逆转录病毒HTLV-1才被分离出来。从那时起，HTLV-2、HIV-1和HIV-2也相继被发现。这四种病毒都能通过性传播、母婴垂直传播以及输血或污染血液等方式，以不同的效率进行传播。HTLV-1在日本西南部、台湾、撒哈拉以南非洲、加勒比地区、美国南部、中南美洲、澳大利亚、巴布亚新几内亚、所罗门群岛和西亚的人群中呈地方性流行。现在，在北美、南美和南欧的静脉注射毒品者中出现了流行传播。HTLV-1是成人T细胞白血病/淋巴瘤（ATL）和热带痉挛性截瘫/HTLV-1相关脊髓病（TSP/HAM）的病原体。其他可能具有因果关系的关联包括与多发性肌炎（皮肌炎）、感染性皮炎、胃肠道恶性淋巴瘤和慢性淋巴细胞白血病。ATL似乎是由于HTLV-1感染细胞的恶性转化所致，而TSP/HAM则是由于这些细胞的慢性激活。直到最近，通过应用聚合酶链反应（PCR），HTLV-2的流行病学才与HTLV-1区分开来。它在中非以及中南美洲的人群中地方性流行程度较低。在北美和南欧的静脉注射毒品者中呈流行传播。它与人类任何病理状况的关联仍不确定。HIV-1呈流行性，且在全球迅速传播。在以同性恋接触为主要传播方式的地区，异性传播正变得越来越重要。以异性接触为主要传播方式的地区包括世界上受影响最严重的人群，例如撒哈拉以南非洲和一些加勒比地区。最近，亚洲尤其是泰国和印度的静脉注射毒品者和女性妓女中HIV-1血清阳性率急剧上升。在感染后的各种病理状况中，仅对血液学后果进行了详细综述：这些包括贫血、白细胞减少、血小板减少、凝血障碍和淋巴瘤。与HIV-1相比，HIV-2的传染性较低，导致的免疫抑制较少，疾病进展也较为缓慢。它在西非流行，但尽管传播缓慢，却已扩散到更远的地区。
