Laboratório de Investigação em Dermatologia e Imunodeficiência, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Soc Bras Med Trop. 2014 May-Jun;47(3):265-74. doi: 10.1590/0037-8682-0232-2013.
Human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in many parts of the world and is primarily transmitted through sexual intercourse or from mother to child. Sexual transmission occurs more efficiently from men to women than women to men and might be enhanced by sexually transmitted diseases that cause ulcers and result in mucosal ruptures, such as syphilis, herpes simplex type 2 (HSV-2), and chancroid. Other sexually transmitted diseases might result in the recruitment of inflammatory cells and could increase the risk of HTLV-1 acquisition and transmission. Additionally, factors that are associated with higher transmission risks include the presence of antibodies against the viral oncoprotein Tax (anti-Tax), a higher proviral load in peripheral blood lymphocytes, and increased cervicovaginal or seminal secretions. Seminal fluid has been reported to increase HTLV replication and transmission, whereas male circumcision and neutralizing antibodies might have a protective effect. Recently, free virions were discovered in plasma, which reveals a possible new mode of HTLV replication. It is unclear how this discovery might affect the routes of HTLV transmission, particularly sexual transmission, because HTLV transmission rates are significantly higher from men to women than women to men.
人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）在世界许多地区流行，主要通过性接触或母婴传播。性传播从男性到女性比从女性到男性更有效，并且可能通过引起溃疡和导致黏膜破裂的性传播疾病（如梅毒、单纯疱疹病毒 2 型（HSV-2）和软下疳）而增强。其他性传播疾病可能导致炎症细胞的募集，并可能增加获得和传播 HTLV-1 的风险。此外，与更高传播风险相关的因素包括存在针对病毒癌蛋白 Tax 的抗体（抗 Tax）、外周血淋巴细胞中更高的前病毒载量以及增加的宫颈阴道或精液分泌物。据报道，精液可增加 HTLV 复制和传播，而男性包皮环切术和中和抗体可能具有保护作用。最近，在血浆中发现了游离病毒粒子，这揭示了 HTLV 复制的一种可能的新模式。目前尚不清楚这一发现将如何影响 HTLV 的传播途径，特别是性传播，因为 HTLV 从男性到女性的传播率明显高于从女性到男性。
