de Thé G, Bomford R
Unité d'Epidémiologie des Virus Oncogènes, Institut Pasteur, Paris, France.
AIDS Res Hum Retroviruses. 1993 May;9(5):381-6. doi: 10.1089/aid.1993.9.381.
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.
现已确认，人类T细胞白血病/淋巴瘤病毒I型和II型（HTLV-I/II）的地方性感染在全球范围内存在，并且在美国和欧洲的静脉注射吸毒者（IVDA）中呈流行态势。全世界感染HTLV-I的人数估计在1000万至2000万之间（表1）。HTLV-I可引发进展迅速的成人T细胞白血病/淋巴瘤（ATLL）、一种名为热带痉挛性截瘫/HTLV-I相关脊髓病（TSP/HAM）的无法治愈的进行性神经脊髓病，以及一些研究较少的综合征。有证据表明，与HTLV-I或-II合并感染会加速艾滋病的进展。罹患ATLL或TSP/HAM的终生累积风险约为5%，就引发严重疾病而言，HTLV-I与那些已有有效疫苗可供生产和使用的病毒属于同一类别。此外，存在一些因素有利于研发针对HTLV-I的疫苗，因为该病毒的抗原变异性相对较低，人类存在天然免疫力，并且在动物模型中用包膜（Env）抗原进行实验性疫苗接种取得了成功。针对HTLV-I的疫苗在肿瘤学、神经病学和艾滋病领域将具有重大的公共卫生价值，并且它将成为针对HIV疫苗的先行者。
