HTLV Virus

HTLV  Virus is a retrovirus that usually establishes an asymptomatic, but chronic infection. HTLV-1 is a virus that infects the white cells in the blood in humans. It can cause a disease of the nervous system and leukemia. This virus is known to produce a type of progressive nervous system disorder that causes problems with use of the muscles, particularly use of the legs and urinary bladder. This specific condition is called TSP/HAM.

In a small percentage (1%) of patients, HTLV infection that can progress to adult T-cell leukemia/lymphoma (ATL), or HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP).

Molecular Detection

During infection, the HTLV RNA genome is converted to a proviral DNA form and integrated into the genome of the host cell. Total DNA extracted from a patient specimen therefore will contain HTLV proviral sequences that can be detected directly by PCR. This provides greater sensitivity for low level infections, and is independent of serological conversion. Amplification of a unique human gene is used as an internal positive control to monitor the performance of each reaction and reduce false negative results.

Genetic difference between type I and II can be distinguished by RFLP analysis. Determination of HTLV infection should not rely solely on the results of a PCR analysis. Patients who test positive for the presence of proviral DNA by PCR should be tested using additional assays, evaluated clinically, and retested using a new specimen before the diagnosis is established.

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