Current State of Therapeutics for HTLV-1

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Abstract
Human T cell leukaemia virus type-1 (HTLV-1) is an oncogenic retrovirus that causes lifelong infection in ~5–10 million individuals globally. It is endemic to certain First Nations populations of Northern and Central Australia, Japan, South and Central America, Africa, and the Caribbean region. HTLV-1 preferentially infects CD4+ T cells and remains in a state of reduced transcription, often being asymptomatic in the beginning of infection, with symptoms developing later in life. HTLV-1 infection is implicated in the development of adult T cell leukaemia/lymphoma (ATL) and HTLV-1-associated myelopathies (HAM), amongst other immune-related disorders. With no preventive or curative interventions, infected individuals have limited treatment options, most of which manage symptoms. The clinical burden and lack of treatment options directs the need for alternative treatment strategies for HTLV-1 infection. Recent advances have been made in the development of RNA-based antiviral therapeutics for Human Immunodeficiency Virus Type-1 (HIV-1), an analogous retrovirus that shares modes of transmission with HTLV-1. This review highlights past and ongoing efforts in the development of HTLV-1 therapeutics and vaccines, with a focus on the potential for gene therapy as a new treatment modality in light of its successes in HIV-1, as well as animal models that may help the advancement of novel antiviral and anticancer interventions.
Funding Information
  • An Australian Government Research Training Program Scholarship (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • an NHMRC programme grant (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • a UNSW Rapid Response Research grant (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • the NSW RNA Production Research Network (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • a philanthropic grant to the Immunotherapy Research Fund at the Kirby Institute (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • the Australian NHMRC Ideas grant (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • Australian Centre for HIV and Hepatitis Virology Research (ACH4) Project Grants (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • the ACH4 and the Phyllis Connor Memorial Trust (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)
  • NIH (APP1149990, GNT2004670, R01 1R01MH134389-01 NIMH)

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