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Adult T-cell leukemia/lymphoma in a Caucasian patient after sexual transmission of HTLV-1

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive T-cell lymphoproliferation caused by human T-cell lymphotropic virus type-1 (HTLV-1). This oncogenic human retrovirus can be acquired by mother-to-child transmission through prolonged breast-feeding, sexual transmission, or from transfused infected blood cells or intravenous drug abuse. HTLV-1 infects approximately 5–10 million individuals worldwide and, among them, 1–5% will develop ATLL during their lifetime. Four major geographic molecular subtypes (genotypes) have been reported including the cosmopolitan a-subtype, the Central African b-subtype, the Central African/Pygmies d-subtype and the Australo-Melanesian c-subtype. The results of several studies showed that most cases of ATLL develop in individuals who have been infected with HTLV-1 as young children via their mothers’ breast milk. The very rare ATLL cases observed following transfusion or sexual transmission are still being debated. Here, we report on a Caucasian French patient, with HTLV-1–seronegative parents, who developed ATLL, characterized by a clonal T cell skin proliferation of CD4+ and CD25+ cells, 18 years after highly probable sexual transmission of HTLV-1 through repeated unprotected sexual intercourse with a Cameroonian woman. Indeed, genotyping of the patient's virus revealed infection with an HTLV-1 b-subtype strain, typically of Central African origin, especially Cameroon. This case definitively confirms the hypothesis that ATLL can develop, albeit rarely, after infection during adulthood, outside breast-feeding.

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Correspondence to David Sibon.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Sibon, D., Cassar, O., Duga, I. et al. Adult T-cell leukemia/lymphoma in a Caucasian patient after sexual transmission of HTLV-1. Retrovirology 12, P76 (2015). https://doi.org/10.1186/1742-4690-12-S1-P76

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Keywords

  • Breast Milk
  • Sexual Intercourse
  • Intravenous Drug
  • Molecular Subtype
  • Caucasian Patient