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The Global Virus Network (GVN) is calling on the World Health Organization (WHO) to support the promotion of proven, effective transmission prevention strategies on the debilitating and deadly virus, human T cell leukemia virus subtype 1 (HTLV-1).  An abbreviated version of the letter, Time to eradicate HTLV-1: an open letter to WHO, was published in The Lancet online and will be published in Lancet’s 12 May issue. The full letter was published on the GVN website.

The GVN is an international coalition of the world’s foremost medical virologists, comprising 41 Centers of Excellence – including The Peter Doherty Institute for Infection and Immunity (Doherty Institute) – and 7 Affiliates in 26 countries, dedicated to identifying and researching, combatting and preventing, current and emerging pandemic viruses that pose a critical threat to public health and well-being. The Doherty Institute hosted the GVN’s 9th International Meeting in Melbourne on 25-27 September, 2017 in partnership with Institut Pasteur, and following the meeting’s impressive session on one of the most potent human carcinogens, a group of renowned scientists and activists teamed up to pen the open letter.

Said Robert C. Gallo, MD, Co-Founder and Director, GVN and The Homer & Martha Gudelsky Distinguished Professor in Medicine, Co-Founder and Director, Institute of Human Virology, University of Maryland School of Medicine, a GVN Center of Excellence, “Since my colleagues and I discovered HTLV-1, the first known human retrovirus in 1980 and the first virus shown to directly cause human cancer and later shown also to cause neurological and immune disorders, we have learned that this destructive and lethal virus is causing much devastation in communities with high prevalence.

“The GVN created an HTLV-1 Task Force over three years ago, recognising that there are no effective vaccines against this virus nor antiviral drugs to treat infections. During the GVN meeting last September, I was astounded to learn of the hyper-endemic numbers in the Aboriginal population of Australia. HTLV-1 is endemic in other regions including several islands of the Caribbean, and in countries such as Brazil, Iran, Japan and Peru. We hope that the WHO will agree with us, and begin to take action in promoting prevention strategies against HTLV-1.”  Prof. Gallo is also Co-Chair of GVN’s HTLV-1 Task Force.

HTLV-1 is transmitted via the same routes as HIV, which was co-discovered as the cause of AIDS by Prof. Gallo and his colleagues, along with scientists at Institut Pasteur. HIV and HTLV-1 transmit via infected body fluids including unprotected sexual intercourse, breastfeeding, sharing of injecting equipment, and the transfusion and transplantation of infected blood and organ donations. They are ancient viruses originating from non-human primates. HTLV-1 prevalence is more complex than HIV, in that it is highly endemic in some parts of the world, while surveillance data in many regions are not comprehensive and unknown for six billion persons.

“As with most sexually transmitted viruses, the majority of HTLV positive people transmit the virus unknowingly and are unaware that they are at risk of developing HTLV-1 associated diseases,” said Dr Fabiola Martin, a sexual health, HIV and HTLV physician and scientist at The University of Queensland.

“The statistics speak for themselves and with the support of the World Health Organization, we will be able to support patients and promote effective HTLV-1 prevention strategies internationally.”

In a recent hospital-based cohort study by Dr Lloyd Einsiedel, Head of Infection and Chronic Disease, Baker Heart and Diabetes Institute, Northern Territory, 33.6 % of Indigenous people tested HTLV-1 positive, reaching 48.5 % in older men. Further, the following infection rates are reported worldwide:

• Brazil –  a prevalence rate of 1.3% in blood donors in certain regions, 1.8% in the general population and 1.05% in pregnant women with 33% of their family members including children found to be positive.
• Central African Republic – 7% of older, female Pygmies in the Southern region infected.
• Gabon –  a HTLV-1 prevalence of 5–10% has been observed in adults.
• Iran - up to 3% of adults are infected in the Mashhad area while HTLV-1 is found across the country.
• Jamaica –  6.1% in the general population and other Caribbean islands that have been studied have similar prevalence rates. 
• Japan – 1,000,000 are HTLV-1 positive and in Southern regions 10% of adults more than 50 years of age carry this virus.
• Nigeria –  850,000 to 1.7 million infected.
• Romania – infection rates include 5.3/10,000 among first-time blood donors, and 3-25% in poly-transfused patients.

“Specifically for Australia, we have all of the key components required for an effective response to this virus – indigenous clinical leadership; the medical research skills and capacity; and two forthcoming developments in treatment and vaccine development,” said Professor Damian Purcell, Head of Molecular Virology Laboratory, The University of Melbourne at the Doherty Institute.

“But we need the support of the WHO and Australian Government to accelerate research and implement these strategies.”