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Patients with HAM\/TSP have a vigorous immune response to HTLV\u2013I, and it has been widely suggested that this immune response, particularly the HTLV\u2013I\u2013specific cytotoxic T\u2013lymphocyte (CTL) response, causes the tissue damage that is seen in HAM\/TSP. In this paper we summarize recent evidence that a strong CTL response to HTLV\u2013I does in fact protect against HAM\/TSP by reducing the proviral load of HTLV\u2013I. We conclude that HTLV\u2013I is persistently replicating at a high level, despite the relative constancy of its genome sequence. These results imply that antiretroviral drugs could reduce the risk of HAM\/TSP by reducing the viral load, and that an effective anti\u2013HTLV\u2013I vaccine should elicit a strong CTL response to the virus. The dynamic nature of the infection also has implications for the epidemiology and the evolution of HTLV\u2013I.<\/jats:p>","DOI":"10.1098\/rstb.1999.0422","type":"journal-article","created":{"date-parts":[[2002,7,26]],"date-time":"2002-07-26T19:55:21Z","timestamp":1027713321000},"page":"691-700","source":"Crossref","is-referenced-by-count":31,"title":["Genetic control and dynamics of the cellular immune response to the human T\u2013cell leukaemia virus, HTLV\u2013I"],"prefix":"10.1098","volume":"354","author":[{"given":"Charles R. 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M.","family":"Jeffery","sequence":"additional","affiliation":[{"name":"Department of Immunology, Imperial College School of Medicine, St Mary's, Norfolk Place, LondonW2 1PG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison M.","family":"Vine","sequence":"additional","affiliation":[{"name":"Department of Immunology, Imperial College School of Medicine, St Mary's, Norfolk Place, LondonW2 1PG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aviva","family":"Witkover","sequence":"additional","affiliation":[{"name":"Department of Immunology, Imperial College School of Medicine, St Mary's, Norfolk Place, LondonW2 1PG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin A.","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Wodarz","sequence":"additional","affiliation":[{"name":"Department of Zoology, University of Oxford, South Parks Road, Oxford OX1 3PS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Usuku","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhiro","family":"Osame","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"175","published-online":{"date-parts":[[1999,4,29]]},"reference":[{"key":"p_1","doi-asserted-by":"crossref","unstructured":"Allison A. 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