{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:48:31Z","timestamp":1785527311824,"version":"3.56.0"},"reference-count":122,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Viruses"],"abstract":"<jats:p>Human T-cell leukemia virus type 1 (HTLV-1), the first oncogenic human retrovirus, causes adult T-cell leukemia\/lymphoma (ATLL), an aggressive neoplasm of mature CD4+ T-cells that is incurable in most patients and is associated with a median survival of less than 1 year. HTLV-1 also causes inflammatory disorders, including HTLV-associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) and uveitis. The estimated lifetime risks of ATLL and HAM\/TSP in HTLV-1 carriers are 3\u20135% and 0.25\u20131.8%, respectively. Although there is uncertainty about other health effects of HTLV-1, a recent meta-analysis showed an association between HTLV-1 and cardiovascular, cerebrovascular, and metabolic diseases and a 57% increased risk of early mortality in HTLV-1 carriers, independent of ATLL or HAM\/TSP. Furthermore, emerging studies in endemic areas show that outcomes for common cancers, such as cervical cancer and lymphoma (non-ATLL), are inferior in HTLV-1 carriers compared to publicly reported data. Thus, the impact of HTLV-1 may be greater and more diverse than currently understood. This review provides an outline of the prevalence and impact of HTLV-1 and associated disorders in the US, focused on\u2014but not limited to\u2014ATLL, with an emphasis on the social determinants of health that can affect the success of screening and prevention strategies. We also discuss the mechanisms by which HTLV-1 drives the pathogenesis of ATLL and potential strategies for early diagnosis and intervention. Finally, we conclude by suggesting approaches to designing and implementing community-informed research initiatives in HTLV-1 and ATLL.<\/jats:p>","DOI":"10.3390\/v17101333","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T15:38:55Z","timestamp":1759246735000},"page":"1333","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["HTLV-1 and ATLL: Epidemiology, Oncogenesis, and Opportunities for Community-Informed Research in the United States"],"prefix":"10.3390","volume":"17","author":[{"given":"Adrian","family":"Altieri","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA"},{"name":"Sidney Kimmel Comprehensive Cancer Center (SKCCC), Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean Patrick","family":"Reilly","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center (SKCCC), Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"},{"name":"Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abu","family":"Mansalay","sequence":"additional","affiliation":[{"name":"African Cultural Alliance of North America (ACANA), Philadelphia, PA 19143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8268-5271","authenticated-orcid":false,"given":"Alan Soo-Beng","family":"Khoo","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA"},{"name":"Sidney Kimmel Comprehensive Cancer Center (SKCCC), Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nettie","family":"Johnson","sequence":"additional","affiliation":[{"name":"African Cultural Alliance of North America (ACANA), Philadelphia, PA 19143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zafar K.","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Leader","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center (SKCCC), Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8057-7835","authenticated-orcid":false,"given":"Pooja","family":"Jain","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center (SKCCC), Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"},{"name":"Department of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-023X","authenticated-orcid":false,"given":"Pierluigi","family":"Porcu","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center (SKCCC), Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA"},{"name":"Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA 19107, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7415","DOI":"10.1073\/pnas.77.12.7415","article-title":"Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma","volume":"77","author":"Poiesz","year":"1980","journal-title":"Proc. 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