HTLV－1母子感染予防対策 保健指導マニュアル（改訂版）

1 22 T -1 htlv -1 23 3 T htlv -1 T -1 htlv -1 htlv -1 20 htlv -1 21 htlv -1 htlv -1 htlv -1 1 htlv -1 htlv -1 htlv -1 htlv -1 6 htlv -1 htlv -1 htlv -1 htlv -1 23 3 htlv -1 I htlv -1 1 II htlv -1 1 III htlv -1 3 IV htlv -1 3 V htlv -1 3 htlv -1 ATL HAM I 5 II 6 III 7 IV

2 10 T (ATL) I T (ATL) 12 II ATL 12 III ATL 13 htlv -1 I 14 II 14 III 15 htlv -1 I 17 II 18 III 19 IV 19 V 19 htlv -1 I htlv -1 20 II 20 III 23 IV htlv -1 23 I

3 26 II 27 III 28 I 32 II 32 III 32 IV 32 I 33 II 33 III 33 IV htlv -1 34 T - htlv -1 35 htlv -1 36 htlv -1 37 htlv -1 38 40 42 42 1 htlv -1 43 2 htlv -1 44 3 htlv -1 47 4 htlv -1 50 5 htlv -1 51 6 53 7 54 8 56 9 58 10 59 11 3 htlv -1 60 -1 ( htlv -1)

4 0608 2 22 6 8 62 -1 htlv -1 1101 1 22 11 1 64 htlv -1 1220 5 1220 1 22 12 20 68 74 ATL, adult T-cell leukemia T CLEIA, chemiluminescent enzyme immnoassay EIA, enzyme immunoassay HAM, htlv -1-associated myelopathy htlv -1 htlv -1, human T-cell leukemia virus type I T -1 IF, immunofluorescence PA, particle agglutination PCR, polymerase chain reaction PCR SIDS, sudden infant death syndrome WB, Western blot - 1 - 1 htlv -1 I htlv -1 1977 T T (ATL, adult T-cell leukemia) (1) 1979 ATL (MT- 1 )(2) 1981 C ATLV (adult T-cell leukemia virus) (3) C ATL ATLV (4) Poiesz C T (5) ATLV T human T-cell leukemia virus type I ( htlv -1)* (6,7) * htlv -I htlv -1 II htlv -1 htlv -1 (8,9) htlv -1 T DNA htlv -1 (10)

5 B HIV htlv -1 (env gag pol p40tax, p27rex) T T (11) htlv -1 T p40tax T ATL (10) htlv -1 HBZ ATL HBZ ATL HAM htlv -1 (12) htlv -1 ATL htlv -1 ATL htlv -1 - 2 - T htlv -1 ( ) - 3 - III htlv -1 htlv -1 T (ATL) ATL ATL htlv -1 HAM, htlv -1 associated myelopathy) (13) htlv -1 ATL htlv -1 htlv -1 (14) IV htlv -1 htlv -1 htlv -1 (15) htlv -1 (16) htlv -1 htlv -1 htlv -1 ( 4 htlv -1 )

6 PA EIA IF WB EIA CLEIA PA CLEIA WB PCR (polymerase chain reaction) V htlv -1 htlv -1 htlv -1 ATL HAM ATL htlv -1 (17)( 7 ) htlv -1 3 (18) (19) - 4 - htlv -1 ATL htlv -1 - 5 - htlv -1 ATL HAM I 1980 120 htlv -1 ( htlv -1 ) 700 ATL 2006 07 htlv -1 108 ATL 1100 (1) ATL / 2009 70 67 2 ATL ATL ATL htlv -1 HLA (2)

7 HAM HAM 1990 10 70 1998 1,400 2009 10 3 / (1) ATL HLA htlv -1 HLA * ATL HLA HAM (3) * HLA HLA - 6 - 2 ATL (1) II 1980 90 ATL (4) 90 ATL htlv -1 ATL 1990 HAM 2006 07 htlv -1 htlv -1 1985 51 44% 11 18 1 2009 HAM (1) htlv -1 3 (5) htlv -1 ATL ATL - 7 - htlv -1 htlv -1 (6)

8 20 htlv -1 HLA htlv -1 HLA ATL (7) 3 htlv -1 III ATL htlv -1 (50 ) 4 (8) htlv -1 5 (9) - 8 - 4 htlv -1 5 htlv -1 ATL - 9 - ATL htlv -1 1 2 htlv -1 3 (10) htlv -1 htlv -1 ( T ) htlv -1 ( ) 1990 ( 6) htlv -1 6 (8) htlv -1 htlv -1 (50 )

9 ( ) htlv -1 ATL ( ) - 10 - IV 1980 htlv -1 120 ATL 700 2002 ATL 1,100 20 ATL 50 ATL htlv -1 7 htlv -1 ( ) htlv -1 ATL 15 20 ATL (40 50 ) htlv -1 htlv -1 50 20 ATL 20 htlv -1 - 11 - 7 1 3 12 2 55 45 35 1 1 1 12 2 55 45 35 3 3 3 - 12 - T (ATL) I T (ATL) htlv -1 T 40 T T ATL ( ) T (ATL) (1) T T