IntroductionHuman T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia/lymphoma (ATLL) 1-3 and the neurologic disease HTLV-1-associated myelopathy/tropical spastic paresis (HAM/TSP). 4,5 In addition to the Gag, Pol, and Env proteins, HTLV-1 encodes through alternative splicing mRNAs for at least 7 additional viral proteins. The 2 essential positive regulators of HTLV-1 replication, the Tax and Rex proteins, are encoded by a unique, double-spliced mRNA and are expressed through ribosomal leaky scanning in orf-III and orf-IV, respectively. 6 Tax is an enhancer of viral transcription by its interaction with CREB/ATF, CBP/p300, and the Tax response element (TRE) located within the viral promoter. 7 In addition, Tax has been reported to interact with more than 100 different cellular proteins that affect gene expression, cell signaling, and proliferation. 8 Tax is also thought to be a promoter of T-cell transformation, because Tax expression immortalizes T cells in vitro and induces tumors in transgenic animals. 8,9 Rex interacts with a viral mRNA secondary structure, designated Rex responsive element (RxRE) located at the 3Ј-long terminal repeat (3Ј-LTR). Rex controls viral production by regulating the transport of unspliced and incompletely spliced viral mRNAs from the nucleus to the cytoplasm. 10 HTLV-1 also encodes 2 negative regulators of viral expression. The first, the p30 protein, is encoded by orf-II, interacts with tax/rex mRNA, and retains it in the nucleus. 11,12 At low concentrations, p30 also represses HTLV-1 LTR-driven transcription, whereas at high concentrations, 13,14 it activates transcription. The second negative regulator of HTLV-1 expression is the HTLV-1 basic zipper factor (HBZ) that is encoded by the antisense strand of the HTLV-1 genome. 15,16 HBZ interacts with CREB and CBP/p300, thereby blocking Tax-dependent transcription and viral expression. 17,18 HBZ also inhibits the activity of JunB and c-Jun by sequestering them in transcriptional inactive nuclear bodies and affects activating protein 1 (AP-1)-dependent cellular and viral transcription. 19,20 More recently, the HBZ antisense mRNA has been shown to induce T-cell proliferation. 21,22 p13 23,24 is a mitochondrial protein encoded by a distinct, singly spliced mRNA from orf-II. It accumulates in the inner membrane of the mitochondria and modulates K ϩ permeability and reactive oxygen species, thereby altering the morphology and function of mitochondria. [25][26][27] Evidence of p13 expression in HTLV-1-infected cells is indirect, because only the presence of mRNA has been demonstrated in both in vitro and ex vivo studies. [28][29][30] orf -II appears to be dispensable for viral infection and transformation of T cells in vitro; however, its requirement in HTLV-1 infection of rabbits remains uncertain because the mutation introduced into the HTLV-1 molecular clone to ablate p13 also affected the HBZ gene. [31][32][33] Furthermore, the p13 protein has been reported to suppress cell growth in vitro, tumorigeni...