Human T-lymphotropic virus type 1 (HTLV-1) is found in indigenous peoples
of the Pacific Islands and the Americas, whereas type 2 (HTLV-2) is widely
distributed among the indigenous peoples of the Americas, where it appears to be more
prevalent than HTLV-1, and in some tribes of Central Africa. HTLV-2 is considered
ancestral in the Americas and is transmitted to the general population and injection
drug users from the indigenous population. In the Americas, HTLV-1 has more than one
origin, being brought by immigrants in the Paleolithic period through the Bering
Strait, through slave trade during the colonial period, and through Japanese
immigration from the early 20th century, whereas HTLV-2 was only brought
by immigrants through the Bering Strait. The endemicity of HTLV-2 among the
indigenous people of Brazil makes the Brazilian Amazon the largest endemic area in
the world for its occurrence. A review of HTLV-1 in all Brazilian tribes supports the
African origin of HTLV-1 in Brazil. The risk of hyperendemicity in these
epidemiologically closed populations and transmission to other populations reinforces
the importance of public health interventions for HTLV control, including the
recognition of the infection among reportable diseases and events.