Genetic risk for
adult T cell leukemia (ATL) has been implicated by ethnic and familial segregation of ATL patients from
HTLV-1-associated myelopathy/
tropical spastic paraparesis (HAM/TSP). To clarify the genetic risk for ATL, we characterized HLA class I alleles of ATL patients and analyzed the anchor motifs of HTLV-1
peptides binding to HLA class I molecules, using 291 lines of anti-HTLV-1 CD8(+) cytotoxic T lymphocytes (CTLs) generated in vitro with a total of 165 synthetic
peptides for HTLV-1 Tax and Env
proteins. Allele frequencies of
HLA-A*26, B*4002, B*4006, and B*4801 were significantly higher in ATL patients than in HAM/TSP patients and asymptomatic HTLV-1 carriers in southern Japan. CD8(+) CTL analysis revealed the HTLV-1
Tax peptide sequence to completely lack anchor motifs of
peptides binding to
HLA-A*26,B*4002, and B*4006 molecules but to possess one anchor for
HLA-B*4801, while the HTLV-1 Env
peptide sequence had many anchor motifs for
HLA-A*26, B*4002, B*4006, and B*4801 molecules. Most ATL patients featured heterozygous HLA class I alleles composed of
HLA-A*26, B*4002, B*4006, and B*4801, with a lower number of HTLV-1
Tax peptide anchor motifs and
epitopes generating anti-HTLV-1 Tax CD8(+) CTLs than individuals possessing other HLA alleles. The relationship between Tax
epitope and ATL incidence was verified by the significantly decreased number of HTLV-1 Tax
epitopes in ATL patients compared with asymptomatic HTLV-1 carriers (p < 0.01) as well as late onset ATL patients (p < 0.001). These results indicate that
HLA-A*26, B*4002, B*4006, and B*4801 alleles predispose to ATL because of the limited recognition of HTLV-1
Tax peptide anchor motifs and
epitopes capable of generating anti-HTLV-1 Tax CD8(+) CTLs.