This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Skin
[{'content': 'A man living in southern Japan contracts HTLV-1 infection through sexual contact. Twenty-five years later he develops generalized lymphadenopathy with hepatosplenomegaly, a skin rash,hypercalcemia, and an elevated white blood count. This man has most likely developed which of the following? \nSelect and explain. \nA. AIDS, B. Autoimmunity, C. Delayed hypersensitivity reaction, D. Leukemia', 'role': 'user'}, {'content': "Answer: D \nExplanation: HTLV-1, or human T-cell lymphotropic virus 1, is an enveloped, single-stranded, RNA retrovirus .Infection by HTLV-1 can lead to T-cell leukemia 20-30 years after the infection. The HTLV-associated T-cell leukemia generally presents as described above, and is very aggressive, progressing to death in under 1 year. AIDS , acquired immunodeficiency syndrome, is transmitted through the HIV virus. Although both viruses are RNA retroviruses and both infect CD4+ T cells, the diseases they produce are distinct. Autoimmune diseases produced after infection are typified by rheumatic fever after infection with Streptococcus. There is speculation that EBV virus (Epstein-Barr virus) may produce the autoimmune reactions in rheumatoid ahritis, but autoimmunity plays no role in leukemia after HTLV-1 infection. Delayed hypersensitivity reactions are T-cell-mediated immune responses typified by the subcutaneous reaction to tuberculin in sensitized individuals. It characteristically occurs 2-3 days after an exposure, and is a local lymphocytic response. Ref: Tschachler E. (2012). Chapter 197. Human T-Lymphotropic Viruses. In K. Wolff (Ed), Fitzpatrick's Dermatology in General Medicine, 8e.", 'role': 'assistant'}]