HTLV-I and -II infections in a nationwide survey of pregnant women in Guinea-Bissau, West Africa.

Abstract

The human T-cell lymphotropic virus (HTLV) is endemic in parts of Africa with overall prevalence rates from 0% to more than 10%. Although most HTLV-infected people carry HTLV-I some reports indicate the presence of HTLV-II in some areas. The origin and spread of HTLVs in Africa are not completely understood and some parts of the continent remain to be explored in that regard. The authors have previously reported high prevalence rates of HTLV in Guinea-Bissau; 3.3% among pregnant women and 6.7% among hospitalized patients (10.6% and higher for hospitalized women). An occupational cohort had a prevalence of 4.0% as well as 5 cases of HTLV-II infection. Guinea-Bissau has the highest prevalence of HIV-2 in the world with rates ranging from 6% among pregnant women to more than 20% among hospitalized patients in the capital. 1231 sera of pregnant women were collected in 1993 as part of the national sentinel surveillance program for HIV. The sera came from 7 of the 8 provinces and were collected consecutively at antenatal clinics in the provincial capitals. ELISA and Western blot screening of the sera found 27 to be positive for HTLV-I and 1 for HTLV-II. 27 other samples were indeterminate by Western blot. HTLV-infected specimens were identified in all provinces studied with no significant differences in prevalence rates between the provinces. The HTLV-II-positive specimen came from an individual in Bafata in the central part of the country. The overall prevalence of HIV infection was 5.3% 0-8.2% in the various provinces 0.6% for HIV-1 and 4.7% for HIV-2. One person was infected with both HIV-1 and HIV-2. No association was observed between HIV and HTLV infections.