Increased prevalence of HTLV-1 among HIV-2-infected women but not HIV-2-infected men in rural Guinea-Bissau.

Abstract

Objective: To assess the prevalence of HTLV infection and its association with HIV and other potential risk factors. Design and Setting: A cross-sectional survey and a case-control study in a rural community in Guinea-Bissau. Methods: A total of 2770 people were included in an HIV and HTLV seroepidemiologic survey. Three hundred of these participants were selected for a case-control study on HIV-2. Sera from both studies were tested for HTLV. Results: In all 2501 and 298 subjects in the survey and case-control study respectively were tested for HTLV. Overall HTLV-1 prevalence was 5.2% and it was higher in women (odds ratio [OR] 1.36; confidence interval [CI] 0.92–2.02). Apart from an infected spouse no significant risk factors could be identified for men. In women HIV-2 infection (adjusted OR 5.58; CI 3.09–10.1) having an infected spouse and area of residence were significantly associated with HTLV-1 infection. The association between HTLV-1 and HIV-2 was significantly different for men and women (test of interaction p=.002). Conclusions: In women the most important determinant of HTLV-1 seropositivity was HIV-2 infection. Because the pattern was significantly different for men and women common sexual risk factors may not be sufficient to explain the co-occurrence of HIV-2 and HTLV-1 in women. These observations may have implications in geographic areas where both types of retroviruses are prevalent. (authors)