Abstract
BackgroundInfection with the human T-cell lymphotropic virus type 1 (HTLV-1), although asymptomatic in most cases, can lead to potentially grave consequences, such as adult T-cell leukemia-lymphoma and HTLV-1-associated myelopathy / tropical spastic paraparesis. Its prevalence varies widely across different populations and geographic regions. A population-based study in the city of Salvador, located in the Northeast region of Brazil, showed an overall prevalence of HTLV-1 seropositivity of 1.7%. Blood borne virus infections are recognized as important hazards for patients and staff in maintenance hemodialysis (MHD) units but most studies focus on hepatitis B, hepatitis C and human immunodeficiency viruses. There are scarce data about HTLV-1 infection in the MHD population. We aimed to determine the prevalence and risk factors for HTLV-1 infection among MHD patients in the city of Salvador-Bahia, Brazil.MethodsWe conducted a multi-center, cross-sectional study nested in a prospective cohort of MHD patients enrolled from four outpatient clinics. HTLV-1 screening was performed with ELISA and positive cases were confirmed by Western Blot. Factors associated with HTLV-1 seropositivity were identified by multivariable logistic regression.Results605 patients were included in the study. The overall prevalence of HTLV-1 infection was 2.48% (15/605), which was similar to that of hepatitis B [1.98% (12/605)] and C [3.14% (19/605)] viruses in our sample. HTLV-1 seropositivity was positively associated with age [prevalence odds ratio (POR) 1.04; 95% confidence interval (CI) 1.01–1.08], unmarried status (POR 3.65; 95% CI 1.13–11.65), and history of blood transfusion (POR 3.35; 95% CI 1.01–11.13).ConclusionsThe overall prevalence of HTLV-1 infection in a sample of MHD patients was similar to that of other viral infections, such as hepatitis B and C. Our data revealed that MHD patients who are older, unmarried or who have received blood transfusions are at higher risk for HTLV-1 infection.
Highlights
Infection with the human T-cell lymphotropic virus type 1 (HTLV-1), asymptomatic in most cases, can lead to potentially grave consequences, such as adult T-cell leukemia-lymphoma and HTLV-1-associated myelopathy / tropical spastic paraparesis
Blood borne virus infections are recognized as important hazards for patients and staff in maintenance hemodialysis (MHD) units but most studies focus on hepatitis B (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV)
We found no published data about the prevalence of HTLV-1 in MHD patients treated in Brazil
Summary
Infection with the human T-cell lymphotropic virus type 1 (HTLV-1), asymptomatic in most cases, can lead to potentially grave consequences, such as adult T-cell leukemia-lymphoma and HTLV-1-associated myelopathy / tropical spastic paraparesis. A population-based study in the city of Salvador, located in the Northeast region of Brazil, showed an overall prevalence of HTLV-1 seropositivity of 1.7%. The human T-cell lymphotropic virus type 1 (HTLV-1), the first human retrovirus identified [1], is the etiologic agent of adult T-cell leukemia-lymphoma (ATLL) and HTLV-1-associated myelopathy / tropical spastic paraparesis (HAM/TSP) [2,3,4,5]. In Brazil, most of the prevalence data have been obtained from serological screening of asymptomatic blood donors These data show a great variation in prevalence within the country, being highest in the northeast region [20,21,22,23]. In a population-based study, the overall prevalence of HTLV-1 seropositivity in Salvador was 1.7% [95% CI 1.1–2.5%] [24]
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