Abstract
Human T-lymphotropic virus 1 and 2 (HTLV-1/2) belong to the delta group of retroviruses which may cause a life-long infection in humans, HTLV-1 leading to adult T-cell leukemia/lymphoma and other diseases. Different transmission modes have been described, such as breastfeeding, and, as for other blood-borne pathogens, unsafe sexual activity, intravenous drug usage, and blood transfusion and transplantation. The present systematic review was conducted to identify all peer-reviewed studies concerning the work-related infection by HTLV-1/2. A literature search was conducted from January to May 2021, according to the PRISMA methodology, selecting 29 studies: seven related to health care workers (HCWs), five to non-HCWs, and 17 to sex workers (SWs). The findings showed no clear evidence as to the possibility of HTLV-1/2 occupational transmission in HCWs, according to the limited number and quality of the papers. Moreover, non-HCWs showed a higher prevalence in jobs consistent with a lower socioeconomic status or that could represent a familial cluster, and an increased risk of zoonotic transmission from STLV-1-infected non-human primates has been observed in African hunters. Finally, a general increase of HTLV-1 infection was observed in SWs, whereas only one paper described an increased prevalence for HTLV-2, supporting the urgent need for prevention and control measures, including screening, diagnosis, and treatment of HTLV-1/2, to be offered routinely as part of a comprehensive approach to decrease the impact of sexually transmitted diseases in SWs.
Highlights
Human T-lymphotropic virus 1 and 2 (HTLV-1 and HTLV-2) belong to the delta group of retroviruses, together with virus 3 and 4 (HTLV-3, HTLV-4), their simian counterparts (Simian T-lymphotropic viruses, STLVs), and the bovine leukemia virus (BLV) [1].It has been estimated that 5–10 million people are currently infected by HTLV-1, mainly in the endemic regions, including South Japan, Northeastern Iran, sub-SaharanAfrica, almost all of the Caribbean islands, southeastern U.S regions, Melanesia, and SouthAmerica [2,3]
To the best of our knowledge, this is the first systematic literature review to analyze the risk of work-related infection by HTLV-1/2
A higher risk of infection has been supposed for health care workers (HCWs), our review did not identify a clear increased rate of seropositivity in HCWs than in the general population, due to the severe limitations of the observational studies, whereas the main evidence of infection was referred to case-reports in which inadequate use of personal protective equipment had been reported
Summary
Human T-lymphotropic virus 1 and 2 (HTLV-1 and HTLV-2) belong to the delta group of retroviruses, together with virus 3 and 4 (HTLV-3, HTLV-4), their simian counterparts (Simian T-lymphotropic viruses, STLVs), and the bovine leukemia virus (BLV) [1].It has been estimated that 5–10 million people are currently infected by HTLV-1, mainly in the endemic regions, including South Japan, Northeastern Iran, sub-SaharanAfrica, almost all of the Caribbean islands, southeastern U.S regions, Melanesia, and SouthAmerica [2,3]. It has been estimated that 5–10 million people are currently infected by HTLV-1, mainly in the endemic regions, including South Japan, Northeastern Iran, sub-Saharan. Almost all of the Caribbean islands, southeastern U.S regions, Melanesia, and South. HTLV-2 is most common in the native Amerindian population, in Amazon region, with the number of known infected people significantly lower than with. HTLV-1, being estimated at between 670,000 and 890,000 people [2,4]. Confined to specific geographic areas, HTLV-1 and HTLV-2 are becoming a major concern in non-endemic countries, due to international migration flows. HTLV-3 and HTLV-4 have been discovered in central Africa in the past decade and both shared similarities in replication and genomic organization to HTLV-1/2 [5]. Most HTLV-1-infected subjects are asymptomatic, but 2–5% suffer the onset of adult
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