Prevalence Of HTLV-I Research Articles

Prevalence of HTLV-I Infection and Its Association with Tuberculosis among Patients at an Urban Clinic in Haiti.

This retrospective case-control study examined the prevalence of HTLV-I and its association with tuberculosis among urban clinic patients in Haiti. Prevalence of HTLV-I among tuberculosis cases was 2.1% and among controls was 2.4%. Prevalence of HLTV-I was higher in females than males (odds ratio [OR] 2.45, P = 0.020). HTLV-I prevalence in those ≥ 50 years was 8.4% compared with 1.3% in those < 50 (OR 6.74, P < 0.001). We found no association between HTLV-I and tuberculosis in this population.

Low prevalence of human T lymphocyte virus in blood donors in Guangdong, China

Background: To investigate the prevalence of human T lymphocyte virus (HTLV) in blood donors in Guangdong province, China. Methods: The enzyme-linked immunosorbent assay (ELISA) was applied for primary screening of anti-HTLV-I/II antibodies in blood donors. Reactive samples were subjected to secondary detection using the electrochemiluminescence immunoassay (ECLIA). Samples reactive for both ELISA and ECLIA were further identified by nucleic acid testing (NAT) and Western-blot (WB). Results: A total of 2,058,790 samples collected from 20 blood stations across the whole province of Guangdong were screened through March 2016 to February 2018. Among them, 758 samples were reactive with ELISA, and 182 were reactive with followed ECLIA detection. Of ECLIA reactive samples, 43 were identified positive by NAT and WB, accounting for an overall positive rate of 0.002% (43/2,058,790). Forty-three positive samples were classified as HTLV-I, and no HTLV-II was identified. Conclusions: The prevalence of HTLV-I was approximately 1:50,000, that was low in blood donor population in Guangdong province. In term of blood safety, a leukocyte filtration for blood components might reduce the risk of HTLV-1 transmission in transfusion, which could be also considered as an alternative of high cost blood screening by the immunoassays and NAT for the viruses in blood donation.

Cell death of salivary gland epithelial cells and involvement of HTLV-I in Sjögren's syndrome

Chronic sialadenitis in Sjögren's syndrome (SS) is associated with cell death induced by Fas or cytotoxic granules. Furthermore, tumor necrosis factor-related apoptosis inducing ligand or toll-like receptor3 are known to induce apoptosis in the salivary gland epithelial cells (SGECs) derived from patients with SS. Anti-apoptotic molecules that are closely related to epidermal growth factor are known to inhibit apoptosis. Epidemiologically, high prevalence of HTLV-I in primary Sjögren's syndrome (SS) patients has been found in an endemic area. However, by comparison of radiographic imaging with mononuclear cells (MNCs) infiltration of LSGs, we have found that there are significantly fewer abnormalities determined by sialography in HTLV-I-seropositive SS patients in comparison with HTLV-I-seronegative SS patients irrespective of similar grade of MNCs infiltration. In HTLV-I-seropositive SS patients, low frequency of salivary gland destruction was observed and this phenomenon was associated with frequency of the ectopic germinal center (GC). Then, we show cytokine profile in culture supernatant of salivary gland epithelial cells co-cultured with HCT-5 established from spinal fluid of patients with HAM. Up-regulation of adhesion molecule or migration factor was observed in culture supernatant. On the other hand, co-cultured cell lysate showed apoptotic and anti-apoptotic molecules without increase of apoptosis. Detailed molecular mechanisms in these processes are under study.

Population-based Seroprevalence of HTLV-I Infection in Golestan Province, South East of Caspian Sea, Iran.

Human T-cell lymphotropic virus type-1 is an oncornavirus that causes adult T cell leukemia (ATL) HTLV-I-associated myelopathy⁄tropical spastic paraparesis (HAM/TSP). Golestan province is located in North West of Khorasan province known as an endemic area for HTLV-I in Iran. This study aimed to evaluate seroprevalence of HTLV-I in Golestan province. In this cross-sectional descriptive study in 2007, blood samples were collected from 2034 healthy people residing in different parts of Golestan province. Sera were assessed for HTLV-I/II-specific antibodies by ELISA method and reactive samples were confirmed by Western blot. Demographic and serologic data were entered in SPSS version 11.5 and statistical analysis was performed. An overall HTLV-I/II prevalence of 0.7% was observed in 15 cases by ELISA. Six out of 15 were confirmed as HTLV-I by western blot. Regional variation in the prevalence of HTLV-I was observed; 0%, 0%, 0.1%, 1.9%, 0.3%, 0%, and 2.6% tested HTLV-I-positive from west to east of Golestan Province regions, respectively. Seropositivity increased with age. No association between HTLV-I infection and sex status was detected. Highest rate of HTLV-I seroprevalence was shown in east of this region located in neighborhood with Khorasan province, the only confirmed endemic area in Iran. It seems that eastern area of our province is endemic for HTLV-I. Further comprehensive detailed epidemiological and molecular studies are recommended.

Association Between HTLV-I Infection with Chronic Lupoid Leishmaniasis.

One of the different types of skin leishmaniasis is the Chronic Lupoid Leishmaniasis (CLL), which is caused by abnormal immune response. On the other hand, HTLV-I has been known to exist in some infectious diseases. Human T cell lymphotropic virus type1 (HTLV-I) and cutanous leishmaniasis exists endemically in Mashhad. The objective of this study was to evaluate the prevalence of HTLV-I in CLL patients. This cross sectional study involved 51 CLL patients admitted to cutaneous leishmaniasis clinics of Ghaem and Imam Reza hospitals in Mashhad, Iran. The blood samples were examined for serology tests through ELISA method. The results of the experiments for evaluating the existence of HTLV-I in 51 patients under study in this research were proved to be negative. According to this pilot study, the distribution of HTLV-I in CLL patients is not higher than normal population.

Human T-Lymphotropic Virus Type 1 Prevalence in Northeastern Iran, Sabzevar: An Epidemiologic-Based Study and Phylogenetic Analysis

Human T-lymphotropic virus type 1 (HTLV-I) is an important global health problem in the world mainly in the endemic areas of HTLV-I infection. It was previously reported that Mashhad, in northeastern Iran, is a new endemic region of HTLV-I. The aim of this study was to examine the prevalence and phylogenetic analysis of HTLV-I in Sabzevar, located in the southeast of Mashhad. In this cross-sectional study 1445 individuals were selected by multistage cluster sampling. Serum samples were screened for anti-HTLV-I antibody using enzyme-linked immunosorbent assay (ELISA); all of the ELISA-positive samples were confirmed by polymerase chain reaction (PCR). Long terminal repeat (LTR) sequencing was carried out to determine the type of HTLV-I in Sabzevar. In the primary screening by ELISA, 26/1445 (1.8%) of those sampled were reactive for HTLV-I antibody. Twenty-four out of 26 samples were confirmed HTLV-I infection by PCR (24/1445). The overall prevalence of HTLV-I infection in Sabzevar is 1.66%. The prevalence of the virus infection in men and women was 2.42% (11/455) and 1.31% (13/989), respectively. Seroprevalence was associated with age, increasing significantly among those older than 30 years (p=0.015), and a history of surgery (p=0.002), imprisonment (p=0.018), and hospitalization (p=0.005). Three out of 24 positive HTLV-I samples were selected for sequencing and phylogenetic analysis of LTR. The results showed that HTLV-I in Sabzevar belonged to the cosmopolitan subtype. The present study showed Sabzevar is a new endemic area for HTLV-I infection. Our study emphasizes that systemic HTLV-I screening of blood donors in Sabzevar and other cities in Khorasan province is important and should be taken into account.

Virus safety of human blood products – diagnostics and prevention. Virussicherheit humaner Blutprodukte – Diagnostik und Prävention

Abstract Relevant blood transfusion-transmitted viruses are still HBV, HCV and HIV. As newly emerged infectious agent, the vCJD prion is relevant as well and will cause difficulties within the next decade, since there is no diagnostic tool applicable to blood donation testing. Still, the most effective measure for the virus safety of blood is donor selection followed by antibody and nucleic acid testing, followed by derichment and inactivation performed to the extent possible. For selected recipients, relevant viruses are CMV and Parvovirus B19. Diagnostic testing for both viruses is no challenge. The prevalence of HTLV-I is very low in Germany but higher in many other countries. Therefore epidemiological surveillance is sufficient to control the spreading of this retrovirus in Germany. As the West Nile fever virus and the SARS coronavirus demonstrate, old viruses may newly enter the donor population and the efficient way to prevent these viruses from spreading is still the usual quarantine for donors who have visited contaminated areas. The history of blood transfusion shows that by taking appropriate measures safety will be increased, but also that new infectious agents will enter the donor population in future years.

High Prevalence of HTLV-I and HTLV-II among Blood Donors in Argentina: A South American Health Concern

After an HTLV-I endemic area was discovered in Jujuy, a northwestern province in Argentina, to detect other possible foci of HTLV-I/II we started in 1997 a multicentric study to estimate the seroprevalence of HTLV-I/II including blood banks from different regions of the country. Out of 123,233 samples from nine different provinces, 68 proved seropositive with a final prevalence of 0.05% (95% CI = 0.0432-0.0704%). The seroprevalence ranged from 0.03 to 0.16% depending on the geographic location. An HTLV-I [odds ratio (OR) 12.7, 95% confidence interval (CI), 3.43-47.60] prevalence significantly greater was found in the northwest (Salta Province) and a nonsignificant but higher prevalence of HTLV-II in the North (Chaco). Two (0.001%) of the seropositive blood donors reported risk factors due to receiving transfusions and 19 (0.01%) were born in HTLV-I/II South American endemic areas. Although Argentina has been considered a nonendemic country for HTLV-I/II, the need for systematic screening for such infection became imperative based on the present study.

HTLV-I in the general population of Salvador, Brazil: a city with African ethnic and sociodemographic characteristics.

The city of Salvador has the highest prevalence of HTLV-I among blood donors in Brazil. To study the prevalence of HTLV-I among the general population of Salvador, 30 "sentinel surveillance areas" were selected for the investigation of various infectious diseases, and 1385 individuals within these areas were surveyed according to a simple random sample procedure. ELISA was used to screen plasma samples for antibodies to HTLV-I, and the positive samples were tested by a confirmatory assay (Western blotting). The overall prevalence of HTLV-I was 1.76% (23/1385). Infection rates were 1.2% for males and 2.0% for females. Specific prevalence demonstrated an increasing linear trend with age. No one younger than 13 years of age was infected. Multivariate analysis estimated adjusted odds ratios for the association of HTLV-I with age of 9.7 (3.3; 30.4) for females and 12.3 (1.47; 103.1) for males. Less education and income might be associated with HTLV-I infection in females. Phylogenetic analysis of the long terminal repeat fragments showed that most of the samples belonged to the Latin American cluster of the Transcontinental subgroup (Cosmopolitan subtype). For the entire city of Salvador, it is estimated that approximately 40000 individuals are infected with HTLV-I. Our results suggest multiple post-Colombian introductions of African HTLV-Ia strains in Salvador.

Chlamydia trachomatis, herpes simplex virus 2, and human T-cell lymphotrophic virus type 1 are not associated with grade of cervical neoplasia in Jamaican colposcopy patients.

A few recent studies have suggested that other sexually transmitted infections may increase the likelihood of a human papillomavirus (HPV) infection progressing to high-grade cervical neoplasia and cancer. The goal was to assess whether exposures to Chlamydia trachomatis, human T-cell lymphotrophic virus type 1 (HTLV-I), and/or human simplex virus type 2 (HSV-2) are greater in colposcopy patients with cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) than in patients with low-grade cervical neoplasia (CIN1). Sequential patients (n=447) attending a colposcopy clinic in Kingston, Jamaica, a country with high cervical cancer rates and high HTLV-I prevalence, were tested for (1) HPV DNA by L1 consensus primer (MY09/11) polymerase chain reaction assays, (2) C trachomatis DNA by ligase chain reaction, (3) C trachomatis antibodies by both microimmunofluorescence and a peptide (VS4) enzyme linked immunosorbent assay (ELISA), (4) HTLV-I antibodies by ELISA confirmed by western blotting, and (5) HSV-2 antibodies by a recombinant HSV-2-specific ELISA. Odds ratios and 95% confidence intervals were estimated with use of multinomial logistic regression models. HPV DNA detection was associated with grade of cervical neoplasia but other evaluated sexually transmitted infections were not. HTLV-I, C trachomatis, and/or HSV-2 were not associated with severity of cervical neoplasia in Jamaican women.

Dual infections with HIV-1, HIV-2 and HTLV-I are more common in older women than in men in Guinea-Bissau.

To investigate the association between the three human retroviruses, HIV-1, HIV-2 and HTLV-I. Community-based follow-up studies of retrovirus infections in two cohorts. A total of 2057 individuals aged 35 years and over were eligible for inclusion. Participants were interviewed and had a blood sample drawn. Samples were analysed for HIV-1, HIV-2 and HTLV infections. Uni- and multivariate analyses that included behavioural and socio-economic factors were performed using logistic regression and Poisson regression models. A total of 1686 individuals participated with a blood sample in the HIV prevalence analyses and 1581 individuals participated in the HTLV-I prevalence analyses. The overall prevalence was 2.1% for HIV-1, 13.5% for HIV-2 and 7.1% for HTLV-I. Comparing the < 45 year age group with 45+ year age groups, the female : male (F : M) prevalence ratio increased with age for all three retroviruses. Dual infections were more common in women than in men. Assuming independent distribution of the viruses, the observed prevalence of dual infections in women was significantly higher than expected, while the prevalence was not increased in men. The prevalence of dual infections increased with age in women, the odds ratio (OR) being 3.4 [95% confidence interval (CI), 1.0-11.3] for any combination of dual infection, while the prevalence decreased with age in men (OR, 0.3; 95% CI, 0.1-2.0) (test of interaction, P = 0.033). Control for behavioural factors did not modify these patterns. The pattern of increased prevalence among older women could have public health implications; women of older age groups should be regarded as a potential vulnerable group and included in HIV/AIDS prevention programmes.

Prevalence of HTLV‐I‐associated T‐cell lymphoma

In order to assess the prevalence rate of HTLV-I-associated T-cell lymphomas and human retrovirus infection in general, approximately 21,000 individuals representing various patient populations, retroviral risk groups, and blood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection using serologic and PCR assays. The prevalence rates among volunteer blood donors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increased HTLV prevalence rates were observed among paid blood donors, African American health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and family members of HTLV-positive people, and patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I versus HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade, CD4+ T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died from their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infection. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, and other-than-low-grade NHL patients. Only one patient was infected with HIV-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV-1 positives had B-cell lymphomas, one HIV-1 positive had an HTLV-I-positive CD4+ T-cell lymphoma, and one infected with HIV-2 had a CD4+ T-cell lymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, while uncommon, is not necessarily rare among other-than-low-grade NHL cases in the United States and, given its poor prognosis, should probably be studied separately in clinical trials. Am. J. Hematol. 66:32–38, 2001. © 2001 Wiley-Liss, Inc.

Reply to Origins of HTLV-1 in South America.

In Latin America, the prevalence of HTLV-I is decreasing and at present is not as high (up to 10%; ref. 10) as reported previously. The same phenomenon can be seen in an endemic island in Japan that had a high prevalence of HTLV-I in 1985 (23% in 2,582 adults from 2−50% among 123 villages; ref. 11) and now has a very low prevalence rate in young adults (down to 3%). The rates of transmission of HTLV-I may have easily changed over time depending on transmission routes and infectious conditions. Therefore, it seems reasonable that one of two Andean mummies about 1,500-year-old is positive for HTLV-I.

Risk factors for HTLV-I and II in individuals attending a clinic for sexually transmitted diseases.

To date, few studies have provided information on risk factors for human t-lymphotropic viruses (HTLV) types I and II in European countries. In particular, few data are available from published studies conducted in STD centers. To identify risk factors for HTLV-I and HTLV-II infection and to better distinguish the epidemiologic patterns of the two viruses in Italy. A cross-sectional study of individuals at high risk of sexually or parenterally transmitted infections attending a large STD center in an urban setting was conducted. Serologic tests for HTLV-I and II, HIV, hepatitis virus type B (HBV), hepatitis virus type C (HCV), and syphilis were performed. Information regarding at-risk behavior was collected using a specific questionnaire. From January 1994 to June 1996, 1,457 individuals were recruited; of them, 1,016 (69.7%) were males, 1,051 (72.4%) Italians, and 288 (19.8%) non-Europeans. One thousand seventy-five (74.8%) participants were noninjecting-drug-using heterosexuals, 285 (19.6%) were men who have sex with men, and 97 (6.6%) were injecting drug users (IDU). The mean age of the study participants was 33.6 (+/-10.5) years. Nine (0.6%) individuals were positive for HTLV-I antibodies and 9 (0.6%) for HTLV-II antibodies. The prevalence of HTLV-I among IDUs, men who have sex with men, and noninjecting-drug-using heterosexuals, was 2.1% (2/97), 1.4% (4/ 285), and 0.3% (3/1085), respectively. HTLV-II prevalence was 8.2% (8/97) among IDUs and 0.09% (1/1075) among noninjecting-drug-using heterosexuals. Among the nine HTLV-II-positive individuals, eight were Italian IDUs and one was a noninjecting-drug-using heterosexual man from India. None of the 285 men who have sex with men had HTLV-II antibodies. HTLV-infected individuals tended to be older than those who were uninfected. HTLV-I-infected individuals were more likely to be non-European and to have antibodies against Treponema pallidum. Injecting drug use tended to be independently associated with HTLV-II infection. The data suggest a role of sexual behavior in the spread of HTLV-I, which is more likely to be detected in individuals coming from endemic areas. Injecting drug use remains the most important risk factor for HTLV-II infection in Italy.

Prevalence of HTLV-I-associated T-cell lymphoma.

In order to assess the prevalence rate of HTLV-1-associated T-cell lymphomas and human retrovirus infection in general, approximately 21,000 individuals representing various patient populations, retroviral risk groups, and blood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection using serologic and PCR assays. The prevalence rates among volunteer blood donors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increased HTLV prevalence rates were observed among paid blood donors, African American health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and family members of HTLV-positive people, and patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I versus HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade, CD4+ T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died from their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infection. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, and other-than-low-grade NHL patients. Only one patient was infected with HIV-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV-1 positives had B-cell lymphomas, one HIV-1 positive had an HTLV-I-positive CD4+ T-cell lymphoma, and one infected with HIV-2 had a CD4+ T-cell lymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, while uncommon, is not necessarily rare among other-than-low-grade NHL cases in the United States and, given its poor prognosis, should probably be studied separately in clinical trials.

HTLV-I INFECTION IS NOT ASSOCIATED WITH BREAST CANCERS IN TRINIDAD AND TOBACO

P106 Objective: To determine whether or not breast cancer is associated with HTLV-I infection. Method: Between June 1995 - September 1996, 112 patients with breast cancer, identified through surveillance at the main hospitals in Trinidad, were enrolled. Basic demographic data was collected and sera were screened for HTLV-I antibodies. Results: The patients were 111 females (mean age 55 years) and 1 male. 78 (69.6%) were of African descent, 30 (26.8%) East Indian and 4 (3.6%) other ethnic groups. Types of breast cancer included infiltrating duct carcinoma (32%), invasive duct carcinoma (29%), adenocarcinoma (12%) and the remaining 27% included lobular and papillary carcinoma. Three subjects, all of African descent, ages 47,70,75 were HTLV-I positive, an overall prevalence-2.7%. The HTIV-I prevalence for women of African descent with breast cancer was compared to females of African descent of a 1986 Trinidadian general population serosurvey. The overall HILV-I prevalence for females of African descent with breast cancer 3157 (5.3%) was not different from females of the general population serosurvey 16/388 (4.1%), p=0.8. For women older than 40 there also was no significant difference, general population-8.1% and subjects with breast cancer-7.0%, p=0.9. For women 40 and less, the HTLV-I prevalence was 2.9% among the general population women and 0% for women with breast cancer. Conclusion: This study shows no association of breast cancer and HTLV-I infection in Trinidad and Tobago.

TREPONEMAL CO-INFECTION MAY KINDLE HTLV-I ASSOCIATED TSP

P117 In 1993, 3482 subjects in 32 selected Jamaican communities of St. Catherine Parish were screened for difficulty walking. Of these, 313 screened positive and 271 were examined neurologically and serologically, for a response rate of 86.5%. A diagnosis of tropical spastic paraparesis (TSP) or suspected TSP (STSP) was made using diagnostic field criteria, previously reported. Thirty-one subjects with Western Blot (WB) confirmed HTLV-I infection had a field diagnosis of TSP/STSP. Of these, 18 (7-TSP, 11-STSP) had microhemagglutinin antibody for Treponema pallidum (MHA-TP) seroreactivity indicating past or current treponemal infection and 13 (8-TSP, 5-STSP) had nonreactive MHA-TP. There were 7 (6 women, 1 man) HTLV-I+ subjects with nonreactive MHA-TP who reported difficulty walking but had no clinical myelopathy. The prevalence of HTLV-I associated TSP within the selected Jamaican communities is 890/100,000. The myelopathy risk attributable to syphilitic (or yaws) infection may be 10 times greater than for HTLV-I in this population. History of treponemal infection may expedite the clinical expression of HTLV-I associated TSP.

PHYLOGENETIC STUDIES IN HUMAN T-LYMPHOTROPIC VIRUS TYPE I IN THE NORTH EAST REGION OF BRAZIL

P108 HTLV-I infection and its associated diseases are endemic in Brazil. The city of Salvador is located in the NorthEast region of Brazil, has similar socio-demographic characteristics to some sub-Saharan cities and shows the highest HTLV-I prevalence (1.35%) in the country. According to phylogenetic analysis 3 lineages of HTLV-I have been proposed: Melanesian, Central African and Cosmopolitan. The Cosmopolitan group has been further grouped into four subtypes: A (Transcontinental), B (Japanese), C (West African) and D (North African). So far, in Brazil subtypes A and B have been reported. In order to investigate which HTLV-I subtypes are present in Salvador, 10 seropositive patients were studied. Genomic DNA extracted from patients PBMCs were further analyzed by nested PCR amplifying a pol gene fragment of 318 bp (primers: 12P1/SK111 and 2P3/1P1/12P5). Automated sequencing of purified PCR products was performed in all samples. Phylogenetic analysis of the obtained sequences showed that all the samples under this study belong to the Cosmopolitan group of subtype A. Our data support the previous hypothesis that HTLV-I infection in Brazil was originated from ancestral Mongoloids migration. However, considering that Salvador population is composed of 90% African descendents it is of paramount importance to study a representative sampling in order to obtain a better idea of the origin of this virus in this city.

EPIDEMIOLOGY OF HTLV-I IN GUADELOUPE

P081 Objective: To describe the risk factors for HTLV-I infection among Guadeloupean blood donors. Methods: Between January 1989 and December 1996, 59,426 sera were screened for antibodies to HTLV-I/II by using HTLV-I EIA assays (HTLV-I EIA Abbott, NC, IL). All repeatedly positive sera were confirmed by western blot (Genelabs Diagnostics, Singapore). The seropositivity criteria were based on HTLV-I antibody reactivity to p19, p24, GD21, and rgp46-I. Basic data including age, gender, and current residence were recorded. A multiple logistic regression was performed using SAS version 6.11 software (SAS Institute, Cary, NC). Results: 195 sera were confirmed as HTLV-I seropositive giving an overall prevalence of 0.33% (95%CI, 0.28-0.38). Current residence (Atlantic façade of Guadeloupe, OR 1.9), as well as female gender (OR 1.8), increasing age (≥ 50 years, OR 5.6), positive Hepatitis B core antibodies (OR 2.0), and new donor status (OR, 12.5) were identified as major risk factors for HTLV-I. Conclusion: An overall HTLV-I prevalence of 0.33% is low for an endemic area such as Guadeloupe. Our study highlights foci of microendemicity in Guadeloupe, likely suggesting both a low HTLV-I's spread and its highly intrafamilial restricted transmission within this Caribbean population.

Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru.

A survey was conducted to determine the sexual behavior practices and prevalence of HIV-1, HTLV-I/II, and T. pallidum infections among unlicensed female sex workers (FSWs) in Lima, Peru. To assess the role of unlicensed FSWs as a potential source of retroviral and T. pallidum infection. Female sex workers from 15 brothels were enrolled. Sera samples were obtained and tested for antibodies to HIV-1, HTLV-I, and Treponema pallidum. Of 158 FSWs studied, all were negative for HIV-1, 6 were positive for HTLV-I, and 5 were positive for Treponema pallidum. Of their male clients, 75% used condoms, whereas only 3% reported condom use with their steady partners. When condoms were always used by clients, the history of a sexually transmitted disease was significantly reduced (p < 0.01), and the prevalence of HTLV-I (p < 0.05) and syphilis was lower among these workers. Data suggested that the low rate of sexually transmitted diseases among FSWs reflected the high rate of condom use by their male clients.