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.

The results are consistent with the hypothesis that low serum phosphate is associated with low protein and calorie intake only among MHD patients not on binders. This study supports recommendations to prevent hyperphosphatemia in MHD patients by adequate combination of binder use and selection of foods restricted in phosphors but not severely restricted in protein and calories.