Infection with human T-cell lymphotropic virus type I (HTLV-I) occurs mainly in Japan, Central and West Africa and the Caribbean Basin. Although antibody to HTLV-I has been reported among pregnant women in several endemic countries, there is no information regarding the seroprevalence in pregnant Ghanaian women. The reported seroprevalence of HTLV-I among healthy Ghanaian blood donors is between 0?5 and 4?2 %. Therefore, this study was conducted to determine the seroprevalence of HTLV-I among pregnant women attending the antenatal clinic at the 37 Military Hospital, Accra, Ghana, between the months of January and December 2003. The presence of antibodies specific for HTLV-I/II was tested using a particle agglutination test (PAT) kit and confirmed by Western blotting (WB). Of the 960 sera tested, HTLV-I/II antibodies were detected in 24 samples using the PAT kit. WB results indicated that, of the 24 positive PAT specimens, 20 specimens (83?3 %) were HTLV-I positive, one (4?2 %) was HTLV-II positive, two (8?3 %) were HTLV positive and one (4?2 %) was indeterminate. Therefore, the overall seroprevalence of HTLV-I was 2?1 %. Seroprevalence increased with age, suggesting sexual contact as the primary mode of transmission among women of childbearing age, rather than breastfeeding during infancy. The seroprevalence of 2?1 % reported here for HTLV-I in pregnant women in Accra is comparable to that of human immunodeficiency virus among the same population. In conclusion, the results indicate that HTLV-I is prevalent among asymptomatic Ghanaian pregnant women and thus there is a need to consider introducing antenatal screening for HTLV-I in Ghana.
INTRODUCTIONHuman T-cell lymphotropic virus type I (HTLV-I) is known to be the pathogenic agent of adult T-cell leukaemia/lymphoma (ATLL) (Poiesz et al., 1980;Yoshida et al., 1982) and HTLV-I-associated myelopathy/tropical spastic paraparesis (Gessain et al., 1985; Osame et al., 1987). ATLL develops after a long incubation period, with an estimated lifetime risk of approximately 3-8 % in individuals infected before the age of 20 years (Cleghorn et al., 1995). As the prognosis for patients with ATLL is extremely poor, with median survival after diagnosis of <6 months (Takatsuki et al., 1996), the prevention of mother-to-child transmission of HTLV-I is of the utmost importance. HTLV-I is not ubiquitous, but is endemic in some geographical areas and among some ethnic groups. Population-based studies have reported the prevalence of antibody to HTLV-I to range from 3-6 % in Jamaica, Trinidad and the Caribbean islands to 23?2 % in Nagasaki Prefecture in south-western Japan (Blattner et al., 1990;Murphy et al., 1991; Kishihara et al., 2001). High HTLV-I seroprevalence rates (>2 % in the adult population) have been described in southern Japan, sub-Saharan Africa, the Caribbean Basin, parts of South America and some areas of Melanesia and the Middle East, where 15-20 million people are infected with this virus (Kazanji & Gessain, 2003). In every endemic population, there is an increase i...