Prevalences of HTLV-1 Infection and Associated Risk Determinants in an Urban Population in Guinea-Bissau, West Africa

Larsen, Olav; Andersson, Sören; Z, da Silva; Hedegaard, Kathryn; Sandström, Anita; Nauclér, Anders; Dias, Francisco; Melbye, Mads; Aaby, Péter

doi:10.1097/00042560-200010010-00010

Cited by 30 publications

(17 citation statements)

References 26 publications

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“…In this study, HIV and HTLV-1 infections showed a cross-sectional association, as has been shown before in this study area in 1990 [25] and in the general adult population [16,41], elderly people [10], an occupational cohort [42] and pregnant women [43] in Bissau. Why this association is stronger for women than for men remains unclear.…”

Section: Discussionsupporting

confidence: 74%

“…Screening of blood transfusions for HIV since 1989 may have lead indirectly to a decrease of HTLV-1 in Bissau [16,41]. This mechanism seems unlikely to have played a role in the Caió area, where having received a blood transfusion was not associated with HTLV-1 infection in either 1990 [25] nor in 1997 (this risk factor was not assessed in 2007).…”

Section: Discussionmentioning

confidence: 99%

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HTLV-1 in rural Guinea-Bissau: prevalence, incidence and a continued association with HIV between 1990 and 2007

et al. 2010

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BackgroundHTLV-1 is endemic in Guinea-Bissau, and the highest prevalence in the adult population (5.2%) was observed in a rural area, Caió, in 1990. HIV-1 and HIV-2 are both prevalent in this area as well. Cross-sectional associations have been reported for HTLV-1 with HIV infection, but the trends in prevalence of HTLV-1 and HIV associations are largely unknown, especially in Sub Saharan Africa. In the current study, data from three cross-sectional community surveys performed in 1990, 1997 and 2007, were used to assess changes in HTLV-1 prevalence, incidence and its associations with HIV-1 and HIV-2 and potential risk factors.ResultsHTLV-1 prevalence was 5.2% in 1990, 5.9% in 1997 and 4.6% in 2007. Prevalence was higher among women than men in all 3 surveys and increased with age. The Odds Ratio (OR) of being infected with HTLV-1 was significantly higher for HIV positive subjects in all surveys after adjustment for potential confounding factors. The risk of HTLV-1 infection was higher in subjects with an HTLV-1 positive mother versus an uninfected mother (OR 4.6, CI 2.6-8.0). The HTLV-1 incidence was stable between 1990-1997 (Incidence Rate (IR) 1.8/1,000 pyo) and 1997-2007 (IR 1.6/1,000 pyo) (Incidence Rate Ratio (IRR) 0.9, CI 0.4-1.7). The incidence of HTLV-1 among HIV-positive individuals was higher compared to HIV negative individuals (IRR 2.5, CI 1.0-6.2), while the HIV incidence did not differ by HTLV-1 status (IRR 1.2, CI 0.5-2.7).ConclusionsTo our knowledge, this is the largest community based study that has reported on HTLV-1 prevalence and associations with HIV. HTLV-1 is endemic in this rural community in West Africa with a stable incidence and a high prevalence. The prevalence increases with age and is higher in women than men. HTLV-1 infection is associated with HIV infection, and longitudinal data indicate HIV infection may be a risk factor for acquiring HTLV-1, but not vice versa. Mother to child transmission is likely to contribute to the epidemic.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

HTLV-1 in rural Guinea-Bissau: prevalence, incidence and a continued association with HIV between 1990 and 2007

et al. 2010

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“…There are different seroprevalence rates for each continent. They range from 0% to 3.6% in Africa and from 0% to 1.5% in the Americas (with a peak of 2% in some Caribbean islands) . In Australia, the prevalence ranges from 0.001% to 0.3% and in Asia from 0% to 1.9%, while in Europe it ranges from 0% to 2.12% .…”

Section: Epidemiologymentioning

confidence: 99%

Human T‐lymphotropic virus and transfusion safety: does one size fit all?

Marano¹,

Vaglio

Pupella³

et al. 2015

Transfusion

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Human T-cell leukemia viruses (HTLV-1 and HTLV-2) are associated with a variety of human diseases, including some severe ones. Transfusion transmission of HTLV through cellular blood components is undeniable. HTLV screening of blood donations became mandatory in different countries to improve the safety of blood supplies. In Japan and Europe, most HTLV-infected donors are HTLV-1 positive, whereas in the United States a higher prevalence of HTLV-2 is reported. Many industrialized countries have also introduced universal leukoreduction of blood components, and pathogen inactivation technologies might be another effective preventive strategy, especially if and when generalized to all blood cellular products. Considering all measures available to minimize HTLV blood transmission, the question is what would be the most suitable and cost-effective strategy to ensure a high level of blood safety regarding these viruses, considering that there is no solution that can be deemed optimal for all countries.

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“…Other studies were performed on pregnant women or representative general adult population or on different control groups. The HTLV-1 prevalence was around 1% in Guinea, with variations from 0.2 to 1.9% depending on the region (Jeannel et al, 1995), and ranged from 2.2 to 3.6% in Guinea-Bissau (Andersson et al, 1997; Larsen et al, 2000; da Silva et al, 2009). It was of 1.2% in Gambia (Del Mistro et al, 1994) and ranged from 0.2 to 1.2% in Senegal (Hunsmann et al, 1984).…”

Section: Htlv-1 Worldwide Distribution and Prevalence Estimates By Gementioning

confidence: 99%

Epidemiological Aspects and World Distribution of HTLV-1 Infection

Gessain¹,

Cassar²

2012

Front. Microbio.

1,170

1,152

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The human T-cell leukemia virus type 1 (HTLV-1), identified as the first human oncogenic retrovirus 30 years ago, is not an ubiquitous virus. HTLV-1 is present throughout the world, with clusters of high endemicity located often nearby areas where the virus is nearly absent. The main HTLV-1 highly endemic regions are the Southwestern part of Japan, sub-Saharan Africa and South America, the Caribbean area, and foci in Middle East and Australo-Melanesia. The origin of this puzzling geographical or rather ethnic repartition is probably linked to a founder effect in some groups with the persistence of a high viral transmission rate. Despite different socio-economic and cultural environments, the HTLV-1 prevalence increases gradually with age, especially among women in all highly endemic areas. The three modes of HTLV-1 transmission are mother to child, sexual transmission, and transmission with contaminated blood products. Twenty years ago, de Thé and Bomford estimated the total number of HTLV-1 carriers to be 10–20 millions people. At that time, large regions had not been investigated, few population-based studies were available and the assays used for HTLV-1 serology were not enough specific. Despite the fact that there is still a lot of data lacking in large areas of the world and that most of the HTLV-1 studies concern only blood donors, pregnant women, or different selected patients or high-risk groups, we shall try based on the most recent data, to revisit the world distribution and the estimates of the number of HTLV-1 infected persons. Our best estimates range from 5–10 millions HTLV-1 infected individuals. However, these results were based on only approximately 1.5 billion of individuals originating from known HTLV-1 endemic areas with reliable available epidemiological data. Correct estimates in other highly populated regions, such as China, India, the Maghreb, and East Africa, is currently not possible, thus, the current number of HTLV-1 carriers is very probably much higher.

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Prevalences of HTLV-1 Infection and Associated Risk Determinants in an Urban Population in Guinea-Bissau, West Africa

Cited by 30 publications

References 26 publications

HTLV-1 in rural Guinea-Bissau: prevalence, incidence and a continued association with HIV between 1990 and 2007

HTLV-1 in rural Guinea-Bissau: prevalence, incidence and a continued association with HIV between 1990 and 2007

Human T‐lymphotropic virus and transfusion safety: does one size fit all?

Epidemiological Aspects and World Distribution of HTLV-1 Infection

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