HTLV-I infections in Barbados: results of a 20-year follow-up study - abstract

ABSTRACT

Human T-cell lymphotrophic virus type I(HTLV-1) infection is known to be associated with adult T-cell leukaemia/lymphoma (ATL), tropical spastic paraparesis, polymyositis, arthritis, alveolitis, uveitis, and infective dermatitis. Examination of stored sera from Barbados previously identified 41 HTLV-1 seropositives among 1012 participants in a 1972 survey. We have followed up this cohort (1) to determine the long-term persistence of antibody, (2) to ascertain the risk of seroconbersion in household contacts, and (3) to identify long-term clinical sequelae of HTLV-1 infection. There were 79 HTLV-1 seronegative household contacts from 1972. Subjects were seen without knowledge of their serostatus and those who could be traced completed a questionnaire, had a clinical examination, serological, skin and stool tests. All 16 of the initially identified HTLV-1 seropositive sujects, whowere studied, remained seropositive and all 22 of the identified seronegative household contacts remained uninfected. Of the 22 household contacts, 10 were children of HTLV-1 seropositive mothers. In conclusion, we have confirmed persistence of HTLV-1 infection over 20 years' follow-up. There was no evidence of household transmission or of occult infection with late antibody expression in this study. Many HLTV-I infections are asymptomatic but we identified HLTV-I-associated clinical disorders in 4 cases chronic dermatitis (2), hepatosplenomegaly (1), and hepatomegaly alone (1); the latter subject also had smouldering ATL (AU)