Prevalence of antibodies to HTLV in antenatal clinic attenders in south east London

ABSTRACT

The prevalence of antibodies to HTLV in women attending a south east London antenatal clinic between October 1990 and July 1992 was determined using sera referred for rountine rubella antibody testing. Samples were screened for HTLV antibody using a modified Fujirebio gel particle agglutination test and reactive sera confirmed by ELISA (Abbott Laboratories, North Chicago, IL) and two commercial Western blots (Cambridge Biotech Inc., Rockville, MD, and Diagnostic Biotechnology, Genelab Diagnostics, Louvaine, Belgium). This strategy confirmed the presence of HTLV-1 antibodies in 12 out of 6,289 sera (0.19 percent, 95 percent confidence limits 0.083 percent to 0.30 percent) and HTLV-2 antibodies in 2 (0.03 percent) sera. Specimens from 8 to 821 (0.97 percent, 95 percent confidence limits 0.42 percent to 1.9 percent). Afro-Caribbean women, three of 1,136 (0.26 percent, 95 percent confidence limits 0.055 percent to 0.78 percent). African women, and one of 3,049 (0.033 percent, 95 percent confidence limits 0.006 percent to 0.18 percent). Caucasian women were positive for HTLV-1 antibodies. Sera from Afro-Caribbean women born in the Caribbean were 7.6 times more likely to be HTLV-1 antibody positive than sera from Afro-Caribbean women born in the UK (P = 0.012). Selective testing of Afro-Caribbean and African antenatal clinic attenders, in this setting, would have identified 11 of the 12 HTLV-1 infections at an estimated cost of prevention of HTLV-1 associated disease of 100,000 pounds per case which is considerably less than the 1.3 million pounds which has been estimated to prevent a case by universal screening of UK blood donors.(AU)