Health effects of human T-lymphotropic virus type I (HTLV-I) in a Jamaican cohort

ABSTRACT

BACKGROUND: Other than adult T-cell leukaemia (ATL) and HTLV-I associated myelopathy (HAM), the health effects of infection with human T-lymphotropic virus type I (HTLV-I) are not well defined. METHOD: A cohort of 201 confirmed HTLV-I seropositive Jamaican food service workers and 225 seronegative controls of similar age and sex from the same population was examined. A health questionnaire, physical examination, and laboratory tests were performed at enrollment into the cohort in 1987-1988. RESULTS: One of 201 HTLV-I seropositives, but no controls were diagnosed with HAM, for a prevalence of 0.5 percent (95 percent confidence interval) (CI) 0.01-2.7 percent); no cases of ATL were diagnosed. While there was no difference in current symptoms, the HTLV-I seropositive group was more likely to report a past medical history of hepatitis or jaundice (OR = 3.49, 95 percent CI 0.93-13.08), malaria (OR = 2.13, 95 percent CI 0.96-4.73), and dengue fever (OR = 1.37, 95 percent CI 0.82-2.29); however, these differences were of borderline statistical significance. Low income HTLV-I seropositive women had lower body weight (P , 0.01) and body mass index (P < 0.009) than their seronegative counterparts; similar differences were seen in the smaller male group. A trend toward higher prevalence of severe anaemia (haemoglobin < 10 g/dl) (12.6 percent verus 7.7 percent, P < 0.105) and a significantly lower prevalence of eosinophilia (1.0 percent verus 6.3 percent, P < 0.004) was seen among HTLV-I seropositives are asymptomatic, HAM may be diagnosed in approximately 0.5 percent of carriers. Chronic HTLV-I infection may also subtle effects on body mass and haematological parameters.(AU)