The epidemiology of HTLV-1 and risk of disease and outcome: Jamaica

ABSTRACT

HTLV-1 is a human retrovirus endemic in the Caribbean and Japan. The crude prevalence in Jamaica is 5-6 per cent but there is a steady increase with age peaking in the 8th decade at 17 per cent among females and 9 per cent among males. The majority of persons infected with HTLV-1 do not manifest any clinical disease. However, some persons develop adult T-cell lymphoma, tropical spastic paraparesis or infective dermatitis. Associations with arthropathy, uveitis, polymyositis and panbronchiolitis have also been reported. HTLV-1 is transmitted via sexual contact, mother to child (mainly through breast milk) and by transfusion of cellular blood product. Male to female sexual transmission is far more efficient than female to male. Control of HTLV-1 requires screening blood transfusions and reducing sexual and vertical transmission. (AU)