HTLV-1 infection in a population-based cohort of older persons in Guinea-Bissau, West Africa: Risk factors and impact on survival
✍ Scribed by Mads Melbye; Anne-Grethe Poulsen; Dana Gallo; Jakob B. Pedersen; Robert J. Biggar; Olav Larsen; Francisco Dias; Peter Aaby
- Book ID
- 101235716
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- French
- Weight
- 87 KB
- Volume
- 76
- Category
- Article
- ISSN
- 0020-7136
No coin nor oath required. For personal study only.
✦ Synopsis
In 1989, a population-based cohort of persons aged H50 years was established in an urban area of Guinea-Bissau, West Africa. Overall, 346 persons were interviewed in detail about risk behaviors and had capillary blood drawn. Among women, 12.4% were HTLV-1 seropositive, compared with 4.6% in men. No HTLV-2 was found. Seropositivity varied considerably according to place of birth and ethnic group. In women, but not in men, HTLV-1 seropositivity was strongly associated with early sexual debut (10-14 yrs, 33.3%; 15-17 yrs, 26.0%; 18-20 yrs, 6.5%; 21ϩ yrs, 0%; p trend ؍ 0.001), lifetime number of male partners (p trend ؍ 0.006), and the male partner's number of co-wives (p trend ؍ 0.006). There was also a 3.1-fold increased risk of being HTLV-1 seropositive if the woman was also HIV-2 seropositive. In a multivariate-riskfactor analysis, the strongest association with HTLV-1 was a history of having been bitten by a monkey (n ؍ 11; combined OR adjusted ؍ 10.1; 95% CI 2.3-44.4). Ornamental scarification was associated with a 3.3-fold increased risk. Ethnic affiliation also significantly influenced the risk of being HTLV-1 seropositive. Follow-up performed in January 1996 revealed no difference in survival between HTLV-1-seropositive and -seronegative individuals over 6 years (rate ratio ؍ 1.4, 95% CI 0.7-2.8). In conclusion, this population, which has very high HIV-2 seroprevalence, is also highly endemic for HTLV-1. Whereas sexual behaviors are clearly important for HTLV-1 spread in women, non-sexual risk factors were the only ones of potential importance in men. HTLV-1 had no impact on survival in this older population.