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HTLV-I infection in French West Indies: a case-control study
N Frery1, M Chavance, I Valette
1Recherches en épidémiologie: INSERM U169, Villejuif, France.
Abstract:
A case-control study was performed in Martinique, French West Indies, comparing 66 anti-p24 antibody carriers to 91 seronegative subjects for HTLV-I, matched for age and place of residence. The aim of our study was to identify factors associated with HTLV-I infection and to observe whether clinical examination and biological measurements would reveal any abnormalities among the seropositive subjects. We observed a predominance of females among seropositive subjects (74% compared to 59%, p less than 0.05), and a greater risk due to earlier blood transfusions (p less than 0.001). This survey revealed important differences between cases and controls regarding socioeconomic factors: cases had fewer luxuries or advantages (i.e. bathroom, toilets, refrigerator, telephone, p less than 0.01), were more corpulent (p less than 0.05), and more often widowed, divorced or separated (p less than 0.01) than the controls. Although the differences were not significant, the seropositive donors seemed to be less educated, and were from a lower socioprofessional class than the seronegative donors. With regard to clinical symptoms (infections, adenopathies, splenomegaly, hepatomegaly) and biological parameters (blood count; T-cell subsets, electrophoresis of protids, immunoglobulins, calcemia, antischistosomal antibody), seropositive subjects appeared to be healthy; no parameters, except for alpha 1 globulin (p less than 0.05) and monocytes (p less than 0.05), were found to be correlated with seropositivity; but these two parameters remained within their normal ranges. This study confirms blood transfusion as a risk factor. It underscored the importance of socioeconomic factors for seropositivity.
Insights
This study identified blood transfusions and specific socioeconomic factors as significant risks for Human T-lymphotropic virus type I (HTLV-I) infection in Martinique. Seropositive individuals showed no significant clinical abnormalities but had distinct lifestyle characteristics.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Human T-lymphotropic virus type I (HTLV-I) is a significant public health concern.
- Understanding risk factors and clinical manifestations is crucial for disease control.
Purpose of the Study:
- To identify factors associated with HTLV-I infection in Martinique.
- To assess clinical and biological differences between HTLV-I seropositive and seronegative individuals.
Main Methods:
- A case-control study comparing 66 HTLV-I antibody carriers (cases) with 91 seronegative subjects (controls).
- Matching was performed for age and place of residence.
- Data collection included socioeconomic factors, clinical examination, and biological measurements.
Main Results:
- Female predominance was observed among seropositive subjects (74% vs. 59%, p<0.05).
- Earlier blood transfusions significantly increased the risk of HTLV-I infection (p<0.001).
- Socioeconomic factors, including fewer amenities and higher prevalence of being widowed, divorced, or separated, were associated with seropositivity (p<0.01).
- Seropositive individuals were more corpulent (p<0.05).
- No significant clinical symptoms or biological abnormalities were found, except for minor correlations with alpha 1 globulin and monocyte counts.
Conclusions:
- Blood transfusion is confirmed as a major risk factor for HTLV-I infection.
- Socioeconomic status plays a critical role in HTLV-I seropositivity.
- HTLV-I infected individuals in this cohort appeared clinically healthy, highlighting the need for screening and awareness programs.