HTLV-I/II seroprevalence and HIV/HTLV coinfection among U.S. intravenous drug users

Article Abstract:

Human T-lymphotropic virus type I (HTLV-I) has been implicated as a causative factor for a number of diseases including adult T-cell leukemia/lymphoma, some neurologic diseases, and possibly multiple sclerosis. It has been found mainly in Japanese and Caribbean populations. Human T-lymphotropic virus type II (HTLV-II) has been associated with another type of leukemia, but the populations it infects and the diseases it is associated with are unknown. It is thought by some that intravenous (IV) drug users in the United States are more likely to be infected with these viruses than human immunodeficiency virus (HIV, which causes AIDS) because of easy transmission of HTLV-I/II through shared needles. This study examined the prevalence of infection of HTLV-I/II and of coinfection with HIV in IV drug populations in a number of US cities. IV drug users in Baltimore, Chicago, Los Angeles, Miami, New Jersey, New York City, and San Antonio were tested for HIV, HTLV-I, and HTLV-II infections. Subjects were enrolled from drug treatment programs. Results revealed that 207 of the 1,800 (11.5 percent) subjects tested positive for HTLV-I/II infection. Infection rates for racial groups differed greatly. Blacks had an HTLV-I/II infection rate of 17.1 percent, Hispanics 8.7 percent, and whites 5.6 percent. Infection rates also varied greatly by city. In Los Angeles, the rate of HTLV-I/II infection was 20.1 percent; New York City, Chicago, and San Antonio had rates of about 10 percent; New Jersey had a rate of 5 percent, and Baltimore and Miami about 1 percent. (These rates were based on small numbers of subjects.) HTLV-I/II infection rates also increased with age. Female IV drug users had a slightly higher infection rate than males (14.0 percent versus 10.0 percent). HIV infection rates by race were 33.5 percent for blacks, 20.1 percent for Hispanics, and 10.2 percent for whites. Geographic prevalence of HIV did not mirror that of HTLV-I/II infection. When the observed numbers of co-infection cases were compared with expected numbers, little differences were found. This indicates that HIV infection and HTLV-I/II infections are independently distributed. IV drug users have high rates of infection for these viruses, and regular HTLV testing as well as HIV testing is indicated. (Consumer Summary produced by Reliance Medical Information, Inc.)

HTLV-I infections

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Seroprevalence of HTLV-I/II and HIV-1 infection among male intravenous drug abusers in Chicago

Article Abstract:

Infection with HIV-1 (human immunodeficiency virus type 1) causes AIDS, while infection with HTLV-I/II (human lymphotropic virus types I/II) can cause adult T-cell leukemia and tropical spastic paraparesis (a disease of the spinal cord). The incidence of infection with HIV-1 and HTLV-I/II was examined in 387 male intravenous drug users who were hospitalized for drug rehabilitation in Chicago. Blood serum was tested for the presence of antibodies to HIV-1 and HTLV-I/II (seropositivity). If positive, further testing was done to confirm the results. Approximately 17 percent of the men were infected with HTLV-I/II only, 8 percent were infected with HIV-1 only, and 2 percent were infected with both viruses. The risk factors for HTLV-I/II infection were analyzed. Infectivity with HTLV-I/II was correlated with age, length of time of intravenous drug use and race; HTLV-I/II infection was more common among Afro-Americans. HTLV-I/II infectivity was not correlated with sexual behavior, such as number of sexual partners, the incidence of other sexually transmitted diseases, or drug use behavior, such as type of intravenous drug used and needle sharing. These results define several differences in the incidence of HIV-1 and HTLV-I/II infections and highlight the risk factors associated with HTLV-I/II infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors

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No change in incidence and prevalence of HIV among intravenous drug users in Copenhagen from 1985 to 1990

Article Abstract:

The incidence of HIV infection may be unchanged among intravenous drug users (IVDUs) in Copenhagen, Denmark after an initial drop in 1986. A study examined the incidence of HIV infection among 1,029 IVDUs in Copenhagen who were tested for HIV infection between 1984 and 1990. The incidence of HIV infection among this group of IVDUs increased from 0% in 1984 to 20% in 1985. Between 1986 and 1990, the incidence varied between 12% and 9%. The incidence was the same among male and female IVDUs and decreased with age. IVDUs in Denmark have almost unlimited access to free needles, syringes and condoms. Several informational campaigns have also been targeted to IVDUs. New strategies need to be developed to decrease the transmission of HIV among IVDUs and from IVDUs to the general population.

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