Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department.
OBJECTIVE
To determine the seroprevalence and epidemiologic features of human T-lymphotropic virus (HTLV I-II) among an emergency department patient population with a high rate of human immunodeficiency virus (HIV-1) infection.


METHODS
Prospective survey using identity-unlinked consecutive sampling during a 6-week period in 1988.


METHODS
Inner-city teaching hospital.


METHODS
Sequential sample of 2544 adult patients with sufficient excess sera for analysis.


RESULTS
Twenty-eight (1.1%) (95% CI, 0.7% to 1.5%) serum samples were seropositive for HTLV I-II whereas 152 (6.0%) (CI, 5.1% to 6.9%) were seropositive for HIV-1. The age distribution of HTLV I-II was similar to the study population while HIV-1 was concentrated among younger (25 to 44 years) age groups (P less than 0.05). Only 16 (57.1%) HTLV I-II infected patients had identified risk factors; 11 were intravenous drug users, 4 received transfusions, and 1 had heterosexual exposure to a high-risk partner. None of 39 identified homosexual men had HTLV I-II antibodies although 29 (74.3%) were HIV-1 seropositive.


CONCLUSIONS
HTLV I-II infection may be more prevalent among certain segments of the U.S. population than previously realized and appears to have a different demographic distribution than HIV-1 infection. Although HTLV I-II may represent a nosocomial risk to health care providers, the risk of occupational transmission is probably less than for hepatitis B virus and even HIV-1. Adherence to universal precautions should minimize the risk.
Kelen
G D
GD
Johns Hopkins University School of Medicine, Baltimore, Maryland.
DiGiovanna
T A
TA
Lofy
L
L
Junkins
E
E
Stein
A
A
Sivertson
K T
KT
Lairmore
M
M
Quinn
T C
TC
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000635:transmission; D015528:HIV Seroprevalence; D015481:HTLV-I Antibodies / Q000032:analysis*; D015490:HTLV-I Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission; D015482:HTLV-II Antibodies / Q000032:analysis*; D015491:HTLV-II Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States; D014505:Urban Population
D015481:HTLV-I Antibodies; D015482:HTLV-II Antibodies