title: Modelling the risk of adult T-cell leukemia/lymphoma in persons infected with human T-lymphotropic virus type I.
abstract: Adult T-cell leukemia/lymphoma (ATL), a malignancy of mature CD4-positive lymphocytes, has been etiologically linked to the human retrovirus HTLV-I. Although a long latent period is suggested from migrant studies, little prospective information on the risk of developing ATL among persons with HTLV-I infection is available. We present here a model for ATL risk based upon age- and sex-specific HTLV-I seroprevalence data from a cross-sectional survey of 13,000 Jamaicans and ATL incidence data from a 2 1/2-year case-control study. By examining the age-specific incidence of ATL relative to both adult and childhood-acquired seropositivity versus childhood-acquired seropositivity alone, we provide evidence in support of the hypothesis that childhood infection with HTLV-I is important to the development of ATL. Using this model, the cumulative lifetime risk of ATL for those infected before age 20 is estimated to be 4.0% for males and 4.2% for females. Under this hypothesis, HTLV-I-associated diseases with shorter latent periods, such as tropical spastic paraparesis, should have a higher incidence in adult females than in adult males.
authors.affiliation: Viral Epidemiology Section, National Cancer Institute, Bethesda, MD 20892.
authors.forename: E L
authors.initials: EL
authors.lastname: Murphy
authors.forename: B
authors.initials: B
authors.lastname: Hanchard
authors.forename: J P
authors.initials: JP
authors.lastname: Figueroa
authors.forename: W N
authors.initials: WN
authors.lastname: Gibbs
authors.forename: W S
authors.initials: WS
authors.lastname: Lofters
authors.forename: M
authors.initials: M
authors.lastname: Campbell
authors.forename: J J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: W A
authors.initials: WA
authors.lastname: Blattner
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D015490:HTLV-I Infections / Q000453:epidemiology; D006801:Humans; D007563:Jamaica; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012737:Sex Factors; D013997:Time Factors