Modelling the risk of adult T-cell leukemia/lymphoma in persons infected with human T-lymphotropic virus type I.
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.
Murphy
E L
EL
Viral Epidemiology Section, National Cancer Institute, Bethesda, MD 20892.
Hanchard
B
B
Figueroa
J P
JP
Gibbs
W N
WN
Lofters
W S
WS
Campbell
M
M
Goedert
J J
JJ
Blattner
W A
WA
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