title: HTLV-I infection in the Free State region of South Africa: a sero-epidemiologic study.
abstract: Human T-lymphotropic virus type I (HTLV-1) is associated with tropical spastic paraparesis (TSP) and adult T-cell leukemia/lymphoma. HTLV-I infection is endemic in certain parts of the Natal/KwaZulu region of South Africa. No studies on the seroprevalence of HTLV-I infection in the Free State (FS) have been published. This study was designed to determine the prevalence of HTLV-I antibodies among different patient groups in the FS. Sera from 863 patients were analyzed. There were: 178 asymptomatic rural Blacks, 200 asymptomatic urban Blacks, 50 asymptomatic Whites, 60 patients with spastic myelopathy, 70 patients with other neurologic disorders, 12 patients with T-cell haematologic malignancies and 293 human immunodeficiency virus (HIV) seropositive patients. Sera were tested for the presence of HTLV-I/II antibodies using an enzyme linked immunosorbent assay (ELISA). Positive results were confirmed using a modified Western blot assay. None of the asymptomatic Whites were HTLV-I antibody positive (95 pc confidence interval (CI): 0 to 7 pc), while 2 pc (95 CI: 0.5 to 5 pc) of asymptomatic urban Blacks and 1.1 pc (95 pc CI: 0.14 to 4 pc) of asymptomatic rural Blacks had HTLV-I antibodies. Of the group of patients with spastic myelopathy 33.3 pc (95 pc CI: 21.7 to 46.7 pc had HTLV-I antibodies, while none of the patients with T-cell haematologic malignancies (95 pc CI: 0 to 26.5 pc) or other neurologic disorders (95 pc CI: 0 to 5 pc) had HTLV-I antibodies. Of the HIV seropositive patients 6.1 (95 pc CI: 4 to 9.5) were co-infected with HTLV-I. HTLV-I infection is present in the Free State. It is strongly associated with spastic myelopathy in this region. HIV seropositive patients have a high rate of HTLV-I co-infection.
authors.affiliation: Department of Virology, University of the Orange Free State, Bloemfotein, South Africa.
authors.forename: E
authors.initials: E
authors.lastname: van der Ryst
authors.forename: G
authors.initials: G
authors.lastname: Joubert
authors.forename: M S
authors.initials: MS
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Terblanche
authors.forename: F
authors.initials: F
authors.lastname: Mollentze
authors.forename: A M
authors.initials: AM
authors.lastname: Pretorius
mesh_terms: D000328:Adult; D005260:Female; D015490:HTLV-I Infections / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D044469:Racial Groups; D012111:Residence Characteristics; D016036:Seroepidemiologic Studies; D013019:South Africa / Q000453:epidemiology