title: Human T-lymphotropic virus type II seroprevalence among emergency department and clinic patients.
abstract: To determine the seroprevalence of human T-lymphotropic virus types I and II (HTLV-I and HTLV-II) among emergency department and clinic patients at a San Francisco, California, hospital, consecutive patients from 4 outpatient settings-emergency department, medical clinic, antenatal clinic, and neighborhood health centers-were tested for antibody to 1 of the viruses using an enzyme-linked immunosorbent assay and Western blot test. Of 4,019 patients, 169 (4.2%) had antibody to HTLV-I or -II; the seroprevalence of HTLV-II (3.5%) was greater than that of HTLV-I (0.7%). Seroprevalence for HTLV-II was highest in the emergency department (6.9%) and neighborhood clinics (3.9%) and in those aged 30 to 59 years (5.9%). Crude HTLV-II prevalence was higher in men (5.2%) than in women (2.2%), but sex was not an independent risk factor after age and location were controlled for. This study showed a higher seroprevalence of HTLV-I and HTLV-II among outpatients than did previous studies, probably because of a high proportion of injection-drug users. In view of the recent description of HTLV-II-associated myelopathy, studies of neurologic disease in this population may be warranted. HTLV-II should be included in the list of occupationally transmitted infections for hospitals with many injection-drug-using patients.
authors.affiliation: Department of Laboratory Medicine, University of California, San Francisco (UCSF) 94143-0884, USA.
authors.forename: D
authors.initials: D
authors.lastname: Agranoff
authors.forename: K
authors.initials: K
authors.lastname: Varney
authors.forename: H
authors.initials: H
authors.lastname: Khayam-Bashi
authors.forename: E L
authors.initials: EL
authors.lastname: Murphy
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D015153:Blotting, Western; D002140:California / Q000453:epidemiology; D004636:Emergency Service, Hospital; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015481:HTLV-I Antibodies / Q000097:blood*; D015490:HTLV-I Infections / Q000453:epidemiology* / Q000276:immunology; D015482:HTLV-II Antibodies / Q000097:blood*; D015491:HTLV-II Infections / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D017678:Sex Distribution
chemical_list: D015481:HTLV-I Antibodies; D015482:HTLV-II Antibodies