title: Health effects of human T-lymphotropic virus type I (HTLV-I) in a Jamaican cohort.
abstract: BACKGROUND
  Other than adult T-cell leukaemia (ATL) and HTLV-I associated myelopathy (HAM), the health effects of infection with human T-lymphotropic virus type I (HTLV-I) are not well defined.
  
  
  METHODS
  A cohort of 201 confirmed HTLV-I seropositive Jamaican food service workers and 225 seronegative controls of similar age and sex from the same population was examined. A health questionnaire, physical examination, and laboratory tests were performed at enrollment into the cohort in 1987-1988.
  
  
  RESULTS
  One of 201 HTLV-I seropositives, but no controls were diagnosed with HAM, for a prevalence of 0.5% (95% confidence interval) (CI) 0.01-2.7%); no cases of ATL were diagnosed. While there was no difference in current symptoms, the HTLV-I seropositive group was more likely to report a past medical history of hepatitis or jaundice (OR = 3.49, 95% CI: 0.93-13.08), malaria (OR = 2.13, 95% CI: 0.96-4.73), and dengue fever (OR = 1.37, 95% CI: 0.82-2.29); however, these differences were of borderline statistical significance. Low income HTLV-I seropositive women had lower body weight (P < 0.01) and body mass index (P < 0.009) than their seronegative counterparts; similar differences were seen in the smaller male group. A trend toward higher prevalence of severe anaemia (haemoglobin < 10 g/dl) (12.6% versus 7.7%, P < 0.105) and a significantly lower prevalence of eosinophilia (1.0% versus 6.3%, P < 0.004) was seen among HTLV-I seropositives compared to controls.
  
  
  CONCLUSIONS
  Although most HTLV-I seropositives are asymptomatic, HAM may be diagnosed in approximately 0.5% of carriers. Chronic HTLV-I infection may also exert subtle effects on body mass and haematological parameters.
authors.affiliation: Department of Laboratory Medicine, University of California, San Francisco 94143, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Murphy
authors.forename: R
authors.initials: R
authors.lastname: Wilks
authors.forename: O S
authors.initials: OS
authors.lastname: Morgan
authors.forename: B
authors.initials: B
authors.lastname: Hanchard
authors.forename: B
authors.initials: B
authors.lastname: Cranston
authors.forename: J P
authors.initials: JP
authors.lastname: Figueroa
authors.forename: W N
authors.initials: WN
authors.lastname: Gibbs
authors.forename: J
authors.initials: J
authors.lastname: Murphy
authors.forename: W A
authors.initials: WA
authors.lastname: Blattner
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D015992:Body Mass Index; D015331:Cohort Studies; D004802:Eosinophilia / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies