title: Seroprevalence of HTLV-I and HTLV-II among a cohort of HIV-infected women and women at risk for HIV infection. Women's Interagency HIV Study.
abstract: OBJECTIVE
  To determine the seroprevalence of, and risk factors for, HTLV-I and HTLV-II infection among HIV-infected women and women at high risk for HIV infection.
  
  
  METHODS
  Cross-sectional analysis of baseline data for women enrolled in the prospective Women's Interagency HIV Study (WIHS).
  
  
  METHODS
  From October 1994 through November 1995, 2657 women from five metropolitan areas in the United States (Chicago, Los Angeles, New York City [two sites], Northern California, and Washington DC) were enrolled in WIHS. An interview-based survey collected data on demographics, behavior, and medical history. HTLV-I and HTLV-II determinations were made using a combined HTLV-I/HTLV-II indirect immunofluorescent antibody (IFA) screening test, an IFA titration specificity test, and individual HTLV-I and HTLV-II confirmatory Western blots. Fisher's exact tests and logistic regression were used to determine univariate and multivariate independent predictors for HTLV-II infection.
  
  
  RESULTS
  Of 2625 women enrolled in WIHS with confirmed HIV results, 2487 (95%) were tested for HTLV-I and HTLV-II. Of these, 241 (10%) were HTLV-II-seropositive and 13 (0.5%) were HTLV-I-seropositive. On multivariate analysis, independent predictors of HTLV-II infection included injection drug use (OR = 5.2; p < .001), black race (OR = 3.6; p < 0.001), age >35 years (OR = 3.3; p < .001) and a history of sex with a male injecting drug user (OR = 1.9; p < .001). Among women infected with HIV, the seroprevalence of HTLV-II was 11% compared with 6% for women at risk for HIV but not infected (p < .001). However, HIV was not an independent predictor of HTLV-II infection in multivariate analysis.
  
  
  CONCLUSIONS
  This cross-sectional analysis confirms that HTLV-II is found commonly in HIV-infected women and uninfected women at risk for HIV in major urban areas throughout the United States and that HTLV-II is far more common than HTLV-I in these populations. Although injecting drug use is most strongly associated with HTLV-II infection, sexual transmission likely contributes to the high HTLV-II seroprevalence in this cohort.
authors.affiliation: Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York 10457, USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Telzak
authors.forename: R
authors.initials: R
authors.lastname: Hershow
authors.forename: L A
authors.initials: LA
authors.lastname: Kalish
authors.forename: W D
authors.initials: WD
authors.lastname: Hardy
authors.forename: E
authors.initials: E
authors.lastname: Zuckerman
authors.forename: A
authors.initials: A
authors.lastname: Levine
authors.forename: R
authors.initials: R
authors.lastname: Delapenha
authors.forename: J
authors.initials: J
authors.lastname: DeHovitz
authors.forename: R M
authors.initials: RM
authors.lastname: Greenblatt
authors.forename: K
authors.initials: K
authors.lastname: Anastos
mesh_terms: D015153:Blotting, Western; D017691:Caribbean Region / Q000208:ethnology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015481:HTLV-I Antibodies / Q000097:blood*; D015490:HTLV-I Infections / Q000150:complications / Q000453:epidemiology*; D015482:HTLV-II Antibodies / Q000097:blood*; D015491:HTLV-II Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000150:complications; D014481:United States / Q000453:epidemiology; D014505:Urban Population
chemical_list: D015481:HTLV-I Antibodies; D015482:HTLV-II Antibodies