Prevalence of HTLV-I-associated T-cell lymphoma.
In order to assess the prevalence rate of HTLV-1-associated T-cell lymphomas and human retrovirus infection in general, approximately 21,000 individuals representing various patient populations, retroviral risk groups, and blood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection using serologic and PCR assays. The prevalence rates among volunteer blood donors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increased HTLV prevalence rates were observed among paid blood donors, African American health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and family members of HTLV-positive people, and patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I versus HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade, CD4+ T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died from their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infection. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, and other-than-low-grade NHL patients. Only one patient was infected with HIV-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV-1 positives had B-cell lymphomas, one HIV-1 positive had an HTLV-I-positive CD4+ T-cell lymphoma, and one infected with HIV-2 had a CD4+ T-cell lymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, while uncommon, is not necessarily rare among other-than-low-grade NHL cases in the United States and, given its poor prognosis, should probably be studied separately in clinical trials.
Poiesz
B J
BJ
Department of Medicine, State University of New York Health Science Center, Syracuse, USA. poieszb@vax.cs.hscsyr.edu
Papsidero
L D
LD
Ehrlich
G
G
Sherman
M
M
Dube
S
S
Poiesz
M
M
Dillon
K
K
Ruscetti
F W
FW
Slamon
D
D
Fang
C
C
Williams
A
A
Duggan
D
D
Glaser
J
J
Gottlieb
A
A
Goldberg
J
J
Ratner
L
L
Phillips
P
P
Han
T
T
Friedman-Kien
A
A
Siegal
F
F
Rai
K
K
Sawitsky
A
A
Sheremata
L W
LW
Dosik
H
H
Cunningham
C
C
Montagna
R
R
D001741:Black or African American; D000361:Agammaglobulinemia / Q000453:epidemiology; D001782:Blood Donors; D015897:Comorbidity; D004273:DNA, Neoplasm / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D005192:Family Health; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D015498:HIV-2 / Q000302:isolation & purification; D015490:HTLV-I Infections / Q000453:epidemiology; D015491:HTLV-II Infections / Q000453:epidemiology; D006467:Hemophilia A / Q000453:epidemiology; D007198:Indians, North American; D007938:Leukemia / Q000453:epidemiology; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000453:epidemiology* / Q000208:ethnology; D008223:Lymphoma / Q000145:classification / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology / Q000208:ethnology / Q000821:virology; D016602:Needlestick Injuries / Q000150:complications; D015995:Prevalence; D012192:Retroviridae Infections / Q000453:epidemiology* / Q000208:ethnology / Q000821:virology; D012216:Rheumatic Diseases / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous; D013922:Thrombocytosis / Q000453:epidemiology; D065227:Transfusion Reaction; D014481:United States / Q000453:epidemiology
D004273:DNA, Neoplasm; D004279:DNA, Viral