title: A cohort study of health effects of human T-cell lymphotropic virus type I infection in Jamaican children.
abstract: OBJECTIVE
  Human T-cell lymphotropic virus type I (HTLV-I) infection in childhood is believed to play an important role in risk for adult T-cell leukemia/lymphoma. Although HTLV-I is known to be associated with infective dermatitis in childhood, other HTLV-I-associated morbidity in children has not been well studied. We sought to determine the HTLV-I-associated health effects in Jamaican children.
  
  
  METHODS
  We compared incidence rates of several health outcomes in 28 HTLV-I-infected and 280 uninfected children clinically followed from age 6 weeks to a maximum of 10 years. Cox proportional hazards regression analysis was used to analyze these prospectively collected data, adjusting for confounding effects of other variables as necessary.
  
  
  RESULTS
  HTLV-I-infected children had significantly higher incidence rates of seborrheic dermatitis (rate ratio [RR] = 4.8, 95% confidence interval [CI] = 1.9-12.5), eczema (RR = 3.1, CI = 1.2-7.9) and persistent hyperreflexia (RR = 3.7, CI = 1.6-8.2). Additionally, HTLV-I infected children had increased rates of severe anemia (RR = 2.5, CI = 0.8-7.9) and abnormal lymphocytes (RR = 2.4, CI = 0.8-7.6) that were of borderline statistical significance.
  
  
  CONCLUSIONS
  Our study suggests that HTLV-I-associated skin diseases of childhood may include seborrheic dermatitis and eczema. Additionally, these data suggest that persistent hyperreflexia of the lower limbs may be an early sign of HTLV-I-associated neurologic involvement in children. Expansion and continued clinical observation of this cohort would be valuable.
authors.affiliation: Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, Bethesda, Maryland, USA. em34w@nih.gov
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Maloney
authors.forename: Stefan Z
authors.initials: SZ
authors.lastname: Wiktor
authors.forename: Paulette
authors.initials: P
authors.lastname: Palmer
authors.forename: Beverley
authors.initials: B
authors.lastname: Cranston
authors.forename: Ernest J
authors.initials: EJ
authors.lastname: Pate
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cohn
authors.forename: Norma
authors.initials: N
authors.lastname: Kim
authors.forename: Wendell
authors.initials: W
authors.lastname: Miley
authors.forename: Terry L
authors.initials: TL
authors.lastname: Thomas
authors.forename: William A
authors.initials: WA
authors.lastname: Blattner
authors.forename: Barrie
authors.initials: B
authors.lastname: Hanchard
mesh_terms: D000740:Anemia / Q000453:epidemiology / Q000209:etiology*; D001942:Breast Feeding; D015331:Cohort Studies; D012628:Dermatitis, Seborrheic / Q000453:epidemiology / Q000209:etiology*; D004485:Eczema / Q000453:epidemiology / Q000209:etiology*; D015490:HTLV-I Infections / Q000150:complications* / Q000503:physiopathology; D015994:Incidence; D007563:Jamaica / Q000453:epidemiology; D009460:Neurologic Examination; D016016:Proportional Hazards Models; D012021:Reflex, Abnormal