title: HTLV-1 infection is frequent among out-patients with pulmonary tuberculosis in northern Lima, Peru.
abstract: METHODS
  Tuberculosis (TB) and human T-lymphotropic virus 1 (HTLV-1) are frequent in Peru. The prevalence of HTLV-1 among Peruvian TB patients is unknown.
  
  
  OBJECTIVE
  To determine the prevalence of HTLV-1, HTLV-2 and the human immunodeficiency virus (HIV) in out-patients with TB and to compare HTLV-1-infected patients with seronegative patients.
  
  
  METHODS
  Cross-sectional study including subjects aged 18-65 years diagnosed with smear-positive pulmonary TB at health centres in northern Lima from November 2004 to August 2005. HTLV and HIV screening was performed using enzyme-linked immunosorbent assay; HTLV-1 and HTLV-2 were confirmed using line immunoassay.
  
  
  RESULTS
  There were 311 participants with a median age of 29 years; 173 (56%) were men. HTLV-1 prevalence was 5.8% (18/311, 95%CI 3.2-8.4) and HIV prevalence was 1.3% (4/304, 95%CI 0.4-3.3). HTLV-2 was not diagnosed. In comparison with HIV- and HTLV-seronegative patients, HTLV-1-infected subjects were older (median age 44 vs. 28, P < 0.001) and were more likely to have been born in the southern Andes (OR 4.4, 95%CI 1.6-11.9). They were also more likely to report a history of TB deaths in the family (OR 5.4, 95%CI 1.7-16.8) and had more sputum smear results graded as 3+ (OR 4.1, 95%CI 1.5-11.2).
  
  
  CONCLUSIONS
  HTLV-1 screening among Peruvian TB patients is important. Because 3+ sputum smears are frequent and mortality is high among relatives, families of HTLV-1/TB-positive cases merit special attention.
authors.affiliation: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru. tverdonck@itg.be
authors.forename: K
authors.initials: K
authors.lastname: Verdonck
authors.forename: E
authors.initials: E
authors.lastname: González
authors.forename: G
authors.initials: G
authors.lastname: Henostroza
authors.forename: P
authors.initials: P
authors.lastname: Nabeta
authors.forename: F
authors.initials: F
authors.lastname: Llanos
authors.forename: H
authors.initials: H
authors.lastname: Cornejo
authors.forename: G
authors.initials: G
authors.lastname: Vanham
authors.forename: C
authors.initials: C
authors.lastname: Seas
authors.forename: E
authors.initials: E
authors.lastname: Gotuzzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006678:HIV / Q000276:immunology; D015483:HIV Antibodies / Q000032:analysis; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D015481:HTLV-I Antibodies / Q000032:analysis; D015490:HTLV-I Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D015482:HTLV-II Antibodies / Q000032:analysis; D015491:HTLV-II Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000276:immunology; D015367:Human T-lymphotropic virus 2 / Q000276:immunology; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000453:epidemiology
chemical_list: D015483:HIV Antibodies; D015481:HTLV-I Antibodies; D015482:HTLV-II Antibodies