title: High prevalence of human T-lymphotropic virus infection in indigenous women from the peruvian Amazon.
abstract: BACKGROUND
  In an earlier study, we detected an association between human T-cell lymphotropic virus (HTLV) infection and cervical human papillomavirus (HPV) in indigenous Amazonian Peruvian women of the Shipibo-Konibo ethnic group. As both HTLV and HPV can be transmitted sexually, we now report a population-based study examining the prevalence and risk factors for HTLV-1 and HTLV-2 infection in this population.
  
  
  METHODS
  Between July and December 2010, we conducted a comprehensive screening for HTLV among Shipibo-Konibo women 15 to 39 years of age living in two communities located in Lima and in 17 communities located within four hours by car or boat from the Amazonian city of Pucallpa in Peru.
  
  
  RESULTS
  We screened 1,253 Shipibo-Konibo women for HTLV infection 74 (5.9%) tested positive for HTLV-1, 47 (3.8%) for HTLV-2 infection, and 4 (0.3%) had indeterminate results. In the multivariate analysis, factors associated with HTLV-1 infection included: older age (Prevalence Ratio (PR): 1.04, 95% CI 1.00-1.08), primary education or less (PR: 2.01, 95% CI: 1.25-3.24), younger or same age most recent sex partner (PR: 1.66, 95% CI: 1.00-2.74), and having a most recent sex partner who worked at a logging camp (PR: 1.73, 95% CI: 1.09-2.75). The only factor associated with HTLV-2 infection was older age (PR: 1.08, 95% CI: 1.03-1.12).
  
  
  CONCLUSIONS
  HTLV infection is endemic among Shipibo-Konibo women. Two characteristics of the sexual partner (younger age and labor history) were associated with infection in women. These results suggest the need for implementation of both HTLV screening during the antenatal healthcare visits of Shipibo-Konibo women, and counseling about the risk of HTLV transmission through prolonged breastfeeding in infected women. We also recommend the implementation of prevention programs to reduce sexual transmission of these viruses.
authors.affiliation: Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
authors.forename: Magaly M
authors.initials: MM
authors.lastname: Blas
authors.forename: Isaac E
authors.initials: IE
authors.lastname: Alva
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: García
authors.forename: Cesar
authors.initials: C
authors.lastname: Cárcamo
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Montano
authors.forename: Nicanor
authors.initials: N
authors.lastname: Mori
authors.forename: Ricardo
authors.initials: R
authors.lastname: Muñante
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Zunt
mesh_terms: D000328:Adult; D005260:Female; D062306:Geography, Medical; D015490:HTLV-I Infections / Q000453:epidemiology*; D015491:HTLV-II Infections / Q000453:epidemiology*; D015368:Human T-lymphotropic virus 1; D015367:Human T-lymphotropic virus 2; D006801:Humans; D008489:Medical Indigency; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D062486:Public Health Surveillance; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D012747:Sexual Partners; D055815:Young Adult
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