title: Human T-lymphotropic virus types 1 and 2 are rare among intravenous drug users in Eastern Europe.
abstract: In Europe, human T-lymphotropic virus (HTLV) type 2 mainly occurs among intravenous drug users (IDUs) with prevalence up to 15% and HTLV-1 among general population with prevalence <1%. However, there is no data regarding the prevalence of HTLV-1 or HTLV-2 in Eastern European IDUs population where HIV prevalence is relatively high. We aimed to determine the prevalence and genotypes of HTLV-1/HTLV-2 among IDUs and healthy volunteers in Estonia.
  
  
  
  The study included 345 IDUs and 138 healthy volunteers. The presence of HTLV-1/HTLV-2 was determined by nested PCR; positive and negative controls were used in every PCR run.
  
  
  
  The analysed IDUs resembled the IDUs of HIV epidemic in Estonia: mainly male (79%) with median age of 30years (interquartile range [IQR] 25-34), and prolonged duration of intravenous drug usage (11years; IQR 7-14). The prevalence exposure to blood-borne viral infections was high - 50% were HIV positive, 88% hepatitis C positive, 67% hepatitis B positive. Of IDUs, 64% reported receptive needle sharing in the past and 18% at least once a month during last six months. None of the IDUs carried HTLV-1 but there was a case of HTLV-2 (prevalence 0.3%; 95% CI 0.1-1.6). All healthy volunteers were HTLV-1 and HTLV-2 PCR negative.
  
  
  
  This is the first study investigating the prevalence of HTLV-1/HTLV-2 among high risk population and healthy volunteers in Eastern European region. Our results suggest that despite other widely spread blood-borne infections (e.g. HIV, HBV, HCV) HTLV-1 and HTLV-2 are rare among IDUs in Estonia.
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1). Electronic address: ene-ly.jogeda@ut.ee.
authors.forename: Ene-Ly
authors.initials: EL
authors.lastname: Jõgeda
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1).
authors.forename: Radko
authors.initials: R
authors.lastname: Avi
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1).
authors.forename: Merit
authors.initials: M
authors.lastname: Pauskar
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1).
authors.forename: Eveli
authors.initials: E
authors.lastname: Kallas
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1).
authors.forename: Tõnis
authors.initials: T
authors.lastname: Karki
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Des Jarlais
authors.affiliation: Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
authors.forename: Anneli
authors.initials: A
authors.lastname: Uusküla
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1).
authors.forename: Irja
authors.initials: I
authors.lastname: Lutsar
authors.affiliation: Department of Microbiology, Faculty of Medicine, University of Tartu, Tartu, Estonia(1).
authors.forename: Kristi
authors.initials: K
authors.lastname: Huik
mesh_terms: D000328:Adult; D060085:Coinfection / Q000453:epidemiology*; D004957:Estonia; D005061:Europe, Eastern; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D015490:HTLV-I Infections / Q000453:epidemiology* / Q000821:virology; D015491:HTLV-II Infections / Q000453:epidemiology* / Q000821:virology; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D015368:Human T-lymphotropic virus 1 / Q000235:genetics / Q000302:isolation & purification*; D015367:Human T-lymphotropic virus 2 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000821:virology*
keywords: Blood-borne infection; Co-infection; HIV; HTLV-1/2