title: Prevalence and risk factors for Human T-Lymphotropic Virus Type 1 (HTLV-1) among maintenance hemodialysis patients.
abstract: BACKGROUND
  Infection with the human T-cell lymphotropic virus type 1 (HTLV-1), although asymptomatic in most cases, can lead to potentially grave consequences, such as adult T-cell leukemia-lymphoma and HTLV-1-associated myelopathy / tropical spastic paraparesis. Its prevalence varies widely across different populations and geographic regions. A population-based study in the city of Salvador, located in the Northeast region of Brazil, showed an overall prevalence of HTLV-1 seropositivity of 1.7%. Blood borne virus infections are recognized as important hazards for patients and staff in maintenance hemodialysis (MHD) units but most studies focus on hepatitis B, hepatitis C and human immunodeficiency viruses. There are scarce data about HTLV-1 infection in the MHD population. We aimed to determine the prevalence and risk factors for HTLV-1 infection among MHD patients in the city of Salvador-Bahia, Brazil.
  
  
  METHODS
  We conducted a multi-center, cross-sectional study nested in a prospective cohort of MHD patients enrolled from four outpatient clinics. HTLV-1 screening was performed with ELISA and positive cases were confirmed by Western Blot. Factors associated with HTLV-1 seropositivity were identified by multivariable logistic regression.
  
  
  RESULTS
  605 patients were included in the study. The overall prevalence of HTLV-1 infection was 2.48% (15/605), which was similar to that of hepatitis B [1.98% (12/605)] and C [3.14% (19/605)] viruses in our sample. HTLV-1 seropositivity was positively associated with age [prevalence odds ratio (POR) 1.04; 95% confidence interval (CI) 1.01-1.08], unmarried status (POR 3.65; 95% CI 1.13-11.65), and history of blood transfusion (POR 3.35; 95% CI 1.01-11.13).
  
  
  CONCLUSIONS
  The overall prevalence of HTLV-1 infection in a sample of MHD patients was similar to that of other viral infections, such as hepatitis B and C. Our data revealed that MHD patients who are older, unmarried or who have received blood transfusions are at higher risk for HTLV-1 infection.
authors.affiliation: Division of Nephrology, Hospital Geral Roberto Santos, Salvador, Brazil. rilma_santos@yahoo.com.br.|Postgraduate Program in Health Sciences, Federal University of Bahia, Salvador, Brazil. rilma_santos@yahoo.com.br.
authors.forename: Rilma F S
authors.initials: RF
authors.lastname: Santos
authors.affiliation: Department of Biochemistry, APAE, Salvador, Brazil.
authors.forename: Gildásio C
authors.initials: GC
authors.lastname: Conceição
authors.affiliation: Unit of Clinical Epidemiology and Evidence Based Medicine of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil.
authors.forename: Márcia S
authors.initials: MS
authors.lastname: Martins
authors.affiliation: Unit of Clinical Epidemiology and Evidence Based Medicine of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil.
authors.forename: Angiolina
authors.initials: A
authors.lastname: Kraychete
authors.affiliation: Diretoria Médica da Clínica Nephron-Itapuã, Salvador, Brazil.
authors.forename: Maria A C
authors.initials: MA
authors.lastname: Penalva
authors.affiliation: Centro de Pesquisas Gonçalo Moniz (Fiocruz-Ba), Salvador, Brazil.|Department of Internal Medicine and Diagnostic Support, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil.
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Carvalho
authors.affiliation: Unit of Clinical Epidemiology and Evidence Based Medicine of the Professor Edgard Santos University Hospital, Federal University of Bahia, Salvador, Brazil.|Department of Internal Medicine and Diagnostic Support, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil.
authors.forename: Antonio Alberto
authors.initials: AA
authors.lastname: Lopes
authors.affiliation: Postgraduate Program in Health Sciences, Federal University of Bahia, Salvador, Brazil.|Department of Internal Medicine and Diagnostic Support, Medical School of Bahia, Federal University of Bahia, Salvador, Brazil.
authors.forename: Paulo Novis
authors.initials: PN
authors.lastname: Rocha
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D005260:Female; D015490:HTLV-I Infections / Q000453:epidemiology* / Q000821:virology*; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Blood Transfusion; Chronic Kidney 47 Disease; Hemodialysis; Hepatitis B; Hepatitis C; Human T-Lymphotropic Virus Type 1