HTLV-1 infection is frequent among out-patients with pulmonary tuberculosis in northern Lima, Peru
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.
DESIGN: 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).
CONCLUSION: 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.
Document Type: Regular Paper
Affiliations: 1: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; Virology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium 2: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru 3: Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru; and Division of Infectious Disease and International Health, University of Alabama at Birmingham, Birmingham, Alabama, USA 4: Instituto Nacional de Salud, Lima, Peru 5: Dirección de Salud III, Lima, Peru 6: Virology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; and Department of Biomedical Sciences, Faculty of Pharmaceutical, Veterinary and Biomedical Sciences, University of Antwerp, Antwerp, Belgium
Publication date: October 1, 2007
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