Prevalence of HTLV-I-associated T-cell lymphoma

Abstract

In order to assess the prevalence rate of HTLV-1-associated T-cell lymphomas and human retrovirus infection in general, approximately 21,000 individuals representing various patient populations, retroviral risk groups, and blood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection using serologic and PCR assays. The prevalence rates among volunteer blood donors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increased HTLV prevalence rates were observed among paid blood donors, African American health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and family members of HTLV-positive people, and patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I versus HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade, CD4+ T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died from their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infection. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, and other-than-low-grade NHL patients. Only one patient was infected with HIV-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV-1 positives had B-cell lymphomas, one HIV-1 positive had an HTLV-I-positive CD4+ T-cell lymphoma, and one infected with HIV-2 had a CD4+ T-cell lymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, while uncommon, is not necessarily rare among other-than-low-grade NHL cases in the United States and, given its poor prognosis, should probably be studied separately in clinical trials.

Patterns of leukemia incidence in the United States by subtype and demographic characteristics, 1997–2002

“…The HTLV-1 virus is known to be endemic to the Caribbean and parts of Sub-Saharan Africa, and has been found to cluster in geographic areas of the U.S. with migrants from these regions [28]. The prevalence of the HTLV-1 virus has been reported to be highest among patients from health care clinics primarily serving AfricanAmericans [28,29]. However, only a small percentage of persons infected with the HTLV-1 virus develop adult T-cell leukemia/lymphoma, and it remains to be determined whether or not certain ethnic groups tend to develop cancer more easily once infected.…”

The non-Hodgkin lymphomas: A review of the epidemiologic literature

“…HTLV-I has been found to be associated with other NHL types, although uncommonly, and the etiologic fraction of overall NHL associated with HTLV-1 is believed to be relatively small. 469,592,593 Helicobacter pylori. Gastric infection with the bacterium Helicobacter pylori (H. pylori), a cause of peptic ulcer disease and gastric carcinoma, may also cause B-cell lymphomas, particularly mucosa-associated lymphoid tissue (MALT) tumors in the stomach.…”

Similar Regulation of Cell Surface Human T-Cell Leukemia Virus Type 1 (HTLV-1) Surface Binding Proteins in Cells Highly and Poorly Transduced by HTLV-1-Pseudotyped Virions

“…HTLV-1 and the closely related human T-cell leukemia virus type 2 (HTLV-2) are uncommon in the general populations of the United States and Europe. However, one recent study revealed that HTLV is prevalent in the United States among paid blood donors, African-American health care clinic patients, Amerindians, intravenous drug users, and patients with other-than-low-grade non-Hodgkin's lymphoma (52).…”