Seroprevalence of human T-cell lymphotropic virus type I among pregnant women in Accra, Ghana

Abstract

Infection with human T-cell lymphotropic virus type I (HTLV-I) occurs mainly in Japan, Central and West Africa and the Caribbean Basin. Although antibody to HTLV-I has been reported among pregnant women in several endemic countries, there is no information regarding the seroprevalence in pregnant Ghanaian women. The reported seroprevalence of HTLV-I among healthy Ghanaian blood donors is between 0?5 and 4?2 %. Therefore, this study was conducted to determine the seroprevalence of HTLV-I among pregnant women attending the antenatal clinic at the 37 Military Hospital, Accra, Ghana, between the months of January and December 2003. The presence of antibodies specific for HTLV-I/II was tested using a particle agglutination test (PAT) kit and confirmed by Western blotting (WB). Of the 960 sera tested, HTLV-I/II antibodies were detected in 24 samples using the PAT kit. WB results indicated that, of the 24 positive PAT specimens, 20 specimens (83?3 %) were HTLV-I positive, one (4?2 %) was HTLV-II positive, two (8?3 %) were HTLV positive and one (4?2 %) was indeterminate. Therefore, the overall seroprevalence of HTLV-I was 2?1 %. Seroprevalence increased with age, suggesting sexual contact as the primary mode of transmission among women of childbearing age, rather than breastfeeding during infancy. The seroprevalence of 2?1 % reported here for HTLV-I in pregnant women in Accra is comparable to that of human immunodeficiency virus among the same population. In conclusion, the results indicate that HTLV-I is prevalent among asymptomatic Ghanaian pregnant women and thus there is a need to consider introducing antenatal screening for HTLV-I in Ghana. INTRODUCTIONHuman T-cell lymphotropic virus type I (HTLV-I) is known to be the pathogenic agent of adult T-cell leukaemia/lymphoma (ATLL) (Poiesz et al., 1980;Yoshida et al., 1982) and HTLV-I-associated myelopathy/tropical spastic paraparesis (Gessain et al., 1985; Osame et al., 1987). ATLL develops after a long incubation period, with an estimated lifetime risk of approximately 3-8 % in individuals infected before the age of 20 years (Cleghorn et al., 1995). As the prognosis for patients with ATLL is extremely poor, with median survival after diagnosis of <6 months (Takatsuki et al., 1996), the prevention of mother-to-child transmission of HTLV-I is of the utmost importance. HTLV-I is not ubiquitous, but is endemic in some geographical areas and among some ethnic groups. Population-based studies have reported the prevalence of antibody to HTLV-I to range from 3-6 % in Jamaica, Trinidad and the Caribbean islands to 23?2 % in Nagasaki Prefecture in south-western Japan (Blattner et al., 1990;Murphy et al., 1991; Kishihara et al., 2001). High HTLV-I seroprevalence rates (>2 % in the adult population) have been described in southern Japan, sub-Saharan Africa, the Caribbean Basin, parts of South America and some areas of Melanesia and the Middle East, where 15-20 million people are infected with this virus (Kazanji & Gessain, 2003). In every endemic population, there is an increase i...

Seroprevalence of Human T-Cell Lymphoma/Leukemia Virus Type-1 (HTLV-1) Antibodies among Blood Donors at Ibadan, Nigeria

“…Probably due to the lower number of the participants in that study. The result of the current study is also slightly higher than those obtained from other West African countries; 1.5% in one study in Benin Republic [19] and 2.1% in Ghana [20]. This study shows that the majority of the blood donors are below the age of 30 years (42.4%) when compared with those between the ages of 30 and 40 years (36.8%) and those above 40 years of age (20.8%).…”

“…There was also no significant association between the sero-prevalence of HTLV I/II and the level of education of the participants, but a higher percentage of positivity was found among those with secondary school education (3.7% vs. 2.9%). Sexual transmission of HTLV I and II appears to be relatively inefficient when compared with the transmission of HIV with a risk of HTLV I and II transmission from husband to wife to be 60.8% and from wife to husband to be 0.4% over a 10-year period [18][19][20][21][22][23]. This study did not show any significant association between sexual behaviours of the participants and the sero-prevalence of HTLV I and II.…”

High prevalence of HTLV-I infection in Mashhad, Northeast Iran: A population-based seroepidemiology survey

“…24 The increase in HTLV-I infection with age and the low seroprevalence in the youngest age suggest that sexual contact might be the primary route of HTLV-I transmission and breast feeding during infancy has a small fraction attributable to the seroprevalence. 25,26 Taken together, a birth cohort effect should be taken into account in the age-dependent rise in HTLV-I prevalence. 27 This effect observed in this study for HTLV-I suggests that improved screening strategies might be applied to 35 and above years old in Mashhad.…”

Description of a “Trans-Saharan” Strain of Human T-Lymphotropic Virus Type 1 in West Africa

“…7 HTLV-1 is widespread in sub-Saharan Africa, particularly in West and Central Africa. In West Africa, the reported rates of seropositivity for anti-HTLV-1 antibodies vary from 1% to more than 5% among blood donors and/or pregnant women in Ghana, 8 Benin, 9 Burkina Faso, 10 Mali, 11 Senegal, 12 Nigeria, 13 and Guinea Bissau. 14 The prevalence of HTLV-1 infection in Guinea Bissau is one of the highest in Africa.…”