Khabbaz R F, Onorato I M, Cannon R O, Hartley T M, Roberts B, Hosein B, Kaplan J E
Division of Viral and Rickettsial Diseases, Centers for Disease Control, Atlanta, GA 30333.
N Engl J Med. 1992 Feb 6;326(6):375-80. doi: 10.1056/NEJM199202063260604.
Background. The human T-cell lymphotropic virus Type I (HTLV-I) is associated with adult T-cell leukemia and myelopathy, whereas HTLV-II infection has uncertain clinical consequences. We assessed the seroprevalence of these retroviruses among intravenous drug users and among patients seen at clinics for sexually transmitted diseases (STD clinics).
We used serum samples that were collected in eight cities in 1988 and 1989 during surveys of human immunodeficiency virus infection among intravenous drug users entering treatment and persons seen in STD clinics. The serum samples were tested for antibodies to HTLV, and positive specimens were tested further by a synthetic peptide-based enzyme-linked immunosorbent assay to differentiate between HTLV-I and HTLV-II.
Among 3217 intravenous drug users in 29-drug-treatment centers, the median seroprevalence rates of HTLV varied widely according to city (range, 0.4 percent in Atlanta to 17.6 percent in Los Angeles). Seroprevalence increased sharply with age, to 32 percent in persons over 44 years of age. HTLV infection was more common among blacks (15.5 percent) and Hispanics (10.7 percent) than among whites (4.1 percent), and it was strongly associated with a history of heroin injection (P less than or equal to 0.001). Among 5264 patients in 24 STD clinics, the median rates of HTLV infection were much lower (range, 0.1 percent in Atlanta and Newark to 2.0 percent in Los Angeles). Again, this infection was more common among intravenous drug users (7.6 percent) than among non-drug users (0.7 percent). Eighty-four percent of the seropositive samples from drug-treatment centers and 69 percent of those from STD clinics were due to HTLV-II infection (P = 0.03).
HTLV infections are common among intravenous drug users and are primarily caused by HTLV-II. Among patients seen at STD clinics, HTLV is strongly associated with intravenous drug use, but the retrovirus is also prevalent among non-drug users.
背景。人类嗜T淋巴细胞病毒I型（HTLV-I）与成人T细胞白血病和脊髓病相关，而HTLV-II感染的临床后果尚不确定。我们评估了这些逆转录病毒在静脉吸毒者以及性病门诊患者中的血清流行率。
我们使用了1988年和1989年在八个城市收集的血清样本，这些样本来自接受治疗的静脉吸毒者以及性病门诊的患者，当时正在对他们进行人类免疫缺陷病毒感染情况的调查。检测血清样本中抗HTLV抗体，对阳性样本进一步采用基于合成肽的酶联免疫吸附试验来区分HTLV-I和HTLV-II。
在29个戒毒治疗中心的3217名静脉吸毒者中，HTLV的血清流行率中位数因城市而异（范围从亚特兰大的0.4%到洛杉矶的17.6%）。血清流行率随年龄急剧上升，44岁以上人群中达到32%。HTLV感染在黑人（15.5%）和西班牙裔（10.7%）中比在白人（4.1%）中更常见，并且与海洛因注射史密切相关（P≤0.001）。在24个性病门诊的5264名患者中，HTLV感染率中位数要低得多（范围从亚特兰大和纽瓦克的0.1%到洛杉矶的2.0%）。同样，这种感染在静脉吸毒者（7.6%）中比在非吸毒者（0.7%）中更常见。来自戒毒治疗中心的血清阳性样本中有84%以及来自性病门诊的样本中有69%是由HTLV-II感染所致（P = 0.03）。
HTLV感染在静脉吸毒者中很常见，主要由HTLV-II引起。在性病门诊患者中，HTLV与静脉吸毒密切相关，但这种逆转录病毒在非吸毒者中也很普遍。
