在秘鲁利马北部，肺结核门诊患者中HTLV - 1感染很常见。

HTLV-1 infection is frequent among out-patients with pulmonary tuberculosis in northern Lima, Peru.

作者信息

Verdonck K, González E, Henostroza G, Nabeta P, Llanos F, Cornejo H, Vanham G, Seas C, Gotuzzo E

机构信息

Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.

出版信息

Int J Tuberc Lung Dis. 2007 Oct;11(10):1066-72.

PMID:17945062

Abstract

SETTING

Tuberculosis (TB) and human T-lymphotropic virus 1 (HTLV-1) are frequent in Peru. The prevalence of HTLV-1 among Peruvian TB patients is unknown.

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.

摘要

背景

结核病（TB）和人类嗜T淋巴细胞病毒1型（HTLV-1）在秘鲁较为常见。秘鲁结核病患者中HTLV-1的流行率尚不清楚。

目的

确定结核病门诊患者中HTLV-1、HTLV-2和人类免疫缺陷病毒（HIV）的流行率，并比较HTLV-1感染患者与血清阴性患者。

设计

横断面研究，纳入2004年11月至2005年8月在利马北部卫生中心诊断为涂片阳性肺结核的18至65岁受试者。采用酶联免疫吸附试验进行HTLV和HIV筛查；使用线性免疫测定法确认HTLV-1和HTLV-2。

结果

共有311名参与者，中位年龄为29岁；173名（56%）为男性。HTLV-1流行率为5.8%（18/311，95%CI 3.2-8.4），HIV流行率为1.3%（4/304，95%CI 0.4-3.3）。未诊断出HTLV-2。与HIV和HTLV血清阴性患者相比，HTLV-1感染受试者年龄更大（中位年龄44岁对28岁，P<0.001），更有可能出生在安第斯山脉南部（OR 4.4，95%CI 1.6-11.9）。他们也更有可能报告家族中有结核病死亡史（OR 5.4，95%CI 1.7-16.8），且痰涂片结果评为3+的更多（OR 4.1，95%CI 1.5-11.2）。