1990 年至 2007 年间，农村几内亚比绍的 HTLV-1：流行率、发病率以及与 HIV 的持续关联。
HTLV-1 in rural Guinea-Bissau: prevalence, incidence and a continued association with HIV between 1990 and 2007.
机构信息
Medical Research Council, Fajara, The Gambia.
出版信息
Retrovirology. 2010 Jun 4;7:50. doi: 10.1186/1742-4690-7-50.
BACKGROUND
HTLV-1 is endemic in Guinea-Bissau, and the highest prevalence in the adult population (5.2%) was observed in a rural area, Caió, in 1990. HIV-1 and HIV-2 are both prevalent in this area as well. Cross-sectional associations have been reported for HTLV-1 with HIV infection, but the trends in prevalence of HTLV-1 and HIV associations are largely unknown, especially in Sub Saharan Africa. In the current study, data from three cross-sectional community surveys performed in 1990, 1997 and 2007, were used to assess changes in HTLV-1 prevalence, incidence and its associations with HIV-1 and HIV-2 and potential risk factors.
RESULTS
HTLV-1 prevalence was 5.2% in 1990, 5.9% in 1997 and 4.6% in 2007. Prevalence was higher among women than men in all 3 surveys and increased with age. The Odds Ratio (OR) of being infected with HTLV-1 was significantly higher for HIV positive subjects in all surveys after adjustment for potential confounding factors. The risk of HTLV-1 infection was higher in subjects with an HTLV-1 positive mother versus an uninfected mother (OR 4.6, CI 2.6-8.0). The HTLV-1 incidence was stable between 1990-1997 (Incidence Rate (IR) 1.8/1,000 pyo) and 1997-2007 (IR 1.6/1,000 pyo) (Incidence Rate Ratio (IRR) 0.9, CI 0.4-1.7). The incidence of HTLV-1 among HIV-positive individuals was higher compared to HIV negative individuals (IRR 2.5, CI 1.0-6.2), while the HIV incidence did not differ by HTLV-1 status (IRR 1.2, CI 0.5-2.7).
CONCLUSIONS
To our knowledge, this is the largest community based study that has reported on HTLV-1 prevalence and associations with HIV. HTLV-1 is endemic in this rural community in West Africa with a stable incidence and a high prevalence. The prevalence increases with age and is higher in women than men. HTLV-1 infection is associated with HIV infection, and longitudinal data indicate HIV infection may be a risk factor for acquiring HTLV-1, but not vice versa. Mother to child transmission is likely to contribute to the epidemic.
背景
HTLV-1 在几内亚比绍流行，在 1990 年农村地区的成年人中观察到的最高流行率（5.2%）。该地区也存在 HIV-1 和 HIV-2。已经报道了 HTLV-1 与 HIV 感染的横断面关联，但 HTLV-1 和 HIV 关联的流行率趋势在很大程度上尚不清楚，尤其是在撒哈拉以南非洲。在当前的研究中，使用了 1990 年、1997 年和 2007 年进行的三项横断面社区调查的数据，评估了 HTLV-1 流行率、发病率及其与 HIV-1 和 HIV-2 的关联以及潜在危险因素的变化。
结果
1990 年 HTLV-1 的流行率为 5.2%，1997 年为 5.9%，2007 年为 4.6%。在所有 3 项调查中，女性的流行率均高于男性，且随年龄增长而增加。在调整潜在混杂因素后，所有调查中 HIV 阳性者感染 HTLV-1 的优势比（OR）均显著升高。与未感染母亲的母亲相比，感染 HTLV-1 的母亲的 HTLV-1 感染风险更高（OR 4.6，95%CI 2.6-8.0）。1990-1997 年（发病率（IR）1.8/1000 人年）和 1997-2007 年（IR 1.6/1000 人年）（发病率比（IRR）0.9，95%CI 0.4-1.7）之间 HTLV-1 的发病率保持稳定。与 HIV 阴性个体相比，HIV 阳性个体的 HTLV-1 发病率更高（IRR 2.5，95%CI 1.0-6.2），而 HIV 发病率不受 HTLV-1 状态的影响（IRR 1.2，95%CI 0.5-2.7）。
结论
据我们所知，这是报告 HTLV-1 流行率及其与 HIV 关联的最大的基于社区的研究。HTLV-1 在西非这个农村社区流行，发病率稳定，流行率较高。流行率随年龄增长而增加，女性高于男性。HTLV-1 感染与 HIV 感染相关，纵向数据表明 HIV 感染可能是感染 HTLV-1 的危险因素，但反之则不然。母婴传播可能导致该疾病流行。
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