Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
PLoS One. 2013 Sep 5;8(9):e73978. doi: 10.1371/journal.pone.0073978. eCollection 2013.
In an earlier study, we detected an association between human T-cell lymphotropic virus (HTLV) infection and cervical human papillomavirus (HPV) in indigenous Amazonian Peruvian women of the Shipibo-Konibo ethnic group. As both HTLV and HPV can be transmitted sexually, we now report a population-based study examining the prevalence and risk factors for HTLV-1 and HTLV-2 infection in this population.
Between July and December 2010, we conducted a comprehensive screening for HTLV among Shipibo-Konibo women 15 to 39 years of age living in two communities located in Lima and in 17 communities located within four hours by car or boat from the Amazonian city of Pucallpa in Peru.
We screened 1,253 Shipibo-Konibo women for HTLV infection 74 (5.9%) tested positive for HTLV-1, 47 (3.8%) for HTLV-2 infection, and 4 (0.3%) had indeterminate results. In the multivariate analysis, factors associated with HTLV-1 infection included: older age (Prevalence Ratio (PR): 1.04, 95% CI 1.00-1.08), primary education or less (PR: 2.01, 95% CI: 1.25-3.24), younger or same age most recent sex partner (PR: 1.66, 95% CI: 1.00-2.74), and having a most recent sex partner who worked at a logging camp (PR: 1.73, 95% CI: 1.09-2.75). The only factor associated with HTLV-2 infection was older age (PR: 1.08, 95% CI: 1.03-1.12).
HTLV infection is endemic among Shipibo-Konibo women. Two characteristics of the sexual partner (younger age and labor history) were associated with infection in women. These results suggest the need for implementation of both HTLV screening during the antenatal healthcare visits of Shipibo-Konibo women, and counseling about the risk of HTLV transmission through prolonged breastfeeding in infected women. We also recommend the implementation of prevention programs to reduce sexual transmission of these viruses.
在之前的研究中,我们发现人类 T 细胞嗜淋巴细胞病毒(HTLV)感染与秘鲁亚马逊地区的 Shipibo-Konibo 族裔土著妇女的宫颈人乳头瘤病毒(HPV)有关。由于 HTLV 和 HPV 均可通过性传播,因此我们现在报告了一项基于人群的研究,以检查该人群中 HTLV-1 和 HTLV-2 感染的患病率和危险因素。
2010 年 7 月至 12 月,我们对居住在利马的两个社区和位于亚马逊城市普卡尔帕的 17 个社区的 15 至 39 岁的 Shipibo-Konibo 妇女进行了全面的 HTLV 筛查。
我们对 1253 名 Shipibo-Konibo 妇女进行了 HTLV 感染筛查,其中 74 名(5.9%)HTLV-1 检测呈阳性,47 名(3.8%)HTLV-2 感染呈阳性,4 名(0.3%)结果不确定。在多变量分析中,与 HTLV-1 感染相关的因素包括:年龄较大(患病率比(PR):1.04,95%CI 1.00-1.08)、接受过小学或以下教育(PR:2.01,95%CI:1.25-3.24)、最近的性伴侣年龄较小或相同(PR:1.66,95%CI:1.00-2.74)以及最近的性伴侣在伐木营地工作(PR:1.73,95%CI:1.09-2.75)。唯一与 HTLV-2 感染相关的因素是年龄较大(PR:1.08,95%CI:1.03-1.12)。
HTLV 感染在 Shipibo-Konibo 妇女中流行。性伴侣的两个特征(年龄较小和工作经历)与女性感染有关。这些结果表明,需要在 Shipibo-Konibo 妇女的产前保健就诊期间进行 HTLV 筛查,并就感染妇女通过延长母乳喂养传播 HTLV 的风险提供咨询。我们还建议实施预防计划,以减少这些病毒的性传播。