Gabor D. Kelen, MD; Thomas A. DiGiovanna, MD; Lisa Lofy, MD; Edward Junkins, BS; Allen Stein, BS; Keith T. Sivertson, MD; Michael Lairmore, DVM, PhD; Thomas C. Quinn, MD
Objective: To determine the seroprevalence and epidemiologic features of human T-lymphotropic virus (HTLV I-II) among an emergency department patient population with a high rate of human immunodeficiency virus (HIV-I) infection.
Design: Prospective survey using identity-unlinked consecutive sampling during a 6-week period in 1988.
Setting: Inner-city teaching hospital.
Patients: Sequential sample of 2544 adult patients with sufficient excess sera for analysis.
Measurements and Main Results: Twenty-eight (1.1%) (95% CI, 0.7% to 1.5%) serum samples were seropositive for HTLV I-II whereas 152 (6.0%) (CI, 5.1% to 6.9%) were seropositive for HIV-I. The age distribution of HTLV I-II was similar to the study population while HIV-I was concentrated among younger (25 to 44 years) age groups (P < 0.05). Only 16 (57.1%) HTLV I-II infected patients had identified risk factors; 11 were intravenous drug users, 4 received transfusions, and 1 had heterosexual exposure to a high-risk partner. None of 39 identified homosexual men had HTLV I-II antibodies although 29 (74.3%) were HIV-I seropositive.
Conclusion: HTLV I-II infection may be more prevalent among certain segments of the U.S. population than previously realized and appears to have a different demographic distribution than HIV-I infection. Although HTLV I-II may represent a nosocomial risk to health care providers, the risk of occupational transmission is probably less than for hepatitis B virus and even HIV-I. Adherence to universal precautions should minimize the risk.
Kelen GD, DiGiovanna TA, Lofy L, Junkins E, Stein A, Sivertson KT, et al. Human T-Lymphotropic Virus (HTLV I-II) Infection among Patients in an Inner-City Emergency Department. Ann Intern Med. ;113:368–372. doi: 10.7326/0003-4819-113-5-368
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Published: Ann Intern Med. 1990;113(5):368-372.
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