Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department

Gabor D. Kelen, Thomas A. DiGiovanna, Lisa Lofy, Edward Junkins, Allen Stein, Keith T. Sivertson, Michael Dale Lairmore, Thomas C. Quinn

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

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-1) 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-1. The age distribution of HTLV I-II was similar to the study population while HIV-1 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-1 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-1 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-1. Adherence to universal precautions should minimize the risk.

Original languageEnglish (US)
Pages (from-to)368-372
Number of pages5
JournalAnnals of Internal Medicine
Volume113
Issue number5
StatePublished - Sep 1 1990
Externally publishedYes

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HTLV-II Infections
HTLV-I Infections
Human T-lymphotropic virus 2
HIV-1
Hospital Emergency Service
Human T-lymphotropic virus 1
Viruses
HIV Infections
HTLV-II Antibodies
HTLV-I Antibodies
Universal Precautions
Population
Urban Hospitals
Heterosexuality
Age Distribution
Seroepidemiologic Studies
Drug Users
Serum
Hepatitis B virus
Teaching Hospitals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kelen, G. D., DiGiovanna, T. A., Lofy, L., Junkins, E., Stein, A., Sivertson, K. T., ... Quinn, T. C. (1990). Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department. Annals of Internal Medicine, 113(5), 368-372.

Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department. / Kelen, Gabor D.; DiGiovanna, Thomas A.; Lofy, Lisa; Junkins, Edward; Stein, Allen; Sivertson, Keith T.; Lairmore, Michael Dale; Quinn, Thomas C.

In: Annals of Internal Medicine, Vol. 113, No. 5, 01.09.1990, p. 368-372.

Research output: Contribution to journalArticle

Kelen, GD, DiGiovanna, TA, Lofy, L, Junkins, E, Stein, A, Sivertson, KT, Lairmore, MD & Quinn, TC 1990, 'Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department', Annals of Internal Medicine, vol. 113, no. 5, pp. 368-372.
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. Annals of Internal Medicine. 1990 Sep 1;113(5):368-372.
Kelen, Gabor D. ; DiGiovanna, Thomas A. ; Lofy, Lisa ; Junkins, Edward ; Stein, Allen ; Sivertson, Keith T. ; Lairmore, Michael Dale ; Quinn, Thomas C. / Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department. In: Annals of Internal Medicine. 1990 ; Vol. 113, No. 5. pp. 368-372.
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abstract = "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-1) 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-1. The age distribution of HTLV I-II was similar to the study population while HIV-1 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-1 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-1 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-1. Adherence to universal precautions should minimize the risk.",
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