Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
EPIDEMIOLOGY OF ADULT T-CELL LEUKEMIA/LYMPHOMA AND THE ACQUIRED IMMUNODEFICIENCY SYNDROME
Retrovirus Biology and Human Disease. Gallo RC and Wong-Staal F, eds. New York, Marcel Dekker, p. 209-39, 1990.. Unique Identifier : AIDSLINE ICDB/91676225 Manns A; Blattner WA; Enviromental Epidemiology Branch, NCI, Bethesda, MD
Abstract:
The discovery of the first human retrovirus, human T-lymphotropic virus (HTLV-I), was facilitated by advances in virologic and cell culture techniques. HTLV-I was linked with a specific clinical syndrome, adult T-cell leukemia/lymphoma (ATLL); this finding set the stage for discovery of HTLV-II and HIV-1. HTLV-II was isolated initially from a patient with hairy cell leukemia, but has not been consistently associated with any single disease. HIV-1 is associated with AIDS. The epidemiologies are reviewed, covering for ATLL, historic overview, geographic distribution, incidence/prevalence of HTLV-I and ATLL, modes of HTLV-I transmission, and other disease associations; and for AIDS, historic overview, demographics (United States, Europe and Latin America, and Africa), clinical spectrum (opportunistic infections, AIDS-related cancers [Kaposi's sarcoma and lymphomas], neurologic syndromes), and transmission of HIV infection (blood and blood products, sexual transmission, iv drug use, maternal-infant transmission, occupational exposure, and casual contact). Several features of ATLL and HTLV-I infection are apparent: (1) The disease and virus are endemic among the Japanese; blacks in southeastern United States, Caribbean, and Africa; and some individuals exposed via travel or born in an endemic area. (2) There is an age-dependent increase in prevalence of infection, with disease incidence peaking in the mid-40s. (3) There are no male:female differences in occurrence of ATLL. (4) There is a worldwide geographic distribution, with rural and coastal areas showing increased prevalence. (5) Transmission has been demonstrated to be sexual (specifically male-to-female, mother-to-child), through cellular blood products, and by needle sticks. (6) There is generally a long incubation period between infection and disease onset. (7) There is an apparently low rate of infectivity secondary to inefficient transmission, although the discovery of new disease associations may establish a more prominent role for this retroviral infection. Epidemiology has contributed considerably to establishing the retrovirus association with human disease. (157 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/TRANSMISSION Comparative Study Cross-Cultural Comparison Cross-Sectional Studies Human Incidence Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/*EPIDEMIOLOGY/ TRANSMISSION Leukemia, T-Cell, HTLV-II-Associated/*EPIDEMIOLOGY/TRANSMISSION Risk Factors MONOGRAPH REVIEW
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
