Abstract:
The purpose of this study was to define (1) the distribution and the mode of transmission of HTLV-I in Gabon, (2) the diagnostic value of HTLV-I serology compared with PCR, and (3) the clinical implications of infection with this virus in Gabon. The distribution of HTLV-I in the general adult populations of five central African countries was heterogenous with an increasing gradient of infection rates, ranging from the lack of infection in Chad to about 10% in the tropical equatorial rain forest. In a community living in a high HTLV-I seroprevalence area the main variables associated with HTLV-I antibody were age, sex and ethnic group. In Franceville mother-to-child transmission and blood transfusion were equally implicated for HTLV-I infection among hospitalized children. A prospective cohort study on mother-to-child transmission showed the absence of HTLV-I DNA by PCR in cord blood of newborns from seropositive mothers and the absence of reappearance of HTLV-I antibody in infants born from seropositive mothers at 1 yr of age, which are strong arguments for the predominance of a postnatal transmission. In contrast with HIV infection women with a high rate of sexually transmitted diseases were not more often infected with HTLV-I than controls. By PCR the significance of indeterminate HTLV-I WB patterns (1/4 corresponds to HTLV infections) and the type of HTLV infections were identified (HTLV-I is predominant but HTLV-II is also present). Clinical manifestations related to HTLV-I exist in Gabon, but their importance in terms of public health priorities appears limited. The minimal annual incidence rate of tropical spastic paraparesis is about 0.2 per 1000 infected persons. Cases of adult T-lymphoma/leukemia (ATLL) were diagnosed in Libreville and the roughly minimal incidence of ATLL is also 0.2 per 1000. Full text available from University Microfilms International, Ann Arbor, MI, as Order No. AAD93-07510)
Keywords: *HTLV-I Infections/EPIDEMIOLOGY 931130
M93B5833
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