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  • Title: Human T-lymphotropic virus (HTLV I-II) infection among patients in an inner-city emergency department.
    Author: Kelen GD, DiGiovanna TA, Lofy L, Junkins E, Stein A, Sivertson KT, Lairmore M, Quinn TC.
    Journal: Ann Intern Med; 1990 Sep 01; 113(5):368-72. PubMed ID: 2382919.
    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 less than 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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