FINDINGS FROM THE MIYAZAKI COHORT STUDY

The purpose of the Miyazaki Cohort Study is to describe and analyze th e natural history of human T-cell lymphotropic virus type I (HTLV-I) i n a highly endemic population in southwestern Japan. As of August 1995 , 1,960 individuals have been enrolled, of whom 27% were HTLV-I antibo dy positive at baseline. Our achievements over the past decade of foll owing this cohort include the identification of several viral markers that characterize high-risk carriers and the documentation that carrie rs have subclinical evidence of impaired cellular immunity. We have be gun to estimate the impact of the infection on the health of carriers and have found that men are at greater risk of HTLV-I-associated disea ses than women, We have been able to identify prospectively risk facto rs associated with sexual transmission. Most important, by identifying subclinical markers of pathogenesis, we hope to provide the foundatio n for developing interventions to prevent HTLV-I-associated disease.