RISK-FACTORS FOR MATERNAL HTLV-I INFECTION IN FRENCH-GUIANA - HIGH HTLV-I PREVALENCE IN THE NOIR-MARRON POPULATION

The aim of this study was to compare rates of human T-cell lymphotropi c virus type I (HTLV-I) seroprevalence in pregnant women belonging to different ethnic groups in French Guiana and to determine the risk fac tors associated with HTLV-I seropositivity. All 1,873 deliveries betwe en 1 July 1991 and 30 June 1993 in the only gynecologic and obstetric unit at Saint Laurent du Maroni were enrolled. Serologic status could be established for 1,727 women, with 75 (4.3%) being HTLV-I seropositi ve. The HTLV-I seroprevalence rate differed significantly between ethn ic groups: 5.7% for Noir-Marron (70/1,302), 6.3% for Haitian (3/50), a nd 0% for Creole (126), Amerindians (166), and Hmong (64). In Noir-Mar ron pregnant women, HTLV-I seropositivity was associated with a matern al age of > 35 years [odds ratio (OR), 3.3; 95% confidence interval (C I), 1.4-7.6], prior miscarriage (OR, 1.7; CI, 1-2.8), prior cesarean s ection (OR, 2.1; CI, 1.1-4.0), a parity > 4 (OR, 4.0; CI, 1.8-8.8), a gravidity > 6 (OR, 4.2; CI, 2.0-7.2), and a negative Rhesus factor (OR , 2.2; CI, 1.1-4.5). Two separate stepwise logistic regressions were d one because gravidity and parity were highly correlated. HTLV-I seropo sitivity remained associated with a gravidity > 6 (OR, 3.9; CI, 2.1-7. 4) and a negative Rhesus factor (OR, 2.6; CI, 1.2-5.3) for the first m odel and with a parity > 4 (OR, 4.1; CI, 1.9-9.0) and a negative Rhesu s factor (OR, 2.5; CI, 1.2-5.1) for the second model. Thus, the Noir-M arron, descendents of fugitive slaves of African origin, with limited contact with other groups, represent a major reservoir for HTLV-I infe ction in French Guiana. High gravidity and parity are better markers o f HTLV-I seropositivity than age because they may reflect a low socioe conomic status and/or a high number of lifetime sex partners. The asso ciation with a negative rhesus factor may reflect a genetic predisposi tion to HTLV-I infection, which merits further studies.