DEMOGRAPHIC AND FAMILIAL CHARACTERISTICS OF HTLV-I INFECTION AMONG ANISOLATED, HIGHLY ENDEMIC POPULATION OF AFRICAN ORIGIN IN FRENCH-GUIANA

To determine the epidemiological characteristics of human T cell leuke mia/lymphoma virus type I (HTLV-1) infection in the endemic village of Maripasoula, French Guiana, 1,614 persons (83.2% of the population) a ged 2 to 91 years (mean age 21) were studied from November 1994 throug h April 1995, Plasma samples were screened by an HTLV-I ELISA and an I FA test (on MT2 cells), and positive samples were tested by an HTLV-I and -II type-specific Western blot. Overall seropositivity in the vill age was 6.7%, but HTLV-I infection was restricted to 3 of 6 ethnic gro ups, including the Noir-Marron (descendants of escaped African slaves, 8%), the Creoles (4.1%) and those of mixed Noir Marron/other ethnicit y (3.6%), In the Noir-Marron population of 1,222 persons, including 60 6 men and 616 women and representing 76% of those tested, HTLV-I serop revalence increased significantly with age in both sexes, reaching 40% in women older than 50 years. Univariate risk factors for HTLV-I sero positivity in women included older age, more pregnancies, more live bi rths and a history of hospitalization. A cross-sectional analysis of s exual partners demonstrated an excess of discordant female HTLV-I+/mal e HTLV-I- couples, indicating preferential male-to-female sexual trans mission. The demonstration of II HTLV-I-seropositive children aged les s than 15 years, of whom 9 had a seropositive mother, suggested matern al-child HTLV-I transmission. Our results demonstrate a very high sero prevalence of HTLV-I in this South American population descended from African slaves, probably due to high rates of mother-to-child and sexu al transmission within this rather isolated group. (C) 1998 Wiley-Liss , Inc.