Geographical clustering of human T-cell lymphotropic virus type I in Guadeloupe, an endemic Caribbean area

Between January 1989 and December 1996, 59,426 blood donors from Guadeloupe (French West Indies) were screened for antibodies to human T-cell lymphotr opic virus type I (HTLV-I), Of these, 195 were confirmed as being positive for HTLV-I, yielding an overall prevalence of 0.33% [95% confidence interva l(CI) 0.28-0.38], On multiple logistic regression analysis, risk factors fo r HTLV-I were female gender [odds ratio (OR) 1.8; CI 1.3-2.4], increasing a ge (30-39 years, OR 2.2, CI 1.4-3.4; 40-49 years, OR 3.1, CI 2.1-4.7; great er than or equal to 50 years, OR 5.6, CI 3.6-8.6) and positive hepatitis B core antibodies (OR 2.0; CI 1.5-2.8), HTLV-I seropositivity was also signif icantly associated with current residence in certain areas, highlighting mi crogeographic clustering: individuals living along the Atlantic Facade of G uadeloupe, which is a traditional sugar cane plantation area where Africans were brought during slave trading, were at increased risk for HTLV-I infec tion (OR 1.9; CI 1.3-2.7) compared with other areas in Guadeloupe devoted t o other activities. Our report of HTLV-I cluster identification in Guadelou pe probably reflects both its low spread and its highly intrafamilial restr icted transmission within this endemic Caribbean population. (C) 1999 Wiley -Liss, Inc.