PREVALENCE OF ANTIBODIES TO HTLV IN ANTENATAL CLINIC ATTENDERS IN SOUTH EAST LONDON

The prevalence of antibodies to HTLV in women attending a south east L ondon antenatal clinic between October 1990 and July 1992 was determin ed using sera referred for routine rubella antibody testing. Samples w ere screened for HTLV antibody using a modified Fujirebio gel particle agglutination test and reactive sera confirmed by ELISA (Abbott Labor atories, North Chicago, IL) and two commercial Western blots (Cambridg e Biotech Inc., Rockville, MD, and Diagnostic Biotechnology, Genelab D iagnostics, Louvaine, Belgium). This strategy confirmed the presence o f HTLV-1 antibodies in 12 out of 6,289 sera (0.19%, 95% confidence lim its 0.083% to 0.30%) and HTLV-2 antibodies in 2 (0.03%) sera. Specimen s from 8 of 821 (0.97%, 95% confidence limits 0.42% to 1.9%) Afro-Cari bbean women, three of 1,136 (0.26%, 95% confidence limits 0.055% to 0. 78%) African women, and one of 3,049 (0.033%, 95% confidence limits 0. 006% to 0.18%) Caucasian women were positive for HTLV-1 antibodies. Se ra from Afro-Caribbean women born in the Caribbean were 7.6 times more likely to be HTLV-1 antibody positive than sera from Afro-Caribbean w omen born in the UK (P = 0.012). Selective testing of Afro-Caribbean a nd African antenatal clinic attenders, in this setting, would have ide ntified 11 of the 12 HTLV-1 infections at an estimated cost of prevent ion of HTLV-1 associated disease of pound 100,000 per case which is co nsiderably less than the pound 1.3 million which has been estimated to prevent a case by universal screening of UK blood donors. (C) 1997 Wi ley-Liss, Inc.