Prevalence of HTLV-I-associated T-cell lymphoma

In order to assess the prevalence rate of HTLV-l-associated T-cell lymphoma s and human retrovirus infection in general, approximately 21,000 individua ls representing various patient populations, retroviral risk groups, and bl ood donors were examined for HTLV-I, HTLV-II, HIV-1, or HIV-2 infection usi ng serologic and PCR assays. The prevalence rates among volunteer blood don ors were 0.02% and 0% for HTLV and HIV, respectively. Significantly increas ed HTLV prevalence rates were observed among paid blood donors, African Ame rican health care clinic patients, Amerindians, recipients of HTLV-positive cellular blood products, intravenous drug users, sexual contacts and famil y members of HTLV-positive people, end patients with primary thrombocytosis and other-than-low-grade non-Hodgkin's lymphoma (NHL). Among some of these groups there were significant differences in the prevalence of HTLV-I vers us HTLV-II. The eight HTLV-positive NHL patients all had mature, high-grade , CD4(+) T-cell lymphomas with clonally integrated HTLV-I, for a prevalence of 4% among other-than-low-grade NHL patients. Seven of the eight died fro m their disease within 2 years despite treatment. Interestingly, two groups at risk for HTLV infection, namely needle stick victims and recipients of HTLV-infected and/or pooled plasma products, showed no evidence for infecti on. Significantly increased HIV-1 prevalence was observed among paid blood donors, African Americans, homosexuals, female prostitutes, hemophiliacs, a nd other-than-low-grade NHL patients. Only one patient was infected with HI V-2. Of the nine HIV-positive, other-than-low-grade NHL patients, seven HIV -I positives had B-cell lymphomas, one HIV-1 positive had an HTLV-l-positiv e CD4(+) T-cell lymphoma, and one infected with HIV-2 had a CD4(+) T-cell l ymphoma that was HTLV negative. The data indicate that HTLV-I lymphoma, whi le uncommon, is not necessarily rare among other-than-low-grade NHL cases i n the United States and, given its poor prognosis, should probably be studi ed separately in clinical trials. (C) 2001 Wiley-Liss, Inc.