       Document 0074
 DOCN  M9620074
 TI    Risk factors and cofactors for human T-cell lymphotropic virus type I
       (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in
       Jamaica.
 DT    9602
 AU    Kramer A; Maloney EM; Morgan OS; Rodgers-Johnson P; Manns A; Murphy EL;
       Larsen S; Cranston B; Murphy J; Benichou J; et al; Viral Epidemiology
       Branch, National Cancer Institute, National; Institutes of Health,
       Rockville, MD, USA.
 SO    Am J Epidemiol. 1995 Dec 1;142(11):1212-20. Unique Identifier : AIDSLINE
       MED/96071716
 AB    Human T-cell lymphotropic virus type I (HTLV-I) has been etiologically
       associated with a neurologic syndrome called HTLV-I-associated
       myelopathy/tropical spastic paraparesis (HAM/TSP) as well as with adult
       T-cell leukemia/lymphoma. The authors sought to quantify the risk in
       Jamaica of HAM/TSP associated with HTLV-I infection and cofactors
       associated with this disease among infected individuals. Between 1988
       and 1989, prevalent and incident HAM/TSP patients and controls with
       other neurologic diseases were enrolled in a retrospective study. A
       second control group was composed of HTLV-I-seropositive, asymptomatic
       carriers in Jamaica, ascertained in a separate study conducted in 1988.
       Although HTLV-I seropositivity was not a component of the case
       definition for HAM/TSP, all 43 HAM/TSP patients were HTLV-I seropositive
       compared with two (4.0%) of the controls with other neurologic diseases.
       Given HTLV-I seropositivity, one cofactor associated with the risk of
       HAM/TSP was young age at initial heterosexual confidence interval
       1.29-12.46 for individuals aged < or = 15; odds ratio = 4.26, 95%
       confidence interval 1.41-12.90 for individuals aged 16-17 years at
       initial intercourse). Among individuals who reported this early age at
       initial sexual intercourse, an increased risk of HAM/TSP was associated
       with having reported more than five lifetime sexual partners (odds ratio
       = 2.88, 95% confidence interval 0.90-8.70). Neither an early age at
       initial sexual intercourse or the number of lifetime sexual partners was
       a risk factor for adult T-cell leukemia/lymphoma. These data support the
       hypothesis that HAM/TSP is associated with sexually acquired HTLV-I
       infection, whereas adult T-cell leukemia/lymphoma is not.
 DE    Adolescence  Adult  Age Factors  Aged  Comparative Study  Female  Human
       Jamaica/EPIDEMIOLOGY  Leukemia-Lymphoma, T-Cell, Acute,
       HTLV-I-Associated/EPIDEMIOLOGY  Logistic Models  Male  Middle Age
       Paraparesis, Tropical Spastic/*EPIDEMIOLOGY/IMMUNOLOGY/  TRANSMISSION
       Retrospective Studies  Risk Factors  Serodiagnosis  Sex Behavior
       Sexually Transmitted Diseases, Viral/*EPIDEMIOLOGY/IMMUNOLOGY  Support,
       U.S. Gov't, P.H.S.  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

