RESUMO
A Peruvian female prostitute population was evaluated over a 3-year period to determine the incidence and risk factors of retroviral and viral hepatitis transmission. At three survey periods, a questionnaire was administered and serum samples were obtained. A total of 966 subjects were studied, with 34% followed for 38 months, 22% followed for 18 months, and 44% evaluated just once. On initial evaluation, 3 (0.3%) had HIV-1 antibody, 170 (17.6%) had HTLV-I antibody, 578 (59.8%) had anti-HBc, and 7 (0.7%) had antibody to hepatitis C virus. The mean annual incidence of HTLV-I and hepatitis B infection was 1.6% and 4.7%, respectively. Univariate and logistic regression analysis of prevalence data indicated an association between sexual activity and HTLV-I and hepatitis B infection, but no independent risk factors were identified in cohort analysis. Parenteral risk factors were not associated with transmission, except for a small percentage of subjects who may have acquired hepatitis B infection from blood transfusions. These findings suggest that there is a high incidence of HTLV-I and hepatitis B infection from heterosexual contact in this female prostitute population.
Assuntos
Infecções por HTLV-I/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Hepatite Viral Humana/epidemiologia , Trabalho Sexual , Adulto , Feminino , Anticorpos Anti-HIV/sangue , HIV-1/imunologia , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/transmissão , Hepacivirus/imunologia , Anticorpos Anti-Hepatite/sangue , Hepatite B/transmissão , Anticorpos Anti-Hepatite B/sangue , Hepatite C/transmissão , Anticorpos Anti-Hepatite C , Hepatite Viral Humana/transmissão , Humanos , Incidência , Pessoa de Meia-Idade , Peru/epidemiologia , Prevalência , Modelos de Riscos Proporcionais , Análise de Regressão , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Reação TransfusionalRESUMO
The heterogeneity of immune responsiveness to the immunodominant epitopes of human T lymphotropic virus (HTLV) types I (MTA-1(162-209)) and II (K-55(162-205)) were determined in natural infections with HTLV-I and -II from diverse geographic areas (n = 285). Of the HTLV-I specimens confirmed by polymerase chain reaction (PCR), all North American (n = 37) and Peruvian (n = 19) specimens reacted with MTA-1. Of HTLV-II specimens confirmed by PCR, 44 (96%) of 46 from North American blood donors, 28 (97%) of 29 from native Americans, and all from intravenous drug users (n = 29) reacted with K-55. Specimens from other geographic areas (Peru, 30; Brazil, 4; Mexico, 10; Italy, 5; Somalia, 13; Ethiopia, 17; Japan, 32; and Jamaica, 15) all reacted either with MTA-1 or K-55. By synthetic peptide-based serologic typing, all of these specimens could be typed as HTLV-I or -II. In addition to the direct implications of these findings for diagnostic purposes, these data provide indirect evidence for the conservation of immunodominant HTLVenv epitopes in diverse geographic populations.
Assuntos
Epitopos/análise , Produtos do Gene gag/análise , Produtos do Gene gag/imunologia , Anticorpos Anti-HTLV-I/sangue , Anticorpos Anti-HTLV-II/sangue , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Vírus Linfotrópico T Tipo 2 Humano/imunologia , Proteínas do Envelope Viral/análise , Proteínas do Envelope Viral/imunologia , África , Doadores de Sangue , Geografia , Humanos , Imunoensaio , Jamaica , México , América do Norte , Reação em Cadeia da Polimerase/métodos , Proteínas Recombinantes/imunologia , América do SulRESUMO
The epidemiology of HTLV-I infection in female prostitutes was studied in a survey of 395 prostitutes from Callao, Peru (the port city of Lima), 72 prostitutes from Iquitos, Peru (another port city on the Amazon River), and 510 prenatal clinic patients from Lima. Prostitutes reported a mean of 8.8 years (range, 1-39 years) of active prostitution and a mean of 205 sexual contacts during the month prior to the study. The percentage of prostitutes with HTLV-I antibody (21.8%) was significantly higher than patients attending a prenatal clinic (3.1%; P less than .0001). The prevalence of HTLV-I antibody increased steadily with age in prostitutes, but no age trend was noted in prenatal patients. By multiple logistic regression analysis, an independent association was found between HTLV-I seropositivity and a history of prostitution in Callao, age, and positive syphilis serology when all 977 study subjects were evaluated. When prostitutes alone were analyzed, the number of years of exposure as a practicing prostitute was associated with HTLV-I seropositivity after controlling for age. These data indicate a greatly increased risk of HTLV-I infection in prostitutes in Callao, Peru, and suggest an association between sexual activity and HTLV-I transmission.