An age- and gender-specific distribution characterizes human T-cell lymphotrophic virus type-I (HTLV-I) seropositivity in Guadeloupe (French West Indies). Further epidemiological studies are required to identify other possible risk factors associated with this retroviral infection.A nested case-control study was conducted between 1997 and 1999 among blood donors. A total of 102 HTLV-I-positive subjects were matched (at a ratio of 1 : 3) by gender, age (+/-5 years) and donor status (new or regular) to 306 HTLV-I-negative controls. Information was obtained through a questionnaire assessing both environmental and behavioural variables.Factors independently associated with HTLV-I infection included a low level of education [odds ratio (OR) 6.61, confidence interval (CI) 2.89-15.15], black ethnicity (OR 3.28, CI 1.01-10.65), two or more sex partners in the previous 3 years (OR 2.43, CI 1.16-5.10), early age at first sexual intercourse (0.84 risk reduction per additional year, CI 0.76-0.93), a history of sexually transmitted diseases (OR 2.29, CI 1.0-5.34) and positive Chlamydia serology (OR 1.95, CI 1.03-3.68).These data provide a wide spectrum of features associated with HTLV-I seropositivity, especially sexual risk factors. It strongly suggests that heterosexual intercourse is an important route of HTLV-I transmission in Guadeloupe, even among low-risk populations such as blood donors.
We report 4 bloodstream infections associated with CC9 agr type II Staphylococcus aureus in individuals without animal exposure. We demonstrate, by microarray analysis, the presence of egc cluster, fnbA, cap operon, lukS, set2, set12, splE, splD, sak, epiD, and can, genomic features associated with a high virulence potential in humans.
Abstract: A patient with chronic lymphocytic leukaemia (CLL) progressive on fludarabine therapy and life‐threatening anaemia related to immune haemolysis and pure red cell aplasia was treated with Campath‐1H. The patient had sustained complete remission of both CLL and anaemia, but died of recurrent sepsis and cachexia 10 months after completion of the treatment. Campath‐1H (alemtuzumab), a humanised anti‐CD52 monoclonal antibody, is a potent therapeutic agent against advanced CLL and immune cytopenias. It could be indicated in the treatment of severe immune complications of CLL unresponsive to corticosteroids. Prolonged immunosuppression is a serious side‐effect leading to severe infectious complication.
In tropical or subtropical areas such as Southern Japan, the Caribbean, Central and South America, both human T-cell lymphotropic virus type I (HTLV-I) and Strongyloides stercoralisinfection are endemic (4, 8). Several studies have documented an unexpectedly high prevalence of S. stercoralisin HTLV-I carriers and of HTLV-I among S. stercoraliscarriers. The links between two such taxonomically distant infectious agents remain unclear and controversial. Japanese S. stercoralis carriers were found to have a significantly higher seroprevalence for HTLV-I than non-S. stercoralis carriers (5). But conversely, Jamaican HTLV-I carriers did not exhibit higher rates for S. stercoralis antibodies than HTLV-I negative subjects (6). In Guadeloupe, a French West Indian island, HTLV-I is endemic (9), whereas parasitic diseases, with the only exception of S. stercoralisinfection, have been largely eradicated in the last 20 years. We conducted a case control study among healthy blood donors in order to determine if HTLV-I infection is associated with S. stercoralis carriage. In Guadeloupe, subjects have to fulfill the French criteria for blood donation, i.e., fully informed consent, free donation, systematic pretest interview, and clinical examination; the sex ratio of Guadeloupean blood donors is about 1:1, and the mean age is 32 years (range, 18 to 65 years).
This case control study was conducted among female blood donors in Guadeloupe. A total of 85 HTLV-1 positive subjects were matched by age (+/- 5 years) in a 1:3 ratio to 255 HTLV-1 negative controls. The mean age was 48.5 and 48.9 years respectively. Ethnic, environmental and socio-economic risk factors were studied. Four risk factors were found independently associated with HTLV-1 seropositivity: Strongyloides stercoralis antibodies (OR = 3.6, CI 1.8, 7.3), low socio-economic status (OR = 2.0 CI 1.0, 4.0), low educational level (OR = 2.0 CI 1.0, 4.0) and agricultural activity (OR = 2.8 CI 1.4, 5.6). This logistic regression analysis demonstrates the reality of the association between HTLV-1 carriers and Strongyloides stercoralis, and its association with socio-economic and environmental risk factors.
To determine the role of enteric pathogens in acute childhood diarrhoea in Guadeloupe, 161 children (108 cases and 53 controls) from 0 to 2 years of age, admitted to Pointe-à-Pitre/Abymes University Hospital, were evaluated over a five-month period. A known enteric pathogen was identified in 40.8% of children. The most commonly identified aetiologic agents were Salmonella (16.7% of cases), especially Haddar serotype and Rotavirus (20.5%). This virus was isolated more often in the dry season. Adenovirus were detected in 3.6% of diarrhoeal stools and were not significatively associated with diarrhoeal disease. No Shigella, Campylobacter or parasites were found.
ABSTRACT To investigate the significance of serological human T-cell lymphotropic virus type 1 (HLTV-1) Gag indeterminate Western blot (WB) patterns in the Caribbean, a 6-year (1993 to 1998) cross-sectional study was conducted with 37,724 blood donors from Guadeloupe (French West Indies), whose sera were routinely screened by enzyme immunoassay (EIA) for the presence of HTLV-1 and -2 antibodies. By using stringent WB criteria, 77 donors (0.20%) were confirmed HTLV-1 seropositive, whereas 150 (0.40%; P < 0.001) were considered HTLV seroindeterminate. Among them, 41.3% (62) exhibited a typical HTLV-1 Gag indeterminate profile (HGIP). Furthermore 76 (50.7%) out of the 150 HTLV-seroindeterminate subjects were sequentially retested, with a mean duration of follow-up of 18.3 months (range, 1 to 70 months). Of these, 55 (72.4%) were still EIA positive and maintained the same WB profile whereas the others became EIA negative. This follow-up survey included 33 persons with an HGIP. Twenty-three of them (69.7%) had profiles that did not evolve over time. Moreover, no case of HTLV-1 seroconversion could be documented over time by studying such sequential samples. HTLV-1 seroprevalence was characterized by an age-dependent curve, a uniform excess in females, a significant relation with hepatitis B core (HBc) antibodies, and a microcluster distribution along the Atlantic coast of Guadeloupe. In contrast, the persons with an HGIP were significantly younger, had a 1:1 sex ratio, did not present any association with HBc antibodies, and were not clustered along the Atlantic façade. These divergent epidemiological features, together with discordant serological screening test results for subjects with HGIP and with the lack of HTLV-1 proviral sequences detected by PCR in their peripheral blood mononuclear cell DNA, strongly suggest that an HGIP does not reflect true HTLV-1 infection. In regard to these data, healthy blood donors with HGIP should be reassured that they are unlikely to be infected with HTLV-1 or HTLV-2.
