Journal Of Acquired Immune Deficiency Syndromes, Volume 8, Issue 4 (1995). pp. 420-425.
Language:
English
Abstract:
The aim of this study was to compare rates of human T-cell lymphotropic virus type 1 (HTLV-I) seroprevalence in pregnant women belonging to different ethnic groups in French Guiana and to determine the risk factors associated with HTLV-I seropositivity. All 1,873 deliveries between 1 July 1991 and 30 June 1993 in the only gynecologic and obstetric unit at Saint Laurent du Maroni were enrolled. Serologic status could be established for 1,727 women, with 75 (4.3%) being HTLV-I seropositive. The HTLV-I seroprevalence rate differed significantly between ethnic groups: 5.7% for Noir-Matron (70/1,302), 6.3% for Haitian (3/50), and 0% for Creole (126), Amerindians (166), and Hmong (64). In Noir-Marron pregnant women, HTLV-I seropositivity was associated with a maternal age of >35 years [odds ratio (OR), 3.3; 95% confidence interval (CI), 1.4-7.6], prior miscarriage (OR, 1.7; CI, 1-2.8), prior cesarean section (OR, 2.1; CI, 1.1-.4.0), a parity >4 (OR, 4.0; CI, 1.8-8.8), a gravidity >6 (OR, 4.2; CI, 2.0-7.2), and a negative Rhesus factor (OR, 2.2; CI, 1.1-4.5). Two separate stepwise logistic regressions were done because gravidity and parity were highly correlated. HTLV-I seropositivity remained associated with a gravidity >6 (OR, 3.9; CI, 2.1-7.4) and a negative Rhesus factor (OR, 2.6; CI, 1.2-5.3) for the first model and with a parity >4 (OR, 4.1; CI, 1.9-9.0) and a negative Rhesus factor (OR, 2.5; CI, 1.2-5.1) for the second model. Thus, the Noir-Marron, descendents of fugitive slaves of African origin, with limited contact with other groups, represent a major reservoir for HTLV-I infection in French Guiana. High gravidity and parity are better markers of HTLV-I seropositivity than age because they may reflect a low socioeconomic status and/or a high number of lifetime sex partners. The association with a negative rhesus factor may reflect a genetic predisposition to HTLV-I infection, which merits further studies.