HTLV and HIV co-infection among key populations, Dominican Republic

Abstract

HTLV and HIV coinfections are not well characterized among most at-risk populations. Overall, there has been a decline in HTLV research in the past 24 years with few studies reporting current data on its prevalence in endemic countries. Past studies have shown that HTLV-1 and HIV coinfection causes increased HTLV-1 seropositivity and subsequent risk for tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM) and other neurological diseases in addition to reduced survival time. Based on the fact that HTLV and HIV share the same modes of transmission, the purpose of this investigation was to estimate the seroprevalence of HTLV IgG and HIV antibodies and to establish the prevalence of coinfection among two key populations, transactional sex workers (SWs) and drug users. A demographic, stratified sample of 200 sera was randomly selected in four high burden regions of Santo Domingo, Dominican Republic. Informed consent was obtained from each participant and each received pre- and post-counselling about HIV and HTLV transmission. Blood samples were drawn from each participant and screened for HIV and HTLV-1/2 IgG antibodies using ImmunoCombRII (Orgenics, Israel) products. Overall weighted seroprevalence of HTLV-1/2 IgG antibodies was 13.91% (CI: }6.32%) in men and 10.59% (CI: }6.54%) in women and for HIV-1 was 13.91% (CI: }6.32%) in men and 17.65% (CI: }8.10%). Of those HTLV positive, 50% of those men and 44.44% of those women were coinfected with HIV and half of whom were SWs. Seroprevalence of both HTLV and HIV antibodies detected among heterosexual SWs (33.33%) appears to be the most important route of transmission. Results call attention for more public health preventive strategies among key populations in the Dominican Republic and further investigation on the neurological complications experienced and clinically relevant effect of HTLV-1 on HIV positive patients in endemic regions.