Increased prevalence of HTLV-1 among HIV-2-infected women but not HIV-2-infected men in rural Guinea-Bissau

Objective: To assess the prevalence of HTLV infection and its association with HIV and other potential risk factors. Design and Setting: A cross-sectional survey and a case-control study in a rural community in Guinea-Bissau. Methods: A total of 2770 people were included in an HIV and HTLV seroepidemiologic survey. Three hundred of these participants were selected for a case-control study on HIV-2. Sera from both studies were tested for HTLV. Results: In all, 2501 and 298 subjects in the survey and case-control study, respectively. were tested for HTLV. Overall HTLV-1 prevalence was 5.2% and it was higher in women (odds ratio [OR]. 1.36 confidence interval [CI], 0.92-2.02). Apart from an infected spouse, no significant risk factors could be identified for men, In women. HIV-2 infection (adjusted OR, 5.58 Cl, 3.09-10.1). having an infected spouse. and area of residence were significantly associated with HTLV- I infection. The association between HTLV- I and HIV-2 was significantly different for men and women (test of interaction, p = .002). Conclusions: In women, the most important determinant of HTLV-1 seropositivity was HIV-2 infection. Because the pattern was significantly different for men an women, common sexual risk factors may not be sufficient to explain file co-occurrence of HIV-2 and HTLV-1 in women. These observations may have implications in geographic areas where both types of retroviruses are prevalent.