HTLV-1 and HTLV-2 infections in HIV-infected individuals from Santos, Brazil: seroprevalence and risk factors.

Because HTLV-I, HTLV-2, and HIV share identical modes of transmission, simultaneous or subsequent infections with these retroviruses are to be expected. The population of Santos, the largest port in Latin America, includes large numbers of female commercial sex workers and intravenous drug users, presumably having been exposed to retroviral infection. To evaluate the seroprevalence of HTLV infection and their associated risk factors, a cross-sectional survey was carried out in 499 HIV-infected individuals from Santos, Brazil. HTLV testing consisted of enzyme immunoassays for serologic screening and confirmatory Western blot testing. Overall HTLV-I and HTLV-2 seroprevalences were 6.0% (95% confidence interval [CI], 3.9-8.1) and 7.4% (95% CI, 5.1-9.7), respectively. Multivariate logistic regression for statistical analysis revealed HTLV-I infection to be independently associated with: intravenous drug use (IDU) (odds ratio [OR]. 2.99; 95% CI, 1.09-8.20), seropositivity to hepatitis C virus (HCV) (OR, 3.03; 95% CI, 1.02-9.01) and < 3 years of education (OR, 4.73; 95% CI, 1.56-14.41). HTLV-2 infection was associated with: IDU (OR, 3.22; 95% CI, 1.33-7.84), HCV seropositivity (OR, 5.40; 95% CI, 1.86-15.66) and nonwhite race (OR, 3.32; 95% CI, 1.58-7.00). Results indicate that HIV-infected individuals living in Santos are at similarly high risk of being exposed to HTLV-1 and HTLV-2. IDU constitutes the main risk factor for HTLV acquisition in this population, and there is no significant risk associated with sexual practice.

Schistosomiasis mansoni in an area of low transmission: I. Impact of control measures

Este trabalho foi realizado no municipio de Pedro de Toledo, no Estado de Sao Paulo, Brasil, em 1987 para esclarecer aspectos sobre niveis de transmissao ao homen de Schistosoma mansoni, quando o hospedeiro intermediario e Biomphalaria tenagophila. Desde 1980 vem sendo desenvolvido um programa de controle neste municipio. Foram submetidos a exames de fezes (metodo de Kato-Katz) 4719 individuos das zonas rural e urbana. A taxa de prevalencia foi de 4,8 por cento, sendo maior nos homens (6,2 por cento) e tambem na zona rural (5,8 por cento). Foi de 35,1 por cento a media de ovos de S. mansoni por grama de fezes (epg). Cerca de 80,0 por cento dos portadores apresentavam menos de 100 epg e somente 20 individuos (9,0 por cento) eliminavam mais do que metade do total de ovos. Os mais altos indices de potencial de contaminacao (IPC) ocorreram nos grupos etarios de 5 a 20 anos (57,6 por cento). Dois tercos dos pacientes investigados (207) eram autoctones de Pedro de Toledo. A distribuicao geografica dos portadores demonstrou evidente agregacao dos casos autoctones, assim como uma intima associacao entre locais de contato da populacao com os criadouros de B. tenagophila. Este estudo demonstra que os portadores de S. mansoni nao estao agregados ao acaso, que os jovens devem ser o principal objetivo na profilaxia e que o programa de controle foi eficaz.

Schistosomiasis mansoni in an area of low transmission. I. Impact of control measures.

This work was undertaken in the municipality of Pedro de Toledo (São Paulo State, Brazil) in 1987, to clarify aspects related to the transmission levels of Schistosoma mansoni in a human population where the snail host is Biomphalaria tenagophila. Since 1980 a control programme has been undertaken in this municipality. Urban and rural populations (4,719 subjects) were submitted to faecal examinations (Kato-Katz method). The overall prevalence rate was 4.8% being higher in males (6.2%) and also in the rural zone (5.8%). The geometric mean of S. mansoni eggs was 35.1 eggs per gramme of faeces (epg). Approximately 80.0% of the carriers presented less than 100 epg and only 20 individuals (9.0%) eliminated more than half of total eggs. The highest index of potential contamination (IPC) was in the age group of 5 to 20 years (57.6%). Two thirds of the investigated patients (207) were autochthonous of Pedro de Toledo. The geographical distribution of the carriers showed a clear aggregation of the autochthonous cases and a close association between human contact sites and breeding places of B. tenagophila. This study shows that schistosomiasis subjects were not randomly aggregated, the youngsters should be the main target in the prophylaxis, and the efficacy of the control programme.