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1998 ; 89
(8
): 797-805
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Human T-lymphotropic virus type-I infection, antibody titers and cause-specific
mortality among atomic-bomb survivors
#MMPMID9765614
Arisawa K
; Soda M
; Akahoshi M
; Matsuo T
; Nakashima E
; Tomonaga M
; Saito H
Jpn J Cancer Res
1998[Aug]; 89
(8
): 797-805
PMID9765614
show ga
There have been few longitudinal studies on the long-term health effects of human
T-lymphotropic virus type-I (HTLV-I) infection. The authors performed a cohort
study of HTLV-I infection and cause-specific mortality in 3,090 atomic-bomb
survivors in Nagasaki, Japan, who were followed from 1985-1987 to 1995. The
prevalence of HTLV-I seropositivity in men and women was 99/1,196 (8.3%) and
171/1,894 (9.0%), respectively. During a median follow-up of 8.9 years, 448
deaths occurred. There was one nonfatal case of adult T-cell leukemia/lymphoma
(incidence rate = 0.46 cases/1,000 person-years; 95% confidence interval [CI]
0.01-2.6). After adjustment for sex, age and other potential confounders,
significantly increased risk among HTLV-I carriers was observed for deaths from
all causes (rate ratio [RR] = 1.41), all cancers (RR = 1.64), liver cancer (RR =
3.04), and heart diseases (RR = 2.22). The association of anti-HTLV-I
seropositivity with mortality from all non-neoplastic diseases (RR = 1.40) and
chronic liver diseases (RR = 5.03) was of borderline significance. Possible
confounding by blood transfusions and hepatitis C/B (HCV/HBV) viral infections
could not be precluded in this study. However, even after liver cancer and
chronic liver diseases were excluded, mortality rate was still increased among
HTLV-I carriers (RR = 1.32, 95% CI 0.99-1.78), especially among those with high
antibody titers (RR = 1.56, 95% CI 0.99-2.46, P for trend = 0.04). These findings
may support the idea that HTLV-I infection exerts adverse effects on mortality
from causes other than adult T-cell leukemia/lymphoma. Further studies on
confounding by HCV/HBV infections and the interaction between HCV/HBV and HTLV-I
may be required to analyze the increased mortality from liver cancer and chronic
liver diseases.