@article{19306, keywords = {Adolescent, Adult, Age Factors, Carrier State, Cause of Death, Child, Child, Preschool, Democratic Republic of the Congo, Female, HTLV-I Infections, Humans, Infant, Infant, Newborn, leprosy, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prevalence, Retrospective Studies, Risk Factors, Sex Factors}, author = {Lechat M F and Shrager D I and Declercq E and Bertrand F and Blattner W A and Blumberg B S}, title = {Decreased survival of HTLV-I carriers in leprosy patients from the Democratic Republic of the Congo: a historical prospective study.}, abstract = {

In this historical prospective study using sera stored for 22 years, we investigated the effect of HTLV-I infection on survival in a population of leprosy patients in the Democratic Republic of the Congo (formerly Zaire). We also determined the distribution of HTLV-I by subpopulation, age, and gender. Stored sera taken from a population of leprosy patients and controls in 1969 were tested for HTLV-I. Follow-up survival data on these patients were obtained in 1991. The sera collected in 1969 from 520 individuals was used to determine the prevalence of HTLV-I. Included in this number were 328 patients resident in the sanatorium. Survival and other data were available for 327 of these. A multivariate survival analysis using a logistic regression model was performed to evaluate the influence of HTLV-I status, age, type of leprosy, gender, duration of hospitalization, and ethnic group on survival. The overall prevalence of HTLV-I among the 520 individuals in the prevalence study was 34%, with 37.4% in the leprosy group and 25.2% in the control group (p < 0.01). Multivariate analysis using logistic regression showed that females of the Mongo and Ngombe ethnic group taken together were significantly more likely to be infected than the other groups (OR = 3.67, 95% CI: 2.14 to 6.30). A comparison of the death rates directly standardized for age and sex showed that the rate was significantly higher for HTLV-I positive (5.5/100 person-years of observation) compared with HTLV-I negative (3.6/100 person-years of observation). A survival analysis using the Cox model showed a risk ratio of 1.4 (CI: 1.04 to 1.89) for those infected with HTLV-I. An increase in the death rate was associated with HTLV-I infection in leprosy inpatients. The decreased survival associated with HTLV-I infection may result from an increased susceptibility to a variety of diseases.

}, year = {1997}, journal = {Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association}, volume = {15}, pages = {387-90}, month = {1997 Aug 15}, issn = {1077-9450}, language = {eng}, }