![]() ![]() In the USA, it is estimates that approximately 266,000 individuals are infected with HTLV-1 or -2, and that 3,600 people with HAM/TSP remain undiagnosed. In the UK 20,000 – 30,000 people live with the virus, whilst in metropolitan France an estimated 10,000 – 25,000 people are HTLV-1 infected. In non-endemic areas, due to the migration of people and the sexual transmission of the virus, HTLV-1 and 2 have also been detected. In Romania, the HTLV-1 prevalence has been reported to be 5.3/10,000 among first-time blood donors, and 3-25% in poly-transfused patients. In Iran, up to 3% of adults are infected in the Mashad area but HTLV-1 is found across the country. In areas of Brazil, especially in people of African ancestry, HTLV-1 prevalence has been reported in 1.3% in blood donors, 1.8% in the general population and 1.05% in pregnant women with 33% of their family members including children found to be positive. Other Caribbean islands that have been studied have similar prevalence rates. In Jamaica, the estimated mean HTLV-1 sero-prevalence is 6.1% (1.7- 17.4%) in the general population (including older persons) and is as high as 2–3.8% among pregnant women and blood donors. In Japan, an estimated 0.8 million people are HTLV-1 positive and in Southern regions 30–40% of adults > 50 years of age and up to 5.8% of pregnant women carry this virus. In Central African Republic, HTLV-1 infection has been reported in 7% of older, female Pygmies of Southern region. In Nigeria, an estimated 850,000 to 1.7 million people are infected with this virus. In Gabon, a HTLV-1 sero-prevalence of 5–10% has been observed in adults, 1-5% in pregnant women and in some villages up to 25% of older women are HTLV-1 positive. HTLV-1 has been detected in most parts of Africa. It is an ancient virus and its prevalence is complex, in that it is highly endemic in some parts of the world, but regrettably available surveillance data is not comprehensive, and in many regions, accounting for 6 billion persons, HTLV-1 prevalence remains unknown. It is well understood that HTLV-1 originated from non-human primates. In 2012 Antoine Gessain and Olivier Cassar (23) published a systematic review of available data on HTLV-1 origin and prevalence, which we are drawing upon to provide you with an overview of the word distribution of HTLV-1. et al P-A-12) and at the 2017 Australasian HIV & AIDS and Sexual Health Conference in Canberra in Australia (22). The sexual transmission of HTLV-1 was also highlighted in several presentations at the 18 th International Retrovirology Conference in Tokyo in Japan in March 2017 (Satake, M. Recently published prevalence data from Central Australia (where in some communities 45% of adults live with HTLV-1)(18), Japan (19) and Brazil (20, 21) report the importance of HTLV-1’s sexual transmission. HTLV-1 is transmitted through the same routes as HIV-1 through infected body fluids, via condom-less sexual intercourse (1-4), breastfeeding (5-7), sharing of needles (8-11) and the transfusion (12, 13) and transplantation of infected blood and organ donations (14-17). However today we are encouraged by the WHO’s mandate to value a healthy sexual life and the availability of many WHO fact sheets on other blood borne and sexually transmitted viruses such as Hepatitis B and C and HIV. This is almost certainly due to having to address many other pressing health priorities. Our global community has been slow to respond to the HTLV-1 predicament, a virus transmitted through body fluids, causing significant morbidity and mortality. With this letter, we hope to raise your awareness about several current shortcomings and potential solutions in this field. We are writing to you today to ask you to support the promotion of proven effective transmission prevention strategies against one of the most potent human carcinogens, Human T Leukemia Virus subtype 1 (HTLV-1). On behalf of Human T Cell Leukemia Virus-1 (HTLV-1) positive patients, expert clinicians and scientists working in the field of HTLV-1 clinical and laboratory research. ** Summary version of this letter published Lancet here. Time to eradicate HTLV-1: an open letter to WHO ![]()
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