HTLV-1 infection in japan, Hawaii, and California : the effect of immigration from endemic southwestern Japan

几项研究记录了在一代或两代人内移居非流行区的移民中HTLV-1血清阳性率下降的情况。我们假设，由于同化到低流行率的宿主人群中，性传播会减少。并在长崎对22名日裔美国人(JA)HTLV-1+女性(病例)和80名日本(JN)HTLV-1+女性(对照组)进行了家庭研究。JA女性比JN女性年龄大(中位年龄50岁比33岁)：JA女性来自献血人群，JN女性来自产后护理诊所。JA女性的文化程度高于JN女性。JA女性的抗体滴度略高(中位数1/对1/16)，但经年龄调整后差异不显著。到本报告发表时，聚合酶链式反应的病毒载量分析已经完成，等待计算机分析。问卷数据显示，JN NAD 20名JA妇女中有75名(90%)曾由母亲母乳喂养，两组的母乳喂养持续时间相似。JA女性现在性伴侣HTLV-1感染率(2/11，18%)与JN女性伴侣(4/20，20%)相比无显著差异(P>0.05)，两组男性终身性伴侣的中位数分别为31/32(97%)和6/12(50%)，差异有统计学意义(P&lt；0.05)。JN女性的避孕套使用率较高，27名(33%)通常或总是与其当前伴侣一起使用安全套，而在17名JA女性中，只有3名(18%)与现任伴侣一起使用安全套。我们的结论是，与移民相关的HTLV-1血清阳性率下降可能是由于移民女性与HTLV-1流行区男性的性接触减少所致。在地方性疾病和移民妇女中，母乳喂养接触情况相似。

Several studies have documented declining HTLV-1 seroprevalence among immigrants to non-endemic areas within one or two generations. we hypothesized a decrease in sexual transmission due to assimilation into the low-prevalence host population. and performed family studies of 22 Japanese-American (JA) HTLV-1+ women (cases) to a group of 80 Japanese (JN) HTLV-1+ women in Nagasaki (controls). The JA women were older than the JN women (median age 50 vs. 33) : JA women were enrolled from blood donor population, and JN women from postnatal care clinic. Educational level of JA women was higher than that of JN women. Antibody titers were slightly higher in the JA women (median 1/64 vs. 1/16), but the difference was not significant after adjustment for age. By the time of this report, the viral load analysis by PCR was done, waiting for computer analysis. Questionnaire data revealed that 75 (90%) of JN nad 20 (90%) of JA women had been breast-fed by their mothers, and both groups had similar duration of breast-feeding. There was no difference in HTLV-1 seroprevalence among current sexual partners of the JA women (2/11,18%) compared to partners of JN women (4/20,20%), Both groups had a median of 2 lifetime male sexual partners.Significantly (p<.05) more JN women than JA women reported that their current of previous sexual partner was from an endemic area (Kyushu, Shikoku or Okinawa) : 31/32 (97%) vs. 6/12 (50%). Condom usage was higher in the JN women, with 27 (33%) using a condom usually or always with their current partner, comared to only 3 (18%) of the 17 JA women with a current parther. We conclude that the immigration-related decline in HTLV-1 seroprevalence may be due to reduced sexual exposure of immigrant women to men from HTLV-1 endemic areas. Breast-feeding exposure was similar in endemic and immigrant women.