Int J STD AIDS. 2026 Sep 9:9564624261486905. doi: 10.1177/09564624261486905. Online ahead of print.
ABSTRACT
BackgroundHuman T-cell lymphotropic virus type-1 (HTLV-1) is a retrovirus, mainly transmitted sexually, which causes adult T-cell leukaemia/lymphoma (ATLL) and HTLV-1 associated myelopathy (HAM). We aimed to update global HTLV-1 seroprevalence estimates, estimate the number of people living with HTLV-1 (PLHTLV) in England and Wales (E&W), and present E&W HTLV-1 surveillance data.MethodWe systematically reviewed countries with new HTLV-1 prevalence data since the 2015 European Centres for Disease Control report, including studies of adults in the general population, pregnant women and blood donors (Ovid MEDLINE, 01/09/2014-17/02/2023). Global seroprevalence and UK census data were used to estimate the number of PLHTLV in E&W for 1991 and 2021. Reference laboratory and hospital data were combined to describe patterns in new HTLV-1 diagnoses, and associated diseases, in 2013-2022, in E&W. Diagnoses in 2013-2022 were compared with 1993-1997 using Incidence Rate Ratios (IRR).ResultsNew seroprevalence data were found for Pakistan (0.19%, blood donors), Malawi (0.96%, healthy mothers), Jordan (0.00%, blood donors), Vietnam (0.00%, blood donors) and New Caledonia (0.60%, general population); 4/5 studies had a high risk of bias. Among 749 newly-diagnosed PLHTLV in E&W (2013-2022), most were women (58%, 434/749) and tested in London (64%, 480/749). Where recorded, Black Caribbean ethnicity predominated (61%, 228/373); 51% (396/619) were symptomatic, most commonly with ATLL (47%, 187/396). Comparing 1993-1997 with 2013-2022, the IRR was 1.26 (95%CI 1.09-1.46) overall, 1.60 (95%CI 1.17-2.23) for ATLL and 0.35 (95%CI 0.23-0.51) for HAM. Assuming all cases were due to migration from endemic countries, the estimated number of PLHTLV in E&W increased from 11,654 (range 3,804-19,504) in 1991 to 28,846 (range 10,365-47,328) in 2021.ConclusionsIn E&W, rising annual ATLL diagnoses are consistent with an increase in the estimate of the number of PLHTLV, necessitating enhanced public health interventions. The reduced IRR for HAM requires further investigation.
PMID:42715448 | DOI:10.1177/09564624261486905
