Document 0074 DOCN M9620074 TI Risk factors and cofactors for human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Jamaica. DT 9602 AU Kramer A; Maloney EM; Morgan OS; Rodgers-Johnson P; Manns A; Murphy EL; Larsen S; Cranston B; Murphy J; Benichou J; et al; Viral Epidemiology Branch, National Cancer Institute, National; Institutes of Health, Rockville, MD, USA. SO Am J Epidemiol. 1995 Dec 1;142(11):1212-20. Unique Identifier : AIDSLINE MED/96071716 AB Human T-cell lymphotropic virus type I (HTLV-I) has been etiologically associated with a neurologic syndrome called HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) as well as with adult T-cell leukemia/lymphoma. The authors sought to quantify the risk in Jamaica of HAM/TSP associated with HTLV-I infection and cofactors associated with this disease among infected individuals. Between 1988 and 1989, prevalent and incident HAM/TSP patients and controls with other neurologic diseases were enrolled in a retrospective study. A second control group was composed of HTLV-I-seropositive, asymptomatic carriers in Jamaica, ascertained in a separate study conducted in 1988. Although HTLV-I seropositivity was not a component of the case definition for HAM/TSP, all 43 HAM/TSP patients were HTLV-I seropositive compared with two (4.0%) of the controls with other neurologic diseases. Given HTLV-I seropositivity, one cofactor associated with the risk of HAM/TSP was young age at initial heterosexual confidence interval 1.29-12.46 for individuals aged < or = 15; odds ratio = 4.26, 95% confidence interval 1.41-12.90 for individuals aged 16-17 years at initial intercourse). Among individuals who reported this early age at initial sexual intercourse, an increased risk of HAM/TSP was associated with having reported more than five lifetime sexual partners (odds ratio = 2.88, 95% confidence interval 0.90-8.70). Neither an early age at initial sexual intercourse or the number of lifetime sexual partners was a risk factor for adult T-cell leukemia/lymphoma. These data support the hypothesis that HAM/TSP is associated with sexually acquired HTLV-I infection, whereas adult T-cell leukemia/lymphoma is not. DE Adolescence Adult Age Factors Aged Comparative Study Female Human Jamaica/EPIDEMIOLOGY Leukemia-Lymphoma, T-Cell, Acute, HTLV-I-Associated/EPIDEMIOLOGY Logistic Models Male Middle Age Paraparesis, Tropical Spastic/*EPIDEMIOLOGY/IMMUNOLOGY/ TRANSMISSION Retrospective Studies Risk Factors Serodiagnosis Sex Behavior Sexually Transmitted Diseases, Viral/*EPIDEMIOLOGY/IMMUNOLOGY Support, U.S. Gov't, P.H.S. JOURNAL ARTICLE SOURCE: National Library of Medicine. NOTICE: This material may be protected by Copyright Law (Title 17, U.S.Code).