Increased Incidence of Infectious Diseases During Prospective Follow-up of Human T-Lymphotropic Virus Type II– and I–Infected Blood Donors

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Abstract
HUMAN T-lymphotropic virus type I (HTLV-I) preferentially infects CD4+ lymphocytes1 and causes adult T-cell leukemia (ATL), a CD4+ lymphocytic malignant disease,2 and tropical spastic paraparesis–HTLV-associated myelopathy (TSP-HAM), a slowly progressive spinal cord disorder resembling multiple sclerosis.3 Human T-lymphotropic virus type I has evolved from simian T-lymphotropic viruses over hundreds to thousands of years, and now infects 15 to 25 million persons in the Caribbean, Japan, and Africa.4,5 The closely related HTLV-II infects CD8+ and CD4+ lymphocytes and macrophages in vivo,6 and also has been associated with HAM,7 but has not been linked conclusively with any hematologic malignant neoplasm. Amerindian tribes in North, Central, and South America recently have been shown to have endemic HTLV-II infection with prevalence estimates of 2% to 30%.8-10 The other major reservoir of HTLV-II is the injection drug user (IDU) population, with seroprevalence rates ranging from 3% to 18% in various US and European cities.11,12

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