A systematic review of Human T-cell Lymphotropic Virus type-1 (HTLV-1) seroprevalence worldwide and an update on HTLV-1 diagnoses and associated diseases in England and Wales.

Mughal S, Tosswill J, Rosadas C, Davison K, Andrews N, Taylor GP, Bradshaw D.

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

HTLV-1 diagnoses in England and Wales rose between 1993-1997 and 2013-2022, with adult T-cell leukaemia/lymphoma diagnoses up 60%, while estimated people living with HTLV-1 more than doubled.

What was studied

Systematic review of global HTLV-1 seroprevalence plus surveillance analysis of 749 new diagnoses in England and Wales (2013-2022).

Key findings

New diagnoses: 58% women, 64% in London, 61% Black Caribbean where recorded
51% symptomatic; ATLL most common (47%)
IRR vs 1993-1997: overall 1.26, ATLL 1.60, HAM 0.35
Estimated PLHTLV rose from 11,654 (1991) to 28,846 (2021)

Clinical relevance

This supports greater awareness and testing for HTLV-1 in people from endemic regions, though estimates rely on assumptions.

Who should care

Dermatology, Venereology & Leprosy

Limitations

Prevalence estimates based on migration assumptions; new global data mostly high risk of bias.

HTLV-1 and related leukaemia are rising in England and Wales.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

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.

DOI

10.1177/09564624261486905

PMID

42715448

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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