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Sexual transmission of HTLV-1 documented in French male
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Researchers in France have documented sexual transmission of human T-cell lymphotropic virus, which is normally passed to young children during breast-feeding.
The man developed adult T-cell leukemia/lymphoma with positive human T-cell lymphotropic virus (HTLV) type-1 serology. Both of his parents were seronegative for HTLV-1.
“The results of several studies showed that most cases of [adult T-cell leukemia/lymphoma (ATLL)] develop in individuals who have been infected with HTLV-1 as young children via their mothers’ breast milk,” the researchers wrote in Open Forum Infectious Diseases. “The very rare ATLL cases observed following transfusion or sexual transmission are still being debated.”
The patient, aged 43 years, presented in 2002 with cutaneous T-cell lymphoma, but began developing erythematosquamous plaques over his body 8 years earlier. After treatment with topical corticosteroids, he relapsed. In 2001, three nodular lesions appeared at different sites. One nodule was biopsied and HTLV-1 serology was positive. He was diagnosed with smoldering ATLL after multiple micronodular lesions were identified on the lungs. He received PUVA therapy followed by zidovudine and interferon-alpha, resulting in complete remission.
The man had no known risk factors for exposure to HTLV-1 through blood products or IV drug use. For 8 months, the man lived in Cameroon with a Cameroonian woman, with whom he had unprotected sexual intercourse. The physicians suspected sexual transmission of HTLV-1, which was corroborated when they genotyped the patient’s virus. It belonged to the Central African subtype B, and the strain was previously characterized in individuals of Cameroonian origin.
“The vast majority of ATLL cases seen in Europe occur in patients of black ancestry from the West Indies or West Africa,” the researchers wrote. “In almost all of those patients, the cosmopolitan subtype-A viral genotype is found. This case demonstrates the occurrence of ATLL in a Caucasian patient infected with an HTLV-1 subtype-B strain, found only in Central Africa, and definitively confirms the hypothesis that ATLL can develop after infection during adulthood, outside breast-feeding and especially after sexual transmission of HTLV-1.” – by Emily Shafer
Disclosure: The researchers report no relevant financial disclosures.
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