Long term follow up study and prevention of ATL occurrence among HTLV-1 carriers : a nationwide cohort study

2009 Fiscal Year Final Research Report

• Project/Area Number: 17015047
• Research Category: Grant-in-Aid for Scientific Research on Priority Areas
• Allocation Type: Single-year Grants
• Review Section: Biological Sciences
• Research Institution: National Institute of Infectious Diseases
• Principal Investigator: 山口 一成 National Institute of Infectious Diseases, 血液・安全性研究部, 客員研究員 (20128325)
• Co-Investigator(Kenkyū-buntansha): 渡辺 俊樹 東京大学, 大学院・新領域科学研究所 (30182934) ; 緒方 正男 大分大学, 医学部 (10332892) ; 魚住 公治 鹿児島大学, 大学院・医歯学総合研究科 (90253864) ; 岩永 正子 活水女子大 (00372772) ; 内丸 薫 東京大学, 医科学研究所 (60251203) ; 上平 憲 長崎大学 (80108290) ; 岡山 昭彦 宮崎大学, 医学部 (70204047) ; 高 起良 大阪市立大学, 大学院 (10315997)
• Project Period (FY): 2005 – 2009
• Keywords: HTLV-1 / ATL / JSPFAD / キャリア / 長期追跡 / ATL高危険群

Research Abstract

There are still 1.0 million HTLV-1 carriers in Japan. Definitive risk factors for ATL development from carrier status remain unclear. To investigate viral- and host-specific determinants of the development of ATL among HTLV-1 carriers. A nationwide cohort study for HTLV-1 carriers named the Joint Study on Predisposing Factors of ATL Development (JSPFAD) comprising of 41 institutions. Participants were HTLV-1 carriers who provided written informed consent. HTLV-1 proviral load (VL) and sIL-2R were measured annually. Demographic characteristics and clinical data were also collected annually. We evaluated 1218 HTLV-1 carriers (426 males and 792 females) who were enrolled during 2002-2008. VL at enrollment was significantly higher in males than females (median, 2.10 vs 1.39 copies/100PBMC), in those aged 40-49 and 50-59 yrs than that of those aged &lt ; 40 yrs (P=0.02 and 0.007, respectively), and in those with a family history of ATL than those without the history (median, 2.32 vs 1.33 copies/100PBMC) (P=0.005). During follow-up as of September 2009, 14 participants progressed to overt ATL. Their baseline VL was high (range, 4. 17-28.58 copies/100PBMC). None developed ATL among those with a baseline VL lower than &lt ; 4 copies/100PBMC. Multivariate Cox analyses indicated that not only a higher VL but also advanced age, family history of ATL, and first opportunity for HTLV-1 testing during treatment for other diseases were independent risk factors for progression of ATL from carrier status

Research Products

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• [Book] HTLV-1と疾患 (2007)
  • Author(s): 渡辺俊樹、上平憲、山口一成(編集)
  • Total Pages: 263
  • Publisher: 文光堂
• [Remarks] (JSPFADホームページ)
  • URL: http://www.htlv1.org/