RESUMEN
INTRODUCTION: The typical factors precipitating diabetic ketoacidosis (DKA) include infections (30%), cessation of antidiabetic medication (20%), and a new diagnosis of diabetes (25%). The etiology remains unknown in 25% of cases. Less frequent causes cited in the literature include severe thyrotoxicosis and, infrequently, pericarditis. Few publications have described the role of human T lymphotropic virus type 1 (HTLV-1) in endocrine and metabolic disorders. Based on a clinical case associated with several endocrine and metabolic disorders, we suggest a potential role for HTLV-1, an endemic virus in the Amazonian area, and review the literature concerning the role of this virus in thyroiditis, pericarditis and diabetes mellitus. CASE REPORT: A fifty-year-old Surinamese woman without any medical history was admitted for diabetic ketoacidosis. No specific anti-pancreatic autoimmunity was observed, and the C-peptide level was low, indicating atypical type-1 diabetes mellitus. DKA was associated with thyrotoxicosis in the context of thyroiditis and complicated by nonbacterial pericarditis and a Staphylococcus aureus subcutaneous abscess. The patient was infected with HTLV-1. CONCLUSION: To our knowledge, this uncommon association is described for the first time. Few studies have analyzed the implications of HTLV-1 infection in thyroiditis and diabetes mellitus. We did not find any reports describing the association of pericarditis with HTLV-1 infection. Additional studies are necessary to understand the role of HTLV-1 in endocrine and cardiac disorders.
Asunto(s)
Absceso/etiología , Infecciones por Deltaretrovirus/complicaciones , Diabetes Mellitus Tipo 1/etiología , Cetoacidosis Diabética/etiología , Pericarditis/etiología , Tirotoxicosis/etiología , Absceso/inmunología , Absceso/microbiología , Enfermedad Aguda , Infecciones por Deltaretrovirus/virología , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/virología , Cetoacidosis Diabética/inmunología , Cetoacidosis Diabética/terapia , Cetoacidosis Diabética/virología , Femenino , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Humanos , Inmunocompetencia , Persona de Mediana Edad , Pericarditis/virología , Infecciones Cutáneas Estafilocócicas/etiología , Infecciones Cutáneas Estafilocócicas/inmunología , Infecciones Cutáneas Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Suriname , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Síndrome de Respuesta Inflamatoria Sistémica/inmunología , Síndrome de Respuesta Inflamatoria Sistémica/virología , Tiroiditis/virología , Tirotoxicosis/virologíaRESUMEN
HIV/human T cell lymphotropic virus (HTLV) coinfection has a large range of prevalence in the different risk groups and geographic regions of the world. Most of the HTLV-infected people live in geographic areas where the virus is endemic, as it happens in Brazil. The aim of this study was to identify HTLV prevalence and risk factors in HIV-positive patients. A cross-sectional study was conducted with 580 HIV-positive patients (mean age of 40.6 years and 45.0% men) from a specialized HIV/AIDS diagnosis and treatment center in Southern Brazil. Sociodemographic data, HIV risk factors, and HTLV-1/2 antibodies were collected. HTLV proviral DNA was detected by polymerase chain reaction (PCR). A multivariate analysis was performed to identify risk factors for HTLV infection. HTLV antibodies were detected in 29 (5.0%) and HTLV provirus in 17 (2.9%) patients. HTLV-1 was identified in 11 (64.7%) patients and HTLV-2 in 6 (35.3%) patients. No significant differences were observed between mono and coinfected patients in clinical characteristics regarding HIV/AIDS (time since HIV diagnosis, HIV viral load, lymphocytes CD4(+) count, and use of highly active antiretroviral therapy). Blood transfusion history was significantly associated with HIV/HTLV coinfection (p=0.039). Alcohol abuse was more prevalent in HTLV-positive (47.1%) than in HIV mono-infected patients (20.4%; p=0.008). Tattooing was the only risk factor independently associated with HIV/HTLV coinfection (p=0.035). This information contributes to an understanding of the epidemiology of HIV/HTLV coinfection in Brazil.
Asunto(s)
Infecciones por Deltaretrovirus/epidemiología , Infecciones por VIH/complicaciones , Adulto , Infecciones por Deltaretrovirus/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de RiesgoAsunto(s)
Humanos , Infecciones por Deltaretrovirus/complicaciones , Medicina Tropical , Paraparesia Espástica Tropical/diagnóstico , Polimiositis/diagnóstico , Virus Linfotrópico T Tipo 1 Humano , Diagnóstico Diferencial , Jamaica , Paraparesia Espástica Tropical/etiología , Paraparesia Espástica Tropical/patología , Polimiositis/etiología , Polimiositis/patologíaRESUMEN
In this study, the epidemiological and clinical features observed in solely HTLV-II-infected individuals were compared to those in patients co-infected with HIV-1. A total of 380 subjects attended at the HTLV Out-Patient Clinic in the Institute of Infectious Diseases "Emilio Ribas" (IIER), São Paulo, Brazil, were evaluated every 3-6 months for the last seven years by infectious disease specialists and neurologists. Using a testing algorithm that employs the enzyme immuno assay, Western Blot and polymerase chain reaction, it was found that 201 (53 percent) were HTLV-I positive and 50 (13 percent) were infected with HTLV-II. Thirty-seven (74 percent) of the HTLV-II reactors were co-infected with HIV-1. Of the 13 (26 percent) solely HTLV-II-infected subjects, urinary tract infection was diagnosed in three (23 percent), one case of skin vasculitis (8 percent) and two cases of lumbar pain and erectile dysfunction (15 percent), but none myelopathy case was observed. Among 37 co-infected with HIV-1, four cases (10 percent) presented with tropical spastic paraparesis/HTLV-associated myelopathy (TSP/HAM) simile. Two patients showed paraparesis as the initial symptom, two cases first presented with vesical and erectile disturbances, peripheral neuropathies were observed in other five patients (13 percent), and seven (19 percent) patients showed some neurological signal or symptoms, most of them with lumbar pain (five cases). The results obtained suggest that neurological manifestations may be more frequent in HTLV-II/HIV-1-infected subjects than those infected with HTLV-II only.
Neste estudo, as características epidemiológicas e clínicas observadas nos indivíduos infectados pelo HTLV-II foram comparadas com os pacientes co-infectados com HIV-1. Um total de 380 indivíduos atendidos na clínica do Ambulatório HTLV do Instituto de Infectologia "Emilio Ribas" (IIER), São Paulo, Brasil, foram avaliados a cada 3-6 meses nos últimos sete anos por especialistas em doenças infecciosas e neurologistas. Usando um algoritmo que emprega ensaio imunoenzimático, Western Blot e reação em cadeia de polimerase, foram incluídos 201 (53 por cento) pacientes infectados pelo HTLV-I e 50 (13 por cento) infectados pelo HTLV-II. Trinta e sete (74 por cento) eram co-infectados pelo HTLV-II e HIV-1. Dos 13 (26 por cento) indivíduos unicamente infectados pelo HTLV-II, infecção do trato urinário foi diagnosticada em três, um com vasculite e em dois casos dor lombar e disfunção erétil mas nenhum caso de mielopatia foi observado. Entre 37 pacientes co-infectados com HIV-1, quatro (10 por cento) casos apresentaram com paraparesia espástica tropical/mielopatia associada ao HTLV similar. Dois casos mostraram paraparesia como sintoma inicial, dois outros casos se apresentaram primeiramente com distúrbios vesical e erétil e as neuropatias periféricas foram observadas em cinco pacientes (13 por cento). Outros sete (19 por cento) pacientes mostraram algum sinal ou sintoma neurológico, a maioria deles com dor lombar (cinco casos). Os resultados sugerem que as manifestações neurológicas podem ser mais freqüentes em indivíduos co-infectados pelo HTLV-II/HIV-1 do que nos indivíduos infectados somente pelo HTLV-II.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , VIH-1 , Infecciones por Deltaretrovirus/complicaciones , Infecciones por HTLV-II/complicaciones , /inmunología , Paraparesia Espástica Tropical/virología , Algoritmos , Brasil/epidemiología , Infecciones por Deltaretrovirus/epidemiología , Infecciones por HTLV-II/epidemiología , Técnicas para Inmunoenzimas , Paraparesia Espástica Tropical/diagnóstico , Reacción en Cadena de la Polimerasa , Prevalencia , Factores de RiesgoAsunto(s)
Infecciones por Deltaretrovirus/complicaciones , Virus Linfotrópico T Tipo 1 Humano , Paraparesia Espástica Tropical/diagnóstico , Polimiositis/diagnóstico , Medicina Tropical , Diagnóstico Diferencial , Humanos , Jamaica , Paraparesia Espástica Tropical/etiología , Paraparesia Espástica Tropical/patología , Polimiositis/etiología , Polimiositis/patologíaRESUMEN
PURPOSE: To describe the ophthalmologic features observed in patients infected by the human T-cell lymphotropic virus, type 1 (HTLV-1) in Martinique (French West Indies). DESIGN: Prospective consecutive observational case series. METHODS: A complete ophthalmic examination was performed. PATIENTS: Of 200 patients infected by HTLV-1, 77 (38.5%) were seropositive and 123 (61.5%) had HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). RESULTS: Uveitis was found in 29 cases (14.5%). Symptoms were mild and the uveitis had little effect on visual function. Ten cases of uveitis were discovered through a systematic examination and had no ocular symptoms. Most of the uveitis was anterior or intermediate. The lesions responded to corticosteroid therapy, but tended to recur. Keratoconjunctivitis sicca existed in 74 patients (37%), accompanied by lymphoplasmocytoid infiltration of the secondary salivary glands rated 3 or 4 on the Chisholm scale in nearly 50% of cases. Corneal alterations were observed in 20 cases (10%), and alterations in the retinal pigment epithelium in 3 cases. CONCLUSION: The three types of ocular affections seen most frequently were uveitis, keratoconjunctivitis sicca, and interstitial keratitis. In patients with HAM/TSP, uveitis was more frequent among younger patients, patients with earlier onset of HAM/TSP, and patients with severe motor disability. Because uveitis is related to a high intrathecal production of immunoglobulin, it could represent a marker for severity of HTLV-1 infection with respect to the course of HAM/TSP. The sicca syndrome related to HTLV-1 virus differs from primary or secondary Sjögren syndrome, because it does not reveal any of the immunologic anomalies generally seen in this disease. Interstitial keratitis was more frequent among patients with HAM/TSP who had high proviral DNA levels.
Asunto(s)
Infecciones por Deltaretrovirus/complicaciones , Infecciones Virales del Ojo/etiología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Queratitis/etiología , Queratoconjuntivitis Seca/etiología , Uveítis/etiología , Adulto , Anciano , Infecciones por Deltaretrovirus/diagnóstico , Infecciones por Deltaretrovirus/epidemiología , Infecciones Virales del Ojo/diagnóstico , Infecciones Virales del Ojo/epidemiología , Femenino , Humanos , Queratitis/diagnóstico , Queratitis/epidemiología , Queratoconjuntivitis Seca/diagnóstico , Queratoconjuntivitis Seca/epidemiología , Masculino , Martinica/epidemiología , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Uveítis/diagnóstico , Uveítis/epidemiologíaRESUMEN
Tropical spastic paraparesis/human T-cell leukemia type I-associated myelopathy (TSP/HAM) is caused by a human T-cell leukemia virus type I (HTLV-I) after a long incubation period. TSP/HAM is characterized by a chronic progressive paraparesis with sphincter disturbances, no/mild sensory loss, the absence of spinal cord compression and seropositivity for HTLV-I antibodies. The pathogenesis of this entity is not completely known and involves a multivariable phenomenon of immune system activation against the presence of HTLV-I antigens, leading to an inflammatory process and demyelination, mainly in the thoracic spinal cord. The current hypothesis about the pathogenesis of TSP/HAM is: 1) presence of HTLV-I antigens in the lumbar spinal cord, noted by an increased DNA HTLV-I load; 2) CTL either with their lytic functions or release/production of soluble factors, such as CC-chemokines, cytokines, and adhesion molecules; 3) the presence of Tax gene expression that activates T-cell proliferation or induces an inflammatory process in the spinal cord; 4) the presence of B cells with neutralizing antibody production, or complement activation by an immune complex phenomenon, and 5) lower IL-2 and IFN-gamma production and increased IL-10, indicating drive to a cytokine type 2 pattern in the TSP/HAM subjects and the existence of a genetic background such as some HLA haplotypes. All of these factors should be implicated in TSP/HAM and further studies are necessary to investigate their role in the development of TSP/HAM
Asunto(s)
Humanos , Infecciones por Deltaretrovirus/complicaciones , Paraparesia Espástica Tropical/etiología , Antígenos de Deltaretrovirus/inmunología , ADN Viral/inmunología , Interferón gamma/biosíntesis , Paraparesia Espástica Tropical/inmunología , Paraparesia Espástica Tropical/patologíaRESUMEN
Cerebellar symptoms at onset are unusual in HTLV-I/II-associated tropical spastic paraparesis (TSP). A prospective study of neurological disorders in Panama (1985-1990) revealed 13 patients with TSP and 3 with HTLV-I/II-associated spinocerebellar syndrome (HSCS) presenting at onset loss of balance, wide-based stance and gait, truncal instability, and mild leg ataxia (vermian cerebellar syndrome), with absent upper limb dysmetria but with postural tremor, downbeat nystagmus, and dysarthria. In 4-5 years, spinal cord manifestations of TSP developed, including spastic paraparesis, pyramidal signs, bladder and sphincter disturbances. Two patients were infected with HTLV-I and another one, a Guaymi Amerindian woman, with HTLV-II. Magnetic resonance imaging (MRI) demonstrated cerebellar atrophy involving predominantly the superior vermis. Mild axonal peripheral neuropathy in the lower limbs, dorsal column involvement and inflammatory myopathy were found by neurophysiology studies. There are 14 similar cases reported in Japan and Canada, but to our knowledge these are the first documented cases of HSCS in the tropics. A cerebellar syndrome constitutes another form of presentation of HTLV-I/II infection of the nervous system.
Asunto(s)
Cerebelo/patología , Cerebelo/virología , Infecciones por Deltaretrovirus/complicaciones , Infecciones por Deltaretrovirus/patología , Virus Linfotrópico T Tipo 1 Humano/fisiología , Virus Linfotrópico T Tipo 2 Humano/fisiología , Degeneraciones Espinocerebelosas/patología , Degeneraciones Espinocerebelosas/virología , Cerebelo/fisiopatología , Infecciones por Deltaretrovirus/virología , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Panamá , Degeneraciones Espinocerebelosas/fisiopatologíaAsunto(s)
Infecciones por Deltaretrovirus/complicaciones , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , Mielitis/virología , Infecciones por Deltaretrovirus/diagnóstico , Progresión de la Enfermedad , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Persona de Mediana EdadAsunto(s)
21003 , Humanos , Infecciones por HTLV-I/inmunología , Strongyloides stercoralis/inmunología , Estrongiloidiasis/inmunología , Adyuvantes Inmunológicos , Anticuerpos Antihelmínticos/análisis , Antígenos Helmínticos/análisis , Ensayo de Inmunoadsorción Enzimática , Anticuerpos Antideltaretrovirus/análisis , Infecciones por Deltaretrovirus/complicaciones , Inmunoglobulina A/análisis , Inmunoglobulina E , Inmunoglobulina G/análisisRESUMEN
To assess the association of the human T-cell lymphotropic virus type I (HTLV-I) and idiopathic facial nerve palsy of the lower motor neuron type, we studied 78 patients consecutively admitted to the Port of Spain General Hospital in Trinidad, the West Indies, with a confirmed diagnosis of idiopathic facial nerve palsy. Patients were compared with two control groups: a population-based group of persons 20 years and older and a hospital-based group of patients 15 to 84 years old admitted to the medical wards. Sixty-two patients were Trinidadians of African origin and 16 were Trinidadians of East Indian origin. None of the East Indian patients was HTLV-I antibody positive. Three Afro-Trinidadians were infected with human immunodeficiency virus type 1 and 1 was coinfected with this virus and HTLV-I. Of the remaining 58 Afro-Trinidadians, 12 (20.7%) were HTLV-I positive only. This rate was statistically higher than the HTLV-I seroprevalence in the Afro-Trinidadian general population (3.5%) and the hospital control group (5.6%). After age standardization, the HTLV-I prevalence for patients with facial nerve palsy remained significantly elevated. HTLV-I antibody assays should be performed on all patients with idiopathic facial nerve palsy of the lower motor neuron type who live in HTLV-I endemic areas or are migrants from these areas.
Asunto(s)
Infecciones por Deltaretrovirus/complicaciones , Parálisis Facial/virología , Virus Linfotrópico T Tipo 1 Humano , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Western Blotting , Infecciones por Deltaretrovirus/diagnóstico , Infecciones por Deltaretrovirus/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Pruebas Serológicas , Trinidad y TobagoRESUMEN
La paraparesia espástica tropical en un cuadro relativamente frecuente en algunos países de América del Sur tales como Perú, Chile y Brasil. Describimos 2 pacientes con mielopatía asociada al HTLV-1 cuyo diagnóstico fue realizado hasta 3 años luego del inicio de los síntomas por falta de conocimiento de la entidad. Ambos casos se presentaron con compromiso medular lentamente progresivo que se manifestó inicialmente en miembros inferiores y se acompañó con incontinencia urinaria. La IRM del caso 1 mostró imágenes hiperintensas en T2 en médula cervical compatibles con desmielinización, mientras que el estudio tomográfico fue normal en el caso 2. Ambos pacientes presentaron serología positiva para HTLV-1 en LCR y sangre. La serología fue también positiva en el marido de la primer paciente. La mielopatía asociada al HTLV-1 es un cuadro relativamente frecuente en algunos países, vecinos a la Argentina; el conocimiento de las manifestaciones clínicas y de las características de laboratorio así como la forma de transmisión de la entidad, podría resultar de gran utilidad para efectuar el diagnóstico precoz y evitar la diseminación del cuadro (AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Paraparesia Espástica Tropical/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Deltaretrovirus/complicacionesRESUMEN
La paraparesia espástica tropical en un cuadro relativamente frecuente en algunos países de América del Sur tales como Perú, Chile y Brasil. Describimos 2 pacientes con mielopatía asociada al HTLV-1 cuyo diagnóstico fue realizado hasta 3 años luego del inicio de los síntomas por falta de conocimiento de la entidad. Ambos casos se presentaron con compromiso medular lentamente progresivo que se manifestó inicialmente en miembros inferiores y se acompañó con incontinencia urinaria. La IRM del caso 1 mostró imágenes hiperintensas en T2 en médula cervical compatibles con desmielinización, mientras que el estudio tomográfico fue normal en el caso 2. Ambos pacientes presentaron serología positiva para HTLV-1 en LCR y sangre. La serología fue también positiva en el marido de la primer paciente. La mielopatía asociada al HTLV-1 es un cuadro relativamente frecuente en algunos países, vecinos a la Argentina; el conocimiento de las manifestaciones clínicas y de las características de laboratorio así como la forma de transmisión de la entidad, podría resultar de gran utilidad para efectuar el diagnóstico precoz y evitar la diseminación del cuadro
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Paraparesia Espástica Tropical/diagnóstico , Infecciones por Deltaretrovirus/complicaciones , Síndrome de Inmunodeficiencia Adquirida/complicacionesAsunto(s)
Humanos , Enfermedades del Sistema Nervioso Periférico/virología , Infecciones por VIH/virología , Infecciones por Deltaretrovirus/virología , Infecciones por VIH/complicaciones , Infecciones por VIH/diagnóstico , Infecciones por Deltaretrovirus/complicaciones , Infecciones por Deltaretrovirus/diagnósticoRESUMEN
Twenty (18%) of 111 Peruvian men with sexually acquired human immunodeficiency virus infection were found also to be infected with human T-lymphotrophic virus type I or II in a retrospective study. At the time of data evaluation, 75 patients had reached Centers for Disease Control stage IV (clinical acquired immunodeficiency syndrome) and had not received antiviral medication; mortality in this group was 63.3% (38/60) among patients infected with human immunodeficiency virus alone and 80% (12/15) in the dually infected group. Of the 50 patients who had died, survival time from onset of stage IV to death was shorter in the dually infected group (5.02 +/- 3.27 months) than in those with human immunodeficiency virus infection alone (10.07 +/- 4.42 months). In Peru, sexually acquired human immunodeficiency virus infection in men is often accompanied by human T-lymphotrophic virus type I/II infection, and dual retrovirus infection is associated with a shorter survival after onset of clinical acquired immunodeficiency syndrome.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/microbiología , Infecciones por Deltaretrovirus/complicaciones , Seropositividad para VIH/complicaciones , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Síndrome de Inmunodeficiencia Adquirida/patología , Adulto , Virus Linfotrópico T Tipo 1 Humano , Virus Linfotrópico T Tipo 2 Humano , Humanos , Masculino , Perú/epidemiología , Pronóstico , Estudios Retrospectivos , Parejas Sexuales , Tasa de SupervivenciaAsunto(s)
Anticuerpos Antideltaretrovirus/sangre , Infecciones por Deltaretrovirus/complicaciones , Virus Linfotrópico T Tipo 1 Humano/inmunología , Virus Linfotrópico T Tipo 2 Humano/inmunología , Fallo Renal Crónico/complicaciones , Diálisis Renal , Cuba/epidemiología , Infecciones por Deltaretrovirus/diagnóstico , Infecciones por Deltaretrovirus/epidemiología , Humanos , Fallo Renal Crónico/terapia , Factores de Riesgo , Reacción a la TransfusiónRESUMEN
The presence of the human T-cell leukemia virus (HTLV) in Dominican blood donors and patients with tropical spastic paraparesis (TSP) was first detected in 1987. To define further the seroprevalence in the country, nearly 4,000 samples from high- and low-risk populations, as well as patients with neurological disease and with leukemia or lymphoma were tested for HTLV antibodies. A 1-2% seropositivity rate was found among the low-risk population, a 2-5% in the high-risk, and at least 87% in those with TSP. A few patients with malignancy also had antibodies to HTLV. An increase in seropositivity with age and a predominance of female seropositive individuals were found. Infectious virus was isolated from TSP patients, prostitutes, and family members of index patients. These data indicate the substantial level of HTLV infection in another Caribbean country and its relation to neurologic disease.
Asunto(s)
Infecciones por Deltaretrovirus/epidemiología , Enfermedades del Sistema Nervioso/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antivirales/sangre , Niño , Preescolar , Deltaretrovirus/aislamiento & purificación , Infecciones por Deltaretrovirus/complicaciones , República Dominicana/epidemiología , Femenino , Humanos , Inmunoensayo , Masculino , Persona de Mediana Edad , Paraparesia Espástica Tropical/etiología , Prevalencia , Factores de RiesgoRESUMEN
The prevalence of human T lymphotropic virus type I (HTLV-I) and human immunodeficiency virus (HIV) antibodies was evaluated in Brazil among 116 aboriginal Indians living in a pre-Amazonian region, and in 44 patients with haematological malignant disorders being treated in Rio de Janeiro. Screening for the presence of antibodies to HIV was performed routinely for 17,224 blood donors at the National Cancer Institute, Rio de Janeiro, from January 1986 to May 1987. The results demonstrated that HIV infection was not endemic among Brazilian Indians, as none of them had antibodies to HIV, in contrast with the population of Rio de Janeiro, which showed a high prevalence (0.34%) of positivity among normal individuals. In a small group of patients with haematological disease only one with acute lymphoblastic leukaemia proved to be HIV-positive, the infection having been acquired through previous blood transfusion. None of the serum samples reacted with HTLV-I, including those of 17 non-Hodgkin's lymphoma patients. HTLV-I infection does not seem to be endemic in this country, but further large scale studies are necessary, especially in patients with haematological disorders, homosexual individuals and drug users.