Volume 94, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



This study evaluated the prevalence of infection and human T-cell lymphotropic virus type 1 (HTLV-1) infection in the population. In addition, this study investigated the relationship between infection or HTLV-1 infection and a patient's risk of developing related cancers. This is a retrospective cohort study of 5,209 patients. The prevalence of infection was 5.2% among all patients. The prevalence among men (6.3%) was significantly higher than among women (3.6%, < 0.001). The prevalence of HTLV-1 infection among this population was 13.6% and the prevalence among women (15.5%) was significantly higher than that of men (12.3%, < 0.001). HTLV-1 seroprevalence was higher in patients with liver cancer ( = 0.003, odds ratio [OR]: 1.91, 95% confidence interval [CI]: 1.24, 2.95) and in those with lymphoma other than adult T-cell leukemia/lymphoma (ATLL) ( = 0.005, adjusted OR: 2.76, 95% CI: 1.36, 5.62) if compared with patients without any neoplasm. The prevalence of both and HTLV-1 in the Okinawan population has been steadily decreasing over the past 24 years. HTLV-1 infection significantly increases the odds of developing liver cancer and lymphomas other than ATLL.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. Asato R, Nakasone T, Yoshida C, Arakakai T, Ikeshiro T, Murakami H, , 1992. Current status of Strongyloides infection in Okinawa, Japan. Jpn J Trop Med Hgy 20: 169173.[Crossref] [Google Scholar]
  2. Toma H, Shimabukuro I, Kobayashi J, Tasaki T, Takara M, Sato Y, , 2000. Community control studies on Strongyloides infection in a model island of Okinawa, Japan. Southeast Asian J Trop Med Public Health 31: 383387. [Google Scholar]
  3. Zaha O, Hirata T, Kinjo F, Saito A, , 2000. Strongyloidiasis—progress in diagnosis and treatment. Intern Med 39: 695700.[Crossref] [Google Scholar]
  4. Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC, , 1980. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proc Natl Acad Sci USA 77: 74157419.[Crossref] [Google Scholar]
  5. Yoshida M, Miyoshi I, Hinuma Y, , 1982. Isolation and characterization of retrovirus from cell lines of human T-cell leukemia and its implication in the disease. Proc Natl Acad Sci USA 79: 20312035.[Crossref] [Google Scholar]
  6. Proietti FA, Carnerio-Proietti AB, Catalan-Soares BC, Murphy EL, , 2005. Global epidemiology of HTLV-1 infection and associated diseases. Oncogene 24: 60586068.[Crossref] [Google Scholar]
  7. Tajima K, , 1988. The third nation-wide study on adult T-cell leukemia/lymphoma (ATL) in Japan: characteristic patterns of HLA antigen and HTLV-1 infection in ATL patients and their relatives. Int J Cancer 41: 505512.[Crossref] [Google Scholar]
  8. Wilks R, Hanchard B, Morgan O, Williams E, Cranston B, Smith ML, Rodgers-Johnson P, Manns A, , 1996. Patterns of HTLV-1 infection among family members of patients with adult T-cell leukemia/lymphoma and HTLV-1 associated myelopathy/tropical spastic paraparesis. Int J Cancer 65: 272273.[Crossref] [Google Scholar]
  9. Khurana S, Dubey ML, Malla N, , 2005. Association of parasitic infections and cancers. Indian J Med Microbiol 23: 7479.[Crossref] [Google Scholar]
  10. Arisawa K, Sobue T, Yoshimi I, Soda M, Shirahama S, Doi H, Katamine S, Saito H, Urata M, , 2003. Human T-lymphotropic virus type-1 infection, survival and cancer risk in southwestern Japan: a prospective cohort study. Cancer Causes Control 14: 889896.[Crossref] [Google Scholar]
  11. Hirata T, Nakamoto M, Nakamura M, Kinjo N, Hokama A, Kinjo F, Fujita J, , 2007. Low prevalence of human T cell lymphotropic virus type 1 infection in patients with gastric cancer. J Gastroenterol Hepatol 22: 22382241.[Crossref] [Google Scholar]
  12. Arisawa K, Soda M, Akahoshi M, Fujiwara S, Uemura H, Hiyoshi M, Takeda H, Kashino W, Suyama A, , 2006. Human T-cell lymphotropic virus type-1 infection and risk of cancer: 15.4 year longitudinal study among atomic bomb survivors in Nagasaki, Japan. Cancer Sci 97: 535539.[Crossref] [Google Scholar]
  13. Arakaki T, Iwanaga M, Kinjo F, Saito A, Asato R, Ikeshiro T, , 1990. Efficacy of agar-plate culture in detection of Strongyloides stercoralis infection. J Parasitol 76: 425428.[Crossref] [Google Scholar]
  14. Fujino R, Kawato K, Ikeda M, Miyakoshi H, Mizukoshi M, Imai J, , 1991. Improvement of gelatin particle agglutination test for detection of anti-HTLV-1 antibody. Jpn J Cancer Res 82: 367370.[Crossref] [Google Scholar]
  15. Aoyama H, Hirata T, Sakugawa H, Watanabe T, Miyagi S, Maeshiro T, Chinen T, Kawane M, Zaha O, Nakayoshi T, Kinjo F, Fujita J, , 2007. An inverse relationship between autoimmune liver diseases and Strongyloides stercoralis infection. Am J Trop Med Hyg 76: 972976. [Google Scholar]
  16. Yoshikawa M, Ouji Y, Nakamura-Uchiyama F, Nawa Y, , 2014. Analysis of strongyloidiasis cases reported in Japan in the recent period, 2000–2013 [in Japanese]. Clin Parasitol 25: 2026. [Google Scholar]
  17. Ogawa S, Boostrom E, , 2009. Okinawa's Post-War Health Recovery and Development: Relevance for International Health. Kanagawa, Japan: Seizansha. [Google Scholar]
  18. Sataka M, Yamaguchi K, Tadokoro K, , 2012. Current prevalence of HTLV-1 in Japan as determined by screening of blood donors. J Med Virol 84: 327335.[Crossref] [Google Scholar]
  19. Hirata T, Uchima N, Kishimoto K, Zaha O, Kinjo N, Hokama A, Sakugawa H, Kinjo F, Fujita J, , 2006. Impairment of host immune response against Strongyloides stercoralis by human T cell lymphotropic virus type 1 infection. Am J Trop Med Hyg 74: 246249. [Google Scholar]
  20. Inaba S, Sato H, Okochi K, Fukuda K, Takakura F, Tokunaga K, , 1989. Prevention of transmission of human T-lymphotropic virus type 1 (HTLV-1) through transfusion, by donor screening with antibody to the virus. One-year experience. Transfusion 29: 711.[Crossref] [Google Scholar]
  21. Ando Y, Saito K, Nakano S, Kakimoto K, Furuki K, Tanigawa T, Hashimoto H, Moriyama I, Ichijo M, Toyama T, , 1989. Bottle-feeding can prevent transmission of HTLV-1 from mothers to their babies. J Infect 19: 2529.[Crossref] [Google Scholar]
  22. Kinoshita K, Hino S, Amagasaki T, Ikeda S, Yamada Y, Suzuyama J, Momita S, Toriya K, Kamihira S, Ichimaru M, , 1984. Demonstration of adult T-cell leukemia virus antigen in milk from three sero-positive mothers. Gan 75: 103105. [Google Scholar]
  23. Nakano S, Ando Y, Ichijo M, Moriyama I, Saito S, Sugamura K, Hinuma Y, , 1984. Search for possible routes of vertical and horizontal transmission of adult T-cell leukemia virus. Gan 75: 10441045. [Google Scholar]
  24. The Japanese Ministry of Health, Labour and Welfare study group, 2011. HTLV-1 Carrier, Guide of the Instruction. Japan. [In Japanese].
  25. Nakada K, Kohakura M, Komoda H, Hinuma K, , 1984. High incidence of HTLV antibody in carriers of Strongyloides stercoralis . Lancet 1: 633.[Crossref] [Google Scholar]
  26. Hayashi J, Kishihara Y, Yoshimura E, Furusyo N, Yamaji K, Kawakami K, Murakami H, Kashiwagi S, , 1997. Correlation between human T cell lymphotropic virus type-1 and Strongyloides stercoralis infections and serum immunoglobulin E responses in residents of Okinawa, Japan. Am J Trop Med Hyg 56: 7175. [Google Scholar]
  27. Carvalho EM, Da Fronseca Porto A, , 2004. Epidemiological and clinical interaction between HTLV-1 and Strongyloides stercoralis . Parasite Immunol 26: 487497.[Crossref] [Google Scholar]
  28. Gotuzzo E, Terashima A, Alvarez H, Tello R, Infante R, Watts DM, Freedman DO, , 1999. Strongyloides stercoralis hyperinfection associated with human T cell lymphotropic virus type-1 infection in Peru. Am J Trop Med Hyg 60: 146149. [Google Scholar]
  29. Montes M, Sanchez C, Verdonck K, Lake JE, Gonzalez E, Lopez G, Terashima A, Nolan T, Lewis DE, Gotuzzo E, White AC, Jr, 2009. Regulatory T cell expansion in HTLV-1 and strongyloidiasis co-infection is associated with reduced IL-5 responses to Strongyloides stercoralis antigen. PLoS Negl Trop Dis 3: e456.[Crossref] [Google Scholar]
  30. Stuver SO, Tachibana N, Okayama A, Shoiri S, Tsunetoshi Y, Tsuda K, Mueller NE, , 1993. Heterosexual transmission of human T cell leukemia/lymphoma virus type I among married couples in southwestern Japan: an initial report from the Miyazaki Cohort Study. J Infect Dis 167: 5765.[Crossref] [Google Scholar]
  31. Moriuchi H, Masuzaki H, Doi H, Katamine S, , 2013. Mother-to-child transmission of human T-cell lymphotropic virus type 1. Pediatr Infect Dis J 32: 175177.[Crossref] [Google Scholar]
  32. Roucoux DF, Wang B, Smith D, Nass CC, Smith J, Hutching ST, Newman B, Lee TH, Chafets DM, Murphy EL, HTLV Outcomes Study Investigators, , 2005. A prospective study of sexual transmission of human T lymphotropic virus (HTLV)-I and HTLV-II. J Infect Dis 191: 14901497.[Crossref] [Google Scholar]
  33. Melbye M, Poulsen AG, Gallo D, Pedersen JB, Biggar RJ, Larsen O, Dias F, Aaby P, , 1998. HTLV-1 infection in a population-based cohort of older persons in Guinea-Bissau, West Africa: risk factors and impact on survival. Int J Cancer 76: 293298.[Crossref] [Google Scholar]
  34. Buonfrate D, Formenti F, Perandin F, Bisoffi Z, , 2015. Novel approaches to the diagnosis of Strongyloides stercoralis infection. Clin Microbiol Infect 21: 543552.[Crossref] [Google Scholar]
  35. Hirata T, Kishimoto K, Kinjo N, Hokama A, Kinjo F, Fujita J, , 2007. Association between Strongyloides stercoralis infection and biliary tract cancer. Parasitol Res 101: 13451348.[Crossref] [Google Scholar]
  36. Hokama A, Adaniya H, Saito A, , 1998. Image of the month. Strongyroides stercoralis larvae. Gastroenterology 114: 6,230.[Crossref] [Google Scholar]
  37. Hennequin C, Pialoux G, Taillet BC, Caujolle B, Petite JP, , 1991. Anguilluliasis hyperinfection in a patient receiving corticosteroids: hepatic and biliary involvement. Gastroenterol Clin Biol 15: 8788. [Google Scholar]
  38. Delarocque AE, Hadengue A, Degott C, Vilgrain V, Erlinger S, Benhamou JP, , 1994. Biliary obstruction resulting from Strongyloides stercoralis infection. Report of a case. Gut 35: 705706.[Crossref] [Google Scholar]
  39. Jones N, Cocchiarella A, Faris K, Heard SO, , 2010. Pancreatitis associated with Strongyloides stercoralis infection in a patient chronically treated with corticosteroids. J Intensive Care Med 25: 172174.[Crossref] [Google Scholar]
  40. Suefuji H, Ohshima K, Hayabuchi N, Nakamura K, Kikuchi M, , 2003. HTLV-1 carriers with B-cell lymphoma of localized stage head and neck: prognosis, clinical and immunophathological features. Br J Haematol 123: 606612.[Crossref] [Google Scholar]
  41. Kozuru M, Uike N, Muta K, Goto T, Suehiro Y, Nagano M, , 1996. High occurrence of primary malignant neoplasms in patients with adult T-cell leukemia/lymphoma, their siblings, and their mothers. Cancer 78: 11191124.[Crossref] [Google Scholar]
  42. Beltran BE, Quiñones P, Morales D, Revilla JC, Alva JC, Castillo JJ, , 2012. Diffuse large B-cell lymphoma in human T-lymphotropic virus type 1 carriers. Leukemia Res Treat 2012: 262363. [Google Scholar]
  43. Tahaei SM, Mohebbi SR, Fatemi SR, Mohammadi P, Malek FN, Azimzadeh P, Almasi S, Mirsattari D, Zali MR, , 2011. Low frequency of human T-cell lymphotropic virus 1 antibodies in Iranian gastric cancer patients in comparison to controls. Asian Pac J Cancer Prev 12: 24472450. [Google Scholar]
  44. Mirsadraee M, Kalantari MR, Saffari A, Mahmoudi M, , 2007. Association of HTLV-1 infection and esophageal squamous cell carcinoma. J Gastrointest Cancer 38: 1518.[Crossref] [Google Scholar]

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  • Received : 31 Jul 2015
  • Accepted : 19 Oct 2015
  • Published online : 03 Feb 2016

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