Human T‐Cell lymphotropic virus type I and severe neoplasia of the cervix in jamaica

Human T‐cell lymphotropic virus type 1 (HTLV‐1) was associated with carcinoma of the cervix in Japan in a recent study that compared hospital cases with healthy population‐based controls. To test this relationship in women more alike for cervical neoplasia risk factors (including sexual behavior and human papilloma virus; HPV), we enrolled consecutive patients from a colposcopy clinic in Kingston, Jamaica (an HTLV‐1 endemic area). Patients underwent Pap smear, colposcopy, biopsy and cervical swab for detection of HPV by polymerase chain reaction. Cases were defined as women with CIN‐3 or invasive cancer (CIN‐3/CA). Controls included all patients with either CIN‐1 or koilocytotic atypia, atypical squamous cells of undetermined significance or benign cervical pathology (all but one had at least inflammatory changes). Patients with CIN‐2 were excluded to minimize risk of case‐control misclassification. Cases were much more likely to be HTLV‐1 seropositive than controls. Although mean age differed significantly between cases (mean age = 39 years) and controls (mean age = 33 years), control for age did not explain the relation of CIN‐3/CA with HTLV‐1. Among HPV DNA positive subjects the age‐adjusted association was not diminished but lost statistical significance. HTLV‐1 seroprevalence may be independently associated with progression to severe neoplasia of the cervix. © 1995 Wiley‐Liss, Inc.