Elevated levels of iC3b and C4d, but not Bb, complement fragments from plasma of persons infected with human T cell leukemia virus (HTLV) with HTLV-I-associated myelopathy/tropical spastic paraparesis

Plasma levels of complement (C) fragments iC3b, C4d, and Bb from human T cell leukemia virus (HTLV)-positive subjects with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP) were analyzed by EIA. Both iC3b and C4d levels were significantly elevated in persons with HAM/TSP. These levels were similar to those in patients with human immunodeficiency virus (HIV) infection or rheumatoid arthritis (RA), who are known to have increased C fragments. Bb levels in persons with HAM/TSP wer unaffected, suggesting that C activation occurred only via the classical pathway. This differed from findings in HIV-infected or RA patients, who had elevated levels of Bb. The results showed an increase in C activation in persons with HAM/TSP and activation via the classical pathway, likely mediated by virus or immune complexes. It is possible that the C activation observed in these subjects contributed to the inflammatory pathogenesis of HAM/TSP.

Commentary. The pastor as patient

During his hospitalization for treatment of prostate cancer, this pastor-author found that the ill are often not put off by the shortcomings of those who would provide spiritual care. They are able to see beyond any shortcomings of their minister to the life and power of the liturgy itself and the pastor's "loving intentions."

Prevalence of HTLV infection in the Dominican Republic: association with neurological disease

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.

Prevalence of antibodies to the human immunodeficiency virus in Dominicans and Haitians in the Dominican Republic

Few patients with the acquired immunodeficiency syndrome have been reported in the Dominican Republic, although they share the island of Hispaniola with Haiti, which has numerous cases. Prevalence of antibodies to the human immunodeficiency virus in serum samples from Dominicans tested from 1983 through 1985 was low in comparison with that of clinically healthy Haitians working in the country. The Haitians, who gave no history of any known risk factor, had a seroprevalence to the virus of more than 10%. Only Dominican homosexuals had a high rate of seropositivity (19%); intravenous drug abusers, healthy heterosexuals, female prostitutes, and other subgroups had virtually no evidence of antibodies to the human immunodeficiency virus. These results suggest that passage of the acquired immunodeficiency syndrome retrovirus between populations in two countries on the same island did not occur except by known risk practices. They emphasize that the extent of viral transmission in Haiti is greater than that observed in the Dominican Republic.