Geographical distribution of subjects seropositive for human T-cell leukemia virus type 1 in Papua New Guinea

Seroprevalence of human T-lymphotropic virus type 1 in Papua New Guinea and Irian Jaya measured using different western blot criteria

BACKGROUND

Endemic foci of HTLV-1 carriers have been found in the world, however, the origin of HTLV-1 in humans is still unclear. Since a distinct type of virus strain was isolated from the Solomon Islands, detailed surveys on HTLV-1 prevalence in New Guinea are important to shed light on its history of dissemination.

OBJECTIVE

To clarify the seroprevalence of HTLV-1 in different regions of New Guinea Island.

STUDY DESIGN

Sera from 1221 individuals (649 males, 454 females and 118 unknown) in New Guinea Island were studied for the presence of antibodies to HTLV-1 by a particle agglutination and the Western blot (WB) tests. Two different sets of criteria, proposed by WHO and Kiyokawa et al., were employed to interpret the WB test. Since the latter seemed to lack adequate specificity, the WHO criteria was used for the evaluation of the seroprevalence throughout the study.

RESULTS

Seroprevalence of HTLV-1 differed by the WB criteria. By the more stringent criteria, HTLV-1 carriers were found in Madang, Chimbu and one hinterland province, Enga, in Papua New Guinea. An overall seroprevalence rate in different regions ranged from 0 to 14.6%. No seropositive individuals were found in Irian Jaya.

CONCLUSIONS

To avoid overestimating the seropositivity rates, the WHO criteria would be more appropriate to employ for WB test by using the samples obtained from tropical and/or malaria endemic areas. This study is the first to show HTLV-1 infected individuals in the hinterland of New Guinea Island.

Pretreatment plasma testosterone and estradiol levels in patients with locally advanced or metastasized prostatic cancer. FINNPROSTATE Group

BACKGROUND

Studies concerning pretreatment plasma hormonal environment in relation to stage of prostatic cancer have given conflicting results. The aim of the present study was to compare the pretreatment plasma testosterone (T), free T (fT), estradiol (E2), and free E2 (fE2) levels in patients with locally advanced (T3-4 M0) and metastatic (T1-4 M1) prostatic cancer, and to further examine the effect of the patients' general condition on these levels.

METHODS

The present series consisted of 238 patients (Finnprostate 6 study). The variables analyzed were E2, fE2, T, fT, age, body mass index (BMI), sex hormone binding globulin capacity (SHBG), prostate-specific antigen (PSA), alkaline phosphatase (ALP), hemoglobin concentration (Hb), erythrocyte sedimentation rate (ESR), and performance status (PS).

RESULTS

The E2 and fE2 levels were significantly higher in M0 patients than in M1 patients, with no significant differences in T and fT levels. In multivariate analyses, a decline in performance status (PS), an increase in ESR, or a decrease in Hb, were related to a decrease in T, fT, E2, or fE2 levels.

CONCLUSIONS

Pretreatment plasma estradiol was significantly lower in M1 patients than in M0 patients, but there were no significant differences in T levels, although the poor general condition was related to a decrease in the pretreatment levels of both testosterone and estradiol.

HTLV-I, HIV-I, and hepatitis B and C viruses in Western Province, Papua New Guinea: a serological survey

Seven hundred and twenty-three serum samples from individuals in 13 Gidra-speaking villages in Western Province, Papua New Guinea were tested for evidence of infection with human T-lymphotropic virus type I (HTLV-I), human immunodeficiency virus type I (HIV-I), hepatitis B virus (HBV) and hepatitis C virus (HCV). No samples were positive for antibodies to HIV-I. Antibodies to HTLV-I were found in 13 samples (1.8%), HBV surface antigens (HBsAg) were found in 86 samples (11.9%), and antibodies to HCV were found in 30 samples (4.1%). Six (46.2%) of 13 HTLV-I positive samples were positive for HCV or HBsAg. The seropositive rate varied in different villages and the incidence of HTLV-I and HCV was higher in coastal and riverine areas than inland.

Erythrocyte sedimentation rate as a tumor marker in human prostatic cancer. An analysis of prognostic factors in 300 population-based consecutive cases

BACKGROUND

The natural history of prostatic cancer is variable. Our knowledge of prognostic factors is limited; therefore, research is needed.

METHODS

The cases of 300 population-based consecutive patients with a diagnosis of cancer of the prostate were analyzed regarding different prognostic factors (but with special reference to the erythrocyte sedimentation rate [ESR]).

RESULTS

After a mean observation time of 100 months, M category, ESR, grade, performance status, hemoglobin level, and T category were found to correlate with disease-specific death using multivariate analysis. The variables correlating with progression in the multivariate model were M category, ESR, T category, grade, treatment, and age. Patients treated with estrogen had a significantly lower risk (relative hazard, 0.3) of relapse. ESR was highly statistically significant (P less than 0.0001) as a prognostic factor. With the variable in linear form, a 20-mm/h higher level suggested a 29% increased risk, on average, for dying of prostatic cancer (using a best-fit multivariate model). However, the relationship was not linear. After correcting for the effect of other factors, the risk for dying of prostatic cancer was lowest when the ESR was 40-50 mm/h and highest when its values were highest.

CONCLUSIONS

ESR is an indicator of increased risk of progression and death in prostatic cancer. Other prognostic factors such as M and T categories, grade, performance status, hemoglobin level, and age currently are more important when planning treatment. It is possible that the ESR reflects aspects of tumor-host relationship and that both a low and high ESR are markers for patients with receding host defence mechanism.

Significance of a new stratification of alkaline phosphatase and extent of disease in patients with prostate carcinoma with bone metastasis

Bone is the most frequent site of metastatic prostate cancer and the prognosis of patients with bone metastasis is poor. The authors have investigated a semiquantitative system to evaluate bone metastatic lesions in terms of cancer-specific survival. Based on the extension of disease (EOD) grade proposed by Soloway and associates, a new EOD grading system obtained from bone scintigraphy alone and EOD score obtained from bone scintigraphy and alkaline phosphatase was studied in 164 patients with prostate cancer with metastatic bone involvement. In terms of a cancer-specific survival and prostate cancer death, both the new EOD grade and the EOD score were apparently superior to eight other items studied (age, medical score, gait disturbance, histologic grade, erythrocyte sedimentation rate, prostatic acid phosphatase, and alkaline phosphatase). Multivariate analysis revealed that the EOD score was better than the new EOD grade. This improvement was due to the elimination of false-positive or nonactive metastatic bone lesions on bone scintigraphy through the alkaline phosphatase evaluation.

Highly divergent molecular variants of human T-lymphotropic virus type I from isolated populations in Papua New Guinea and the Solomon Islands

To determine the molecular genetic relationship between Melanesian strains of human T-lymphotropic virus type I (HTLV-I) and cosmopolitan prototype HTLV-I, we amplified by PCR, then cloned, and sequenced a 522-base-pair region of the HTLV-I env gene in DNA extracted from uncultured (fresh) and cultured peripheral blood mononuclear cells obtained from six seropositive Melanesian Papua New Guineans and Solomon Islanders, including a Solomon Islander with HTLV-I myeloneuropathy. Unlike isolates of HTLV-I from Japan, the West Indies, the Americas, and Africa, which share greater than or equal to 97% sequence homology, the Melanesian strains of HTLV-I were only 91.8%-92.5% identical with a prototype Japanese HTLV-IATK-1. The nucleotide sequence of proviral DNA from the Solomon Islander with HTLV-I myeloneuropathy also diverged markedly from that of HTLV-I isolated from Japanese patients with HTLV-I-associated myelopathy and from Jamaican patients with tropical spastic paraparesis, suggesting that these variant viruses are capable of causing disease. The HTLV-I variants from Papua New Guineans, in turn, differed by nearly 4% from the Melanesian variants from Solomon Islanders, indicating the existence of another HTLV-I quasi-species. By contrast, HTLV-I strains from two residents of Bellona Island, a Polynesian Outlier within the Solomon Islands, were closely related to cosmopolitan prototype HTLV-I (greater than or equal to 97% sequence identity), suggesting recent introduction, possibly during this century. These findings are consistent with a proto-Melanesian HTLV-I strain of archaic presence, which evolved independently of contemporary cosmopolitan strains, and pose new questions about the origin and global dissemination of HTLV-I.