[Question #4132] HTLV (#4101 follow-up)

33 months ago

Dr Handsfield,

Thankyou again for your response to Q #4101. I would like to apologise for not realising the protocol of creating a new question, hope sincerely I didn’t cause any offence from using a follow-up instead.

Below are my questions copied again below - I’m conscious you said there is limited data for HTLV non-sexual/bloodborne transmission, so if my questions are not answerable directly, would it be possible to answer more broadly and give background on HTLV and XMRV?

As presumably there is limited data because these are rare diseases and/or the transmission rates are low? I had thought the former, but the CDC study linked below seems to indicate HTLV is prevalent and can be transmitted relatively easily? So at this point I’m not exactly sure what to make of what I’ve read, and what this translates to in terms of risk?

Question 1. I read about HTLV-1 & HTLV-2, my previous belief was these were rare diseases. However reading articles from CDC (https://wwwnc.cdc.gov/eid/article/15/7/08-0796_article) and EU health authority (https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/geographical-distribution-areas-high-prevalence-HTLV1.pdf) - these are saying HTLV is much more common than I had thought.

Also my ex-girlfriend was not from the US/Europe, and was very promiscuous with previous partners from many different countries. However would I be right that the risk of transmission to my family of HTLV 1&2 through sharing razors/toothbrush/towels/household objects/non-sexual massage, is at least as low or lower than HBV/HCV, i.e. so Dr. Hook's advice in last response #4071 would be unchanged? And that per your comments above on transmission for STDs, no medical condition/medication would impact the risk of HTLV transmission?

I was googling it to save having to ask you, I found this response (from a long time ago) where you stated you didn't actively keep up to date on HTLV literature (https://www.medhelp.org/posts/STDs/HTLV-1-and-2/show/246144). But I would I be right that given your extensive expertise as an epidemiologist, you have current knowledge in this field, and are thus fully able to give expert advice? (I see more recently you have given more detailed responses on HTLV)

Question 2. At the same time I was googling your previous advice, I came across reference to the XMRV virus. Am I correct that the risks through any non-sexual/household transmission methods for XMRV (as mentioned in question 1 on HTLV) would be at least as low or lower than HBV/HCV, so Dr. Hook's response would be unchanged? And that no medical condition/medication has impact on transmission risk?

Sorry I tried googling XMRV as well but apart from a spate of news articles/studies around 2010, I was not able to see anything more current.

Also the CDC study linked above appeared to suggest HTLV was being easily/regularly transmitted from people from high prevalence areas/nationalities, to people they were living with from low prevalence areas. I.e due to this high transmission rate, even people originally from low prevalence areas were at risk of HTLV.

33 months ago
And sorry to be clear, the above is in reference to both HTLV 1 & 2 (and any other variant). Thankyou again Dr
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
What exactly wasn't clear about my closing reply in your previous thread? Its whole point was that we do NOT "...have current knowledge in this field, and are thus fully able to give expert advice." Because these viruses are not commonly sexually transmitted and not widely considered STDs, most STD specialists do not follow the literature and in general should not be considered experts in the viruses, the illnesses they cause, or their overall epidemiology or transmission mechanisms. There may be other online forums that can answer these questions properly, but not this one. Sorry.