Human Immunodeficiency Virus Type 1 and Human T-Cell Lymphotropic Virus Type I and II among Intravenous Drug Users in Malindi Sub-County, Kenya

Abstract

Human T-cell Lymphotropic Virus type one and two (HTLV1/2) infections are highly prevalent among Human Immunodeficiency Virus (HIV) infected intravenous drug users (IDUs). The two viruses share similar routes of transmission and tropism for T-lymphocytes thus co-infection is common. This study aimed at determining prevalence of HIV and HTLV-1/2infections among IDUs in Omari and KANCO Drop-in centres in Malindi Sub-County. These findings were correlated with socio-demographic factors, injection and sexual practices of the study population. A cross-sectional study was conducted using structured questionnaires and laboratory testing of blood samples from 351 consenting adult IDUs. Purposive sampling was used to enroll IDUs from the two Drop-in Centres. Serology for HIV-1 and HTLV-1/2 was carried out using Vironostika HIVAg/Ab protocol and HTLV1/2 Enzyme-linked Immunosorbent Assay (ELISA) respectively. Logistic univariate regression was used to determine significant factors for HIV and HTLV infections at p<0.05. Of the 351 recruited IDUs (with a mean of 33.1and SD ± 6.5years), 9.7% (34/351) were positive for HIV, 5.8% (20/351) were HTLV1/2 positive while 0.9% (3/34) were HIV/HTLV-1/2 co-infected. HIV infection was significantly associated with homelessness (OR, 2.5; 95CI, 1.3-5.3; p=0.009), needle sharing (OR, 2.1; CI, 1.0-4.3; p=0.042) and previous history of gonorrhea and syphilis (OR, 3.7; CI, 1.9-7.5; p=0.000). HTLV-1/2 infection was significantly associated with Omari Centre (OR, 7.9, CI, 1.1-59.6; p=0.043), unprotected anal sex (OR, 3.1, CI, 1.1-8.5; p=0.029) and previous history of gonorrhea and syphilis infections (OR, 2.9; CI, 1.1-7.3; p=0.021). There were no significant factors for HIV/HTLV-1/2 co-infection. High risk injection and sexual behavior increase the risk of HIV and HTLV1/2 transmission. Routine testing of HTLV1/2 and harm reduction measures should be introduced in all outpatient IDU clinics so as to monitor prevalence estimates and mitigate further transmission.