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March 23, 1984

Screening for Human T-Cell Leukemia-Lymphoma Virus-Reply

Author Affiliations

City of Hope National Medical Center Duarte, Calif

JAMA. 1984;251(12):1555. doi:10.1001/jama.1984.03340360023018

In Reply.—  Dr Smally raises two questions: the first, whether hospital employment predisposes to HTLV infection, perhaps by contact with contaminated hospital paraphernalia, patient contact, or other means, cannot be definitively answered. Our survey of laboratory workers who were intensively involved in culture and processing of HTLV-laden specimens and cell culture material uncovered no evidence of seroconversion.1 With the possible exception of pregnant women,2 it is unlikely that casual exposure to the occasional HTLV-positive patient will result in danger to medical workers.The second question raises the issue of general screening for medical workers to protect their colleagues or their patients. In general, screening should not be carried out unless confirmatory assays or effective interventions might follow. To screen workers for presence of a putative "human leukemia virus" with our current body of etiologic knowledge and lack of specific strategies to prevent infection or seroconversion is unjustified. There