Seroepidemiology of HTLV-1 and HTLV-2 infection in Neyshabur City, North-Eastern Iran, during 2010-2014

Background: Retroviruses of human T-lymphotropic viruses [HTLV-1 and HTLV-2] have been demonstrated to be endemic in the north-eastern region of Iran. This study was aimed to determine the HTLV-1 and HTLV-2 prevalence among healthy individuals in Neyshabur City during 2010-2014

Methods: A total of 8054 blood samples were collected from healthy participants in Neyshabur, North-Eastern Iran. The blood samples were screened for the presence of specific antibodies against HTLV-1 and HTLV-2 by using ELISA according to the manufacturer's instructions

Results: The overall seropositivity rate for HTLV-1 and HTLV-2 was found to be 6.55% [528 out of 8054] among participants

Conclusion: Both HTLV-1 and HTLV-2 were demonstrated to be at a high rate in healthy individuals. However, a smaller number of asymptomatic carriers were found in this study, as compared to those identified in previous investigations in the city

Diagnóstico serológico de HTLV-1/2: combinación de técnicas de tamizaje para definir el estatus serológico en donantes de sangre / [Serological diagnosis of HTLV-1/2: combination of screening assays to define the serological status in blood donors].

Alternative algorithms were evaluated in order to reduce the number of false reactive results for antibodies against HTLV-1/2. From 20,210 samples tested, 0.37

(74/20,210) was reactive by ELISA Murex. Of these, 23 were confirmed as positive by the indirect immunofluorescence assay whereas 51 were negative, being the positive predictive value (PPV) 31.08

. From a combination of the ELISA Murex assay with the particle agglutination assay (PA) and ELISA MP, the following results were obtained: 26/74 were reactive by ELISA Murex and PA, PPV 88.5

and 32/74 were reactive by ELISA Murex and ELISA MP, PPV 71.8

. The ROC curve analysis determined that for an RP 4.74, the values for sensitivity, specificity, PPV and NPV by ELISA Murex were 100

, respectively. We propose that reactive samples by ELISA Murex with an RP d 4.74 should be retested in duplicate by PA, and the resulting concordantly nonreactive samples should be defined as negative for HTLV-1/2.

HTLV II em doadores de sangue na Hemorrede do Ceará - HEMOCE / HTLV-II in blood donors at the Blood Center Net of Ceará - HEMOCE

OBJETIVO: O objetivo do trabalho foi identificar a prevalência do HTLV-II em doadores de sangue da Hemorrede do Ceará e aspectos epidemiológicos de casos positivos. MÉTODOS: Foram levantados em bancos de dados os casos considerados positivos, através de método Imunoenzimático (ELISA) e confirmados pelo Western Blot, no período de 2001 a 2008. Foram identificados que 679.610 amostras de sangue de doadores voluntários foram testadas neste período. RESULTADOS: Do total de doadores, 164 amostras foram efetivamente positivas em ambos os testes, destes 33 (20,1 por cento) foram tipadas como HTLV II, mostrando uma prevalência do último de 0,006 por cento. Nos casos positivos, observou-se idade média de 28,2 anos, o sexo predominantemente masculino (54,5 por cento), a cor foi considerada mulato/parda em 78,8 por cento, a maioria procedia de Fortaleza (72,7 por cento), sendo 51,5 por cento casados/união consensual e 33,3 por cento referiam ter ensino médio completo. CONCLUSÃO: Embora a infecção por HTLV-II seja baixa, sua presença é universal, sendo semelhante entre homens e mulheres, em sua maioria de centro urbano. É enfatizada a necessidade de medidas de prevenção como forma de evitar a expansão da infecção.

OBJECTIVE: To identify HTLV-II revalence in blood donors at the Blood Center Net of Ceará (Hemorrede do Ceará - HEMOCE) and epidemiological aspects of positive cases. METHODS: Cases considered positive were surveyed from data bases through the immunoenzymatic method ELISA and confirmed by Western Blot from 2001 to 2008. In this period, 679,610 blood samples from voluntary donors were tested. RESULTS: From all donors, 164 samples were actually positive in both tests; of these, 33 (20.1 percent) were typed as HTLV-II, showing a prevalence of 0.006 percent. In positive cases, a mean age 28.2 years, and a predominantly male gender (54.5 percent) were observed, the race was mixed in 78.8 percent, most donors had Fortaleza as hometown (72.7 percent), with 51.5 percent being married/consensual union, and 33.3 percent reported to have completed high school education. CONCLUSION: Although HTLV-II infection is low, its presence is universal, being similar in males and females mostly in urban centers. The need of preventive measures as a way of avoiding infection spread is stressed.

Seroprevalencia de HTLV-1/2 en donantes de sangre de la Provincia de Misiones / Seroprevalence of HTLV-1/2 in blood donors from Misiones Province

El Virus Linfotrópico T Humano tipo 1 (HTLV-1), primer oncorretrovirus humano descubierto, es el causante etiológico de la leucemia de células T del adulto (ATL) y de la mielopatía asociada al HTLV-1 o paraparesia espástica tropical (HAM/TSP). Es endémico en distintas partes del mundo, inclusive en el noroeste argentino, donde ambas enfermedades fueron detectadas. El HTLV-2, no tiene un rol etiológico definido, si bien ha sido asociado con síndromes neurológicos similares a la HAM/TSP. Ambos virus son endémicos en comunidades originarias del continente americano, tribus de Africa y poblaciones en riesgo. Ambos retrovirus se transmiten por vía sexual, parenteral y de madre a hijo. El objetivo de este trabajo fue determinar la seroprevalencia de HTLV-1/2 en una población de donantes de sangre de la provincia de Misiones. Se analizaron 6912 donaciones de sangre recibidas en el Banco de Sangre Central de la Provincia de Misiones durante 2008. La detección de anticuerpos se realizó por ELISA y aglutinación de partículas, y las muestras reactivas fueron confirmadas por Western Blot. Del total de muestras, 5 resultaron seropositivas con una prevalencia final de 0.00072. De ellas, una era HTLV, tres HTLV-1 y una HTLV-2 positiva. Los donantes positivos provenían de Posadas, Eldorado y Oberá, sin antecedentes de riesgo. Este estudio demuestra la presencia de HTLV-1/2 en donantes de sangre de Misiones, con cifras similares a las notificadas en donantes de sangre de zonas no endémicas.

Human T-cell Lymphotropic viruses type 1 (HTLV-1), the first human oncoretrovirus to be discovered, is the etiologic agent of Adult T-cell Leukemia (ATL) and HTLV-1 Associated Mielopathy or Tropical Spastic Paraparesis (HAM/TSP). It is endemic worldwide, including the North of Argentina where both associated diseases have also been detected. No etiologic role has been described for HTLV-2, although it has been associated with HAM/TSP-like neurologic syndromes. Both retroviruses are endemic in native populations of The Americas, Africa and at-risk populations. They are transmitted through sex contact, parenterally and from mother to child. The aim of this study was to estimate the seroprevalence of HTLV-1/2 in a blood donor population from Misiones province. A total of 6912 accepted blood donations in 2008 were analyzed. HTLV-1/2 screening was performed with ELISA and particle agglutination, and reactive samples were confirmed by Western Blot. From the total, 5 samples resulted seropositive with a final prevalence of 0.00072. Out of the 5 positive samples, one was an HTLV, three HTLV-1 and one HTLV-2. These blood donors were residents of Posadas, Eldorado and Oberá, with no risk antecedents. This study demonstrates the presence of HTLV-1/2 in a population of Misiones with a prevalence rate similar to those reported among blood donors from non-endemic areas.

Influence of human t-cell lymphotropic virus type 1 (HTLV-1) Infection on laboratory parameters of patients with chronic hepatitis C virus / Influência da infecção pelo vírus linfotrópico humano tipo 1 (HTLV-1) em parâmetros laboratoriais de pacientes com hepatite C crônica

Hepatitis C virus (HCV) and human T-cell lymphotropic virus type 1 (HTLV-1) share routes of transmission and some individuals have dual infection. Although some studies point to a worse prognosis of hepatitis C virus in patients co-infected with HTLV-1, the interaction between these two infections is poorly understood. This study evaluated the influence of HTLV-1 infection on laboratory parameters in chronic HCV patients. Twelve HTLV-1/HCV-coinfected patients were compared to 23 patients infected only with HCV, in regard to demographic data, risk factors for viral acquisition, HCV genotype, presence of cirrhosis, T CD4+ and CD8+ cell counts and liver function tests. There was no difference in regard to age, gender, alcohol consumption, smoking habits, HCV genotype or presence of cirrhosis between the groups. Intravenous drug use was the most common risk factor among individuals co-infected with HTLV-1. These patients showed higher TCD8+ counts (p = 0.0159) and significantly lower median values of AST and ALT (p = 0.0437 and 0.0159, respectively). In conclusion, we have shown that HCV/HTLV-1 co-infected patients differs in laboratorial parameters involving both liver and immunological patterns. The meaning of these interactions in the natural history of these infections is a matter that deserves further studies.

O vírus da hepatite C (VHC) e vírus linfotrópico humano tipo 1 (HTLV-1) compartilham formas de transmissão e algumas pessoas apresentam coinfecção. Embora alguns estudos apontem para um pior prognóstico da infecção pelo VHC em pacientes coinfectados com HTLV-1, a interação entre estas infecções é mal compreendida. Este estudo avaliou a influência da infecção pelo HTLV-1 em parâmetros laboratoriais de pacientes com VHC. 12 coinfectados VHC/HTLV-1 foram comparados com 23 pacientes monoinfectados com VHC, no que diz respeito aos dados demográficos, fatores de risco para aquisição viral, genótipo do VHC, presença de cirrose, contagens de linfócitos T CD4+ e CD8+ e testes de função hepática. Não houve diferença em relação à idade, sexo, consumo de álcool, tabagismo, genótipo do VHC ou presença de cirrose entre os grupos. O uso de drogas injetáveis foi o fator de risco mais comum entre coinfectados. Esses pacientes apresentaram maiores contagens de linfócitos T CD8+ e valores medianos de AST e ALT significativamente mais baixos (p = 0,0437 e 0,0159, respectivamente). Em conclusão, demonstrou-se que os pacientes com VHC/HTLV-1 diferem quanto aos parâmetros hepáticos e imunológicos. O significado destas diferenças na história natural destas infecções é um assunto que merece estudos mais aprofundados.

White blood cell counts in healthy Jamaican adults / Conteo de glóbulos blancos en adultos jamaicanos sanos

The investigation of presumed neutropenia places a burden on the health services, especially those of developing countries, including Jamaica. This may be because the normal ranges used in the laboratory are based on the values generated from the Caucasian population. Previous studies looking at African and Afro-Caribbean groups have found lower counts for these populations compared with Caucasians. To address this issue, 195 healthy adults donating blood at the National Public Health Laboratory and the University Hospital of the West Indies blood banks in Kingston, Jamaica, were screened for complete blood count (CBC) differentials between June 2001 and June 2006. The geometric means for the neutrophil counts were found to be 2.4 x 10(9)/L for men and 2.7 x 10(9)/L for women, with 95% confidence intervals of 2.2-2.8 x 10(9)/L and 2.5-3.1 x 10(9)/L respectively. Values for the Jamaican population were similar to those of other Afro-Caribbean groups. Based on this distribution, 14% of healthy Jamaicans would fall below the normal ranges derived from Caucasians and therefore presumed to have neutropenia. We recommend that the lower reference ranges obtained for Afro-Caribbean adults be adopted for that population.

La investigación de una neutropenia presunta, representa una carga para los servicios de salud, sobre todo en los países en vías de desarrollo, incluyendo Jamaica. La razón de ello puede estribar en que los rangos normales usados en el laboratorio, se basan en valores generados a partir de la población caucásica. Estudios previos sobre los grupos africanos y afro-caribeños, han hallado conteos más bajos para estas poblaciones, en comparación con las caucásicas. A fin de abordar este problema, 195 adultos sanos que donaron sangre al Laboratorio Nacional de Salud Pública y a los bancos de sangre del Hospital Universitario de West Indies en Kingston, Jamaica, fueron tamizados en busca de diferenciales en conteos completos de sangre (CCS), entre junio de 2001 y Junio de 2006. Para los conteos de neutrófilos, se halló que las medias geométricas fueron 2.4 x 10(9)/L para los hombres y 2.7 x 10(9)/L para las mujeres, con intervalos de confianza del 95% equivalentes a 2.2-2.8 x 10(9)/L y 2.5-3.1 x 10(9)/L respectivamente. Los valores para la población jamaicana fueron similares a los de otros grupos afro-caribeños. Sobre la base de esta distribución, el 14% de los jamaicanos saludables caerían por debajo de los rangos normales derivados a partir de los caucásicos, y por consiguiente se presumiría que tienen neutropenia. Nosotros recomendamos que los rangos de referencia más bajos obtenidos para los adultos afro-caribeños sean adoptados para esa población.

Seroprevalencia de Anticuerpos para Virus Linfotrópicos Humanos (HTLV I/II) en donantes de sangre de una Clínica de Bogotá, Colombia. 1999-2004 / Human T-lymphotropic virus (HTLV I/II) seroprevalence amongst blood-donors in a hospital Bogotá, Colombia,between 1999 and 2004

Objetivo: Determinar la prevalencia de anticuerpos para HTLV I/II, en los donantes de sangre del Banco de Sangre de la Clínica Reina Sofía, ubicada en Bogotá, Colombia. Métodos: Fueron incluidas las muestras de todos los donantes de sangre en el período comprendido entre Abril de 1999 y Agosto de 2004. A estas muestras se les realizó un ELISA para identificación de los virus HTLV I/II; a los donantes con muestras reactivas se les tomó una nueva muestra, la cual se confirmó mediante Western blot (WB). Se analizaron las encuestas de todos los donantes con pruebas reactivas para HTLV I/II en el periodo descrito y se diligenció un formulario con las variables. Resultados: La población total de donantes de sangre estudiados en los cinco años fue de 8 913 donantes, 5 883 (66 por ciento) hombres y 3 030 (34 por ciento) mujeres, con un promedio de 37 años; de los cuales 26 (0,3 por ciento) tuvieron ELISA doblemente reactivo para HTLV I/II y, de estos, solo seis pacientes fueron confirmados mediante WB, los cuales representan una prevalencia de 0,07 por ciento Conclusión: Aunque nuestros hallazgos sugieren una baja seroprevalencia para HTLV I/II, nos permiten resaltar la importancia de implantar la prueba de detección de anticuerpos contra estos virus en todos los Bancos de Sangre del país junto con las demás pruebas que ya son indispensables según la legislación colombiana para poder suministrar sangre y hemocomponentes de calidad.

Objective: This study was aimed at determining anti-human T-lymphotropic virus I/II (HTLV I/II) seroprevalence amongst blood-donors at the Clínica Reina Sofía in Bogotá, Colombia between 1999 and 2004. Methods: All people donating blood at the Clínica Reina Sofía were selected for anti-HTLV I/II testing; a survey was carried out which focused on risk factors. All blood donations were screened by using enzyme immunolinked assay (ELISA); repeatedly reactive serum samples were confirmed as being HTLV I or HTLV II by using Western blot (WB). Results: 8 913 blood donors, 5 883 (66 percent) males and 3,030 (34 percent) females having a mean age of 37 were included in the study; 26 (0,3 percent) were repeatedly reactive in ELISA tests, 6 (0,07 percent) of whom were confirmed by using Western blot (WB). Our findings revealed 0,07 percent HTLV seroprevalence amongst blood-donors, in line with other European and South-American countries. Conclusion: Although our findings suggest low HTLV I/II seroprevalence, blood-donors should be routinely screened to minimise transmission due to occult HTLV I/II infection in Colombia.

Avaliação do desempenho de parâmetros imunológicos como indicadores de progressão clínica da infecção crônica pelo HTLV-1 / Evaluation of the performance of immunological parameters as indicators for clinical progression of chronic HTLV-1 infection

Neste estudo, foi avaliado o desempenho isolado e combinado de parâmetros laboratoriais, percentual de linfócitos B ( por centoLB), a razão entre células T/B e o por centoCD8+HLA-DR+/CD8+, na identificação de indivíduos assintomáticos-AS ou portadores de HAM/TSP-HT numa população de casos soropositivos para HTLV-1. índices expressos em porcentagem demonstram que cada parâmetro, isoladamente, apresenta desempenho moderado, com co-negatividade=83 por cento e 91 por cento para por centoLB e razão entre células T/B, respectivamente e co-positividade=78 por cento para por centoCD8+HLA-DR+/CD8+. A análise combinada ( por centoCD8+HLA-DR+/CD8+ e razão T/B) não revelou ganho significativo no desempenho (co-positividade=75 por cento, co-negatividade=74 por cento). A análise das razões de verossimilhança em diferentes faixas de valores, para os parâmetros isolados, revelou que um indivíduo soropositivo para HTLV-1 com por centoLB<7 por cento, razão entre células T/B>11 e por centoCD8+HLA-DR+/CD8+>70 por cento possui, respectivamente, 11, 19 e quase 10 vezes mais chances de pertencer ao grupo HT. Portanto, recomenda-se o uso desses indicadores fenótipos na propedêutica laboratorial complementar de monitoração da progressão clínica da infecção crônica pelo HTLV-1.

This study evaluated the performance of single and combined laboratory parameters, B-lymphocyte percentages ( percentLB), T/B cell ratio and percentCD8+HLA-DR+/CD8+, to differentiate asymptomatic cases (AS) from HAM/TSP patients (HT) within a population of HTLV-1 seropositive cases. Percentage indices demonstrated that each parameter alone presented moderate performance, with co-negativity of 83 and 91 percent for percentLB and T/B cell ratio, respectively, and co-positivity of 78 percent for percentCD8+HLA-DR+/CD8+. Combined analysis ( percentCD8+HLA-DR+/CD8+ and T/B cell ratio) did not show any substantial performance enhancement (co-positivity = 75 percent and co-negativity = 74 percent). Likelihood ratio analysis using different value ranges for the separate parameters revealed that HTLV-1 seropositive cases with percentLB<7 percent, T/B cell ratio>11 and percentCD8+HLA-DR+/CD8+>70 percent would have, respectively, 11, 19 and 10 times greater chance of belonging to the HT group. Therefore, use of these phenotypic indicators as complementary laboratory methods for monitoring the clinical progression of chronic HTLV-1 infection is recommended.

Spontaneous neutrophil activation in HTLV-1 infected patients

Human T cell lymphotropic Virus type-1 (HTLV-1) induces lymphocyte activation and proliferation, but little is known about the innate immune response due to HTLV-1 infection. We evaluated the percentage of neutrophils that metabolize Nitroblue tetrazolium (NBT) to formazan in HTLV-1 infected subjects and the association between neutrophil activation and IFN-gamma and TNF-alpha levels. Blood was collected from 35 HTLV-1 carriers, from 8 patients with HAM/TSP (HTLV-1- associated myelopathy); 22 healthy individuals were evaluated for spontaneous and lipopolysaccharide (LPS)-stimulated neutrophil activity (reduction of NBT to formazan). The production of IFN-gamma and TNF-alpha by unstimulated mononuclear cells was determined by ELISA. Spontaneous NBT levels, as well as spontaneous IFN-gamma and TNF-alpha production, were significantly higher (p<0.001) in HTLV-1 infected subjects than in healthy individuals. A trend towards a positive correlation was noted, with increasing percentage of NBT positive neutrophils and levels of IFN-gamma. The high IFN-gamma producing HTLV-1 patient group had significantly greater NBT than healthy controls, 43±24 percent and 17±4.8 percent respectively (p< 0.001), while no significant difference was observed between healthy controls and the low IFN-gamma-producing HTLV-1 patient group (30±20 percent). Spontaneous neutrophil activation is another marker of immune perturbation resulting from HTLV-1 infection. In vivo activation of neutrophils observed in HTLV-1 infected subjects is likely to be the same process that causes spontaneous IFN-gamma production, or it may partially result from direct IFN-gamma stimulation.

HTLV-I/II and blood donors: determinants associated with seropositivity in a low risk population

OBJETIVO: Doadores de sangue no Brasil têm sido avaliados sorologicamente para o HTLV-I/II desde 1993. Assim, realizou-se estudo para estimar a prevalência dessa infecçäo em populaçäo de baixo risco e para melhor compreender os determinantes associados à soropositividade. MÉTODOS: Doadores de sangue soropositivos (n=135), soroindeterminados (n=167) e soronegativos (n=116) foram arrolados como participantes de uma coorte aberta e prevalente. Estudo transversal dos participantes desses três grupos avaliou fatores de risco comportamentais e ambientais para soropositividade. O status sorológico foi definido usando a reaçäo de EIA (enzyme linked immunosorbent assay) e o teste Western blot (WB). RESULTADOS: Os três grupos apresentaram heterogeneidade entre si. A soropositividade mostrou-se associada à história pregressa de transfusäo de sangue, em nível educacional, como um marcador de condiçäo socioeconômica e ao uso de drogas ilegais näo endovenosas. CONCLUSOES: Os resultados confirmam a importância de um monitoramento e refinamento do processo de seleçäo dos doadores de sangue

Tamizaje de HTLV en donantes de sangre: correlación entre enzimoinmunoensayo y Western Blot / HTLV screening in blood donors: correlation between ELISA and Western Blot

Introducción: El HTLV es un retrovirus transmisible por hemocomponentes. Es el agente causal de la leucemia T del adulto y de la paraparesia espástica tropical. Las Normas de Medicina Transfusional vigentes indican el tamizaje en donantes de sangre. El objetivo del presente trabajo es conocer la correlación entre el EIA y su método suplementario, el Western Blot (WB). Material y método: Se estudiaron 9.675 muestras de donantes de sangre voluntarios. Todas fueron controladas para brucelosis, lúes, HIV p24, Chagas, HBsAg, anti-HBc, anti-HCV y anti-HIV. El tamizaje para HTLV I/II se realizó empleando EIA (Abbott), el método suplementario empleado fue WB (Genelabs). Resultados: Veintiocho muestras fueron repetidamente reactivas por EIA (0,3 por ciento), 24 (86 por ciento) de ellas tuvieron un resultado indeterminado por WB, 2 (7 por ciento) resultaron positivas para HTLV-I y 2 (7 por ciento) negativas. Las bandas más frecuentemente reactivas en los 26 donantes positivos o indeterminados fueron el p53 (77 por ciento), p26 (77 por ciento) y p36 (73 por ciento). Las bandas de core p24 y p19 estuvieron presentes en el 58 por ciento y 50 por ciento, respectivamente. Las combinaciones de bandas más frecuentes fueron p53 + p36 (62 por ciento), p53 + p26 (62 por ciento), p36 + p26 (62 por ciento) y p53 + p36 + p26 (54 por ciento). No existió relación entre el valor de reactividad del EIA y la positividad o perfil de bandas del WB. Conclusiones: Un resultado reactivo en la prueba de tamizaje de HTLVI/II por EIA redundará en un alto porcentaje de resultados indeterminados por WB y en una baja frecuencia de WB negativos. Esto implica una muy buena concordancia entre la reactividad de una muestra por EIA y la presencia de varias bandas reactivas en el WB.

Evaluation of serum interlekin - 2 Roc in H A M / TSP patients and HTLV - 1 carriers in Mashhad - Iran

Seropositive rate of human T-cell leukemia virus type 1 [HTLV-1] in Mashhad [a city in the north east of Iran] is 2.3% which is a new endemic area in the world. Less than 2% of these HTLV-1 carriers suffer from HTLV-1 associated myelopathy/tropical spastic paraparesis [HAM/TSP]. Twenty serum samples from HAM/TSP patients, 44 from HTLV-1 carriers and 20 from healthy individuals were tested for serum IL-2R[alpha] by ELISA method. The mean soluble interleukin-2 receptor alpha [sIL-2R[alpha] in HAM/TSP patients, HTLV-1 carriers and healthy subjects was 1420, 1460 and 374 pg/ml respectively. This study revealed that the level of sIL-2R[alpha] in HAM/TSP patients and HTLV -1 carriers was significantly more than healthy subjects [P<0.05], but no significant difference between HTLV-1 carriers and HAM/TSP patients was found

Infecção pelo HTLV-I/II no Estado da Bahia / HTLV-I/II infection in the state of Bahia

A cidade do Salvador, capital do Estado da Bahia, apresenta a população com maior prevalência da infecção pelo HTLV-I no Brasil. Todavia, somente um estudo incluiu uma cidade do interior deste Estado, mesmo assim com número amostral pequeno. O objetivo foi o de avaliar a prevalência de anticorpos anti-HTLV-I/II na população de quatro cidades do interior do Estado da Bahia. As amostras de soro proveninentes de 1.539 indivíduos residentes em Catolândia, Ipupiara, Jacobina e Prado foram triadas através do ELISA, e a confirmação dos resultados nas amostras repetidamente positivas foi realizada através do "Western blot". Quarenta e sete (3,1%) amostras foram positivas pelo ELISA, e 44 destas foram submetidas ao Western blot, com 5 resultados positivos (0,3%), 8 (0,5%) indeterminados (todos da cidade de Jacobina) e 31 negativos. A prevalência geral de anticorpos anti-HTLV-I, nas cidades estudadas, foi de 0,3%. Esta prevalência variou de 0,0% (Prado) a 0,7% (Jacobina), porém não houve diferença estatisticamente significante (p > 0,21). Nenhum indivíduo apresentou anticorpos anti-HTLV-II. Em conclusão, a prevalência da infecção pelo HTLV-I no interior do Estado da Bahia foi baixa, contudo, a população da cidade de Jacobina apresentou a maior prevalência. No entanto, outros estudos epidemiológicos, clínicos e virológicos serão necessários para a melhor compreensão da história natural desta infecção em Jacobina.

The city of Salvador, capital of Bahia, presents a population with the highest prevalence of HTLV-I infection in Brazil. Until now, only one study has investigated this infection in other cities of this state, even though by using a small sample. With objective to evaluate the prevalence of HTLV-I/II antibodies in four cities of the state of Bahia. Serum samples from 1,539 individuals who lived in Catolândia, Ipupiara, Jacobina and Prado were screened by ELISA, and repeatedly reactive samples confirmed by Western Blot. Forty-seven (3.1%) samples were positive by ELISA, and 44 of them were tested by Western blot: 5 (0.3%) were positive, 8 (0.5%) were indeterminate (all of them from Jacobina) and 31 were negative. The overall prevalence of HTLV-I antibodies was 0.3%. This prevalence varied from 0.0% (Prado) to 0.7% (Jacobina), but differences were not statistically significant (p > 0.21). None of these individuals presented HTLV-II antibodies. Jacobina showed the highest prevalence of HTLV-I infection among the cities studied, although the overall prevalence was low. In conclusion, further epidemiological, clinical and virological studies will be of paramount importance to obtain a better understanding of the natural history of this infection in Jacobina.

Confirmación de la presencia en Cuba del virus linfotrópico tipo I de las células T humanas mediante la reacción en cadena de la polimerasa / Confirmation of the presence in Cuba of the human T lymphotropic virus type I by polymerase chain reaction

Se estudiaron por reacción en cadena de la polimerasa los primeros casos diagnosticados en Cuba como seropositivos al HTLV-I/II (virus linfotrópicos de las células T humanas), con el objetivos de diferenciar el tipo de virus causante de la infección. Se utilizaron 3 juegos de oligonucleótidos cebadores y los productos de amplificación fueron detectados mediante hibridación con oligosondas específicas. El 100 por ciento de los casos resultaron positivos para el HTLV-I, no se encontró positividad para el HTLV-II. Se confirmó la presencia en Cuba de este retrovirus, aunque la seroprevalencia es baja si se tiene en cuenta que el Caribe es una zona endémica para el HTLV-I

HTLV-I associated uveitis, myelopathy, rheumatoid arthritis and Sjogren's syndrome

Uma mulher branca de 62 anos foi internada apresentado história de paraparesia lentamente progressiva durante 10 anos. Dois meses antes da internaçao ela apresentou uveíte anterior nao granulomatosa bilateral. Poucos anos após início dos sintomas neurológicos, ela desenvolveu artrite migratória com edema dos joelhos e dor à palpaçao dos joelhos e dedos dos pés, boca, pele e olhos secos. Ao exame físico foi observado paraparesia espástica com sinal de Babisnski positivo, sensibilidade diminuída abaixo de L3, diminuiçao da sensaçao de vibraçao nas extremidades inferiores, e tremor postural dos membros superiores. Apresentou testes positivos para o HTVL-I no sangue. O estudo da velocidade da conduçao dos nervos foi normal. Este caso mostra a associaçao de uveíte, artrite e síndrome de Sjö em uma paciente com paraparesia espástica tropical (HTLV-I) associada a mielopatia (TSP/HAM), ilustra o largo espectro das manifestaçoes clínicas que podem acompanhar a infecçao por este vírus.

HTLV-I antibody study in normal individuals and unselected hospital patients in Malaysia.

A serological investigation for human T cell leukemia virus I (HTLV-I) infection was carried out at the University Hospital, Kuala Lumpur. A total of 626 sera from a non-patient population and 1,038 sera from unselected in-patients were screened for HTLV-I antibodies using an enzyme-linked immunosorbent assay (ELISA). 27/1664 (1.6%) were found to be reactive. However, on Western blotting, only 2 sera were confirmed positive, both showing reactions for the major core (p19 and p24) and the envelope (gp46) proteins. Both of the serum samples were from unselected hospital patients. Most of the remaining sera which were reactive on screening showed indeterminate results on Western blotting. These were further tested by radioimmunoprecipitation assay (RIPA) and none of these sera gave a positive reaction. Therefore, only 2/1038 (0.19%) unselected patients could be confirmed to have antibodies to HTLV-I. None of the normal individuals screened showed a positive Western blot result. Our data indicate that HTLV-I infection is present in our population, but at a low prevalence rate.

Serological profiles for HBV, HDV, HIV-1 and HTLV-1 in Saudi patients with a malignancy.

Serologic markers for HBV, HDV, HIV-1 and HTLV-1 were tested in 42 patients with a primary hepatocellular carcinoma (PHC); 19 with a malignancy of epithelial origin (EPM) and 16 with a non-epithelial malignancy (NEPM) in the Gizan Area of Saudi Arabia. HBV exposure in 77 PHC, EPM and NEPM patients was 92.2 per cent for any marker (overall) while 75.3 per cent positive for HBsAg. 3.9 per cent positive for anti-HBc and 12.9 per cent positive for anti-HBs. There was no inter PHC, EPM, NEPM or intersex variation for an individual marker or total HBV exposure. Among HBsAg-positives, 9 of the 12 PHC tested, 7 of the 10 EPM, 1 of the 9 NEPM were anti-D IgG positive. The HDV prevalence was the lowest in NEPM (p < 0.01). In patients with a malignancy, all HBV and HDV markers were higher than those of control population, even though anti-HBs was lower (p < 0.001). The probable contribution through different viruses in pathogenesis of malignancies of different types should be ascertained through polymerase chain reaction for viral components, oncogenes, etc. on tumourous biopsy tissues. The aggravation in PHC morbidity in HBV hyperendemic foci through HIV infection should be monitored through tests for unintegrated and integrated viral DNA in tumorous and non-tumorous tissues.