HTLV1/2 infection among renal dialysis patients in Egypt

ABSTRACT

Hemodialysis patients are one of the high risk groups for blood borne viral infection including HTLV1/2. This study was carried out on 171 chronic hemodialysis patients. From each patient, a serum sample and EDTA anticoagulated blood were collected. Serum was tested for anti HTLV1/2 antibodies by ELISA. Positive patients were confirmed by whole blood-PCR for detection of HTLV1/2 proviral DNA. Two [1.17%] patients were positive for both HTLV1/2 antibodies [by ELISA] and HTLV1/2 proviral DNA [by whole blood-PCR]. Interestingly, these two patients received more than 30 blood transfusions and were on hemodialysis for more than one year. Among patients who received 30 or more blood transfusions and those on hemodialysis for one year or more, the prevalence of HTLV1/2 positivity [by both ELISA and PCR] was 4.8% and 1.6%, respectively. A high frequency of HCV seropositivity [76%] was detected among our patients. Nevertheless, this frequency was not affected by the number of previously received blood transfusions [x[2] =3.48, P=0.481] or duration of hemodialysis [x[2] =3.21, P=0.073]. Two [1.17%] patients were positive for HBs antigen and they were transferred to the Fevers Hospital Hemodialysis Centre. This probably represents the tip of the iceberg as serum HBs antigen screening in the present setting is done every three months. Therefore, these two patients converted to HBs antigen seropositivity within the last three months only. Fortunately, none of our patients was anti HIV1/2 positive. These results suggest that HTLV1/2 infection occurs in hemodialysis patients in Egypt and the prevalence becomes more among those receiving 30 or more blood transfusions and those on hemodialysis for one year or more. Therefore, we recommend screening of blood for HTLV1/2 antibodies before transfusion to chronic hemodialysis patients. In addition, proper infection control should be stressed in hemodialysis centres. Interestingly, a high prevalence of HCV positivity occurred in our patients in spite of routine anti HCV screening of blood prior to transfusion. Therefore, exclusion of anti-HCV positive patients to separate hemodialysis centres is recommended to control the rapid spread of HCV infection among these vulnerable patients