Detección de anticuerpos contra los virus linfotrópicos de células T Tipo I, II, HTLV I, II, como medida de seguridad sanguínea en donantes de sangre en Costa Rica, mayo del 2002 a diciembre del 2004 / Detection of antibodies against viruses linfotropicos T cell type I, II, HTLV I, II, as a security measure blood in blood donors in Costa Rica, May 2002 December 2004

RESUMEN

Los Virus Linfotrópicos Humanos tipo I y II, HTLV I, II, fueron los primeros retrovirus descritos y aislados en 1980. Tienen distribución mundial y son endémicos en el sur de Japón, el Caribe, algunos países del Sur y Centro América, Africa occidental y algunas otras poblaciones. Aunque la mayoría de infectados permanecen asintomáticos por largos períodos, el HTLV I es el agente causal de la leucemia linfoma de células T del adulto, LTA, y de la Paraparesia Espástica Tropical, PET o mielopatía asociada, MAH. El HTLV II se identificó inicialmente en un paciente con leucemia peluda de células T, pero se requieren más estudios para establecer la relación entre ambos. Dos de las principales vías de transmisión son la transfusión sanguínea o por compartir agujas de individuos infectados en drogadicción. Para controlar la transmisión de la infección en Costa Rica, se inició en el año 2002 un proyecto de la Sección de Laboratorios Clínicos de la CCSS, para la tamización de anticuerpos contra estos retrovirus a todos los donantes de sangre, fecha histórica para nuestro país por ser el primero en tener una cobertura del 100 por ciento de los donantes en América Latina...

ABSTRACT

During 1980, Human T lymphotropic virus (HTLV-I /II) were the first retrovirus identified and isolated.The geographic distribution of the virus is global, with endemic regions like south Japan, the Caribbean islands, western Africa, some South and Central America countries and other specific populations.Most infected patients remain without symptoms for long periods of time but association with human disease has been demonstrated. HTLV-II has been linked to adult T-cell leukemia/lymphoma (ATL/ATLL) and is also the causative agent of a neurological disorder termed HTLV-II associated Myelopathy/ttropical Spastic Parapesis.HTLV-II was first identified in a patient with hairy-cell leukemia, however better studies are needed to establish the relation between both. HTLV can be transmitted by blood transfusion and sharing of needles and syringes. During 2002, Costa Rica became the first Latin American country with 100% coverage of blood donors. In this year, the Sección de Laboratorios Clínicos de la CCSS began as a project the screening for antibodies against HTLV in order to avoid transmission through this route. Of 106958 blood donors, 582 (0,54%) were initially reactive by enzyme-immunolinked assay (EELISA), 272 (46,7%) were reactive in duplicated with the same ELISA and they were analyzed by a second ELISA and 232 were confirmed with an "in-house "Western Blot (WB).. Those represent the 0.25% of the initial population. Twenty seven samples (0.03%) confirmed positives and 136 (0.13%) were indeterminate. A commercial WB was performed with 13 of these positive samples, 7 were HTLV-II, 5 were HTLV-III and 1 was an indeterminate pattern...