[SHTLV-I/II seroprevalence in blood donors of Hospital Pablo Tobón Uribe Blood Bank during the period 2014-2015].

INTRODUCTION: The human-T cell lymphotropic virus is a retrovirus with various types known so far. HTLV-I and HTLV-II are of clinically importance as they cause different diseases such as adult T-cell leukemia/lymphoma, tropical spastic paraparesis, and human T-lymphotropic virus type I-associated myelopathy (HAM). OBJECTIVE: To estimate the prevalence of presumptive and confirmatory reactivity to HTLV-I/II in blood donors of Hospital Pablo Tobón Uribe Blood Bank between 2014 and 2015. MATERIALS AND METHODS: The information was obtained from the Hospital Pablo Tobón Uribe Blood Bank database. We analyzed age, sex, place of origin, and place of residence of donors, and the reactivity using the screening test (ELISA) as well as the confirmatory test (immunoblot). RESULTS: The donor population studied included 6,275 men and 8,148 women, for a total of 14,423 donors recruited between March 1, 2014, and June 30, 2015. Of all tested donors, 25 were positive for HTLV-I/II by the screening test (ELISA). After performing the confirmatory test (immunoblot), only nine patients were positive for HTLV-I/II (36%), of whom eight were reactive to HTLV-I (32%) and one to HTLV-II (4%), for a global seroprevalence of 0.06% (CI 95%: 0.10-0.25). CONCLUSIONS: Our findings were consistent with those found in similar studies in non-endemic areas of the country and with those from studies at international level reported in the literature.

Seroprevalencia de los virus linfotrópicos de células T humanas de tipos I y II en donantes del Banco de Sangre del Hospital Pablo Tobón Uribe, entre 2014 y 2015 / HTLV-I/II seroprevalence in blood donors of Hospital Pablo Tobón Uribe Blood Bank during the period 2014-2015

Resumen Introducción . El virus linfotrópico humano de células T (HTLV) es un retrovirus del cual se conocen varios tipos, entre ellos el HTLV-I y el HTLV-II, los cuales son de importancia clínica por ser los causantes de diferentes enfermedades, como la leucemia y el linfoma de células T del adulto, la paraparesia espástica tropical y la mielopatía asociada al HTLV. Objetivo . Obtener la prevalencia de las reacciones presuntiva y confirmatoria de los virus HTLV-I y HTLV-II en los donantes del Banco de Sangre del Hospital Pablo Tobón Uribe de Medellín, entre el 2014 y el 2015. Materiales y métodos . La información se obtuvo de la base de datos del Banco de Sangre del Hospital Pablo Tobón Uribe. Se analizaron la edad, el sexo y el lugar de procedencia y de residencia de los donantes, así como la reacción en la prueba de tamización (ELISA) y en la prueba confirmatoria (inmunoblot). Resultados . La población de donantes estudiados incluyó a 6.275 hombres y 8.148 mujeres, para un total de 14.423 donantes reclutados entre el 1° de marzo de 2014 y el 30 de junio de 2015. De ellos, 25 resultaron positivos para HTLV-I o HTLV-II en la prueba de tamización (ELISA). En la prueba confirmatoria (inmunoblot), nueve (36 %) pacientes fueron positivos para el HTLV-I o HTLV-II , y de ellos ocho (32 %) lo fueron para el HTLV-I y uno (4 %) para el HTLV-II; la seroprevalencia global fue de 0,06 % (IC95% 0,10-0,25). Conclusiones . Los hallazgos del estudio concordaron con los de estudios similares en áreas no endémicas del país y con los de los estudios consultados a nivel internacional.

Abstract Introduction: The human-T cell lymphotropic virus is a retrovirus with various types known so far. HTLV-I and HTLV-II are of clinically importance as they cause different diseases such as adult T-cell leukemia/lymphoma, tropical spastic paraparesis, and human T-lymphotropic virus type I-associated myelopathy (HAM). Objective: To estimate the prevalence of presumptive and confirmatory reactivity to HTLV-I/II in blood donors of Hospital Pablo Tobón Uribe Blood Bank between 2014 and 2015. Materials and methods: The information was obtained from the Hospital Pablo Tobón Uribe Blood Bank database. We analyzed age, sex, place of origin, and place of residence of donors, and the reactivity using the screening test (ELISA) as well as the confirmatory test (immunoblot). Results: The donor population studied included 6,275 men and 8,148 women, for a total of 14,423 donors recruited between March 1, 2014, and June 30, 2015. Of all tested donors, 25 were positive for HTLV-I/II by the screening test (ELISA). After performing the confirmatory test (immunoblot), only nine patients were positive for HTLV-I/II (36%), of whom eight were reactive to HTLV-I (32%) and one to HTLV-II (4%), for a global seroprevalence of 0.06% (CI 95%: 0.10-0.25). Conclusions: Our findings were consistent with those found in similar studies in non-endemic areas of the country and with those from studies at international level reported in the literature.

Recuento de células CD34+ en sangre periférica como predictor de adecuada recolección de progenitores hematopoyéticos para trasplante autólogo / Peripheral blood CD34+ cell count as a predictor of adequacy of hematopoietic stem cell collection for autologous transplantation / Contagem de células CD34+ em sangue periférico como preditor de adequada recolecção de progenitores hematopoiéticos para transplante autólogo

Introducción: para llevar a cabo un trasplante autólogo se deben movilizar los progenitores hematopoyéticos a la sangre periférica y posteriormente recolectarlos por aféresis. El recuento de células CD34+ es una herramienta para determinar el mejor momento para la recolección. Objetivo: evaluar la asociación entre el recuento de células CD34+ en sangre periférica y la recolección exitosa de progenitores hematopoyéticos. Materiales y métodos: evaluación de una prueba predictiva para determinar la utilidad del recuento de células CD34+ en sangre periférica como predictor del éxito de la recolección de progenitores hematopoyéticos en pacientes a los que se les va a hacer un trasplante autólogo. Resultados: se incluyó a 77 pacientes (mediana de edad: 49 años; rango: 5-66); el diagnóstico predominante fue linfoma (53,2 %). El porcentaje de pacientes con recolección exitosa de progenitores fue proporcional al número de células CD34+ en sangre periférica al finalizar la movilización. Proponemos que se deben tener más de 15 células CD34+/μL en sangre periférica para lograr una adecuada recolección de progenitores hematopoyéticos. Conclusión: el recuento de células CD34+ en sangre periférica es una herramienta útil para predecir la recolección exitosa de progenitores hematopoyéticos.

Introduction: In order to carry out an autologous transplantation, hematopoietic stem cells should be mobilized to peripheral blood and later collected by apheresis. The CD34+ cell count is a tool to establish the optimal time to begin the apheresis procedure. Objective: To evaluate the association between peripheral blood CD34+ cell count and the successful collection of hematopoietic stem cells. Materials and methods: A predictive test evaluation study was carried out to establish the usefulness of peripheral blood CD34+ cell count as a predictor of successful stem cell collection in patients that will receive an autologous transplantation. Results: 77 patients were included (median age: 49 years; range: 5-66). The predominant baseline diagnosis was lymphoma (53.2 %). The percentage of patients with successful harvest of hematopoietic stem cells was proportional to the number of CD34+ cells in peripheral blood at the end of the mobilization procedure. We propose that more than 15 CD34+ cells/μL must be present in order to achieve an adequate collection of hematopoietic stem cells. Conclusion: Peripheral blood CD34+ cell count is a useful tool to predict the successful collection of hematopoietic stem cells.

Introdução: para levar a cabo um transplante autólogo se devem mobilizar os progenitores hematopoiéticos ao sangue periférico e posteriormente os coletá-los por aféreses. A contagem de células CD34+ é uma ferramenta para determinar o melhor momento para a recolecção. Objetivo: avaliar a associação entre a contagem de células CD34+ em sangue periférico e a recolecção exitosa de progenitores hematopoiéticos. Materiais e métodos: avaliação de uma prova preditiva para determinar a utilidade da contagem de células CD34+ em sangue periférico como preditor do sucesso da recolecção de progenitores hematopoiéticos em pacientes aos que se lhes vá fazer um transplante autólogo. Resultados: se incluiu a 77 pacientes (média de idade: 49 anos; faixa: 5-66); o diagnóstico predominante foi linfoma (53,2 %). A porcentagem de pacientes com recolecção exitosa de progenitores foi proporcional ao número de células CD34+ em sangue periférico ao finalizar a mobilização. Propomos que se devem ter mais de 15 células CD34+/μL em sangue periférico para conseguir uma adequada recolecção de progenitores hematopoiéticos. Conclusão: A contagem de células CD34+ em sangue periférico é uma ferramenta útil para prever a recolecção exitosa de progenitores hematopoiéticos.

Hepatitis C virus seroprevalence in multi-transfused patients in Colombia.

BACKGROUND: Hepatitis C Virus (HCV) infection is a public health problem worldwide, with particular relevance in multi-transfused patients given that HCV is principally transmitted by exposure to infected blood. STUDY DESIGN: Between February and September 2003 a cross-sectional study was carried out in four hospital centres in Bogotá and Medellin, Colombia, to determine the risk factors for HCV infection in 500 multi-transfused patients. RESULTS: The study population was distributed in five groups: haemophilia, haemodyalsis, acute bleeding, ontological illnesses and sickle cell disease or thalassemia. Serum samples from patients were tested for HCV antibodies (Asxym, Abbott). An overall prevalence (9.0%; 95% confidence interval (CI): 6.4-11.6) (45/500) of HCV infection was found. Anti-HCV antibodies were detected in 32.2% of patients with haemophilia, 6.1% of patients undergoing haemodialysis, 7.1% of patients with sickle cell disease or thalassemia, 2.6% of patients with acute bleeding and 3.4% of patients with ontological or hematological diseases. The main risk factors associated with infection by HCV were: to be hemophilic (odds ratio, OR = 18.03; 95% Cl: 3.96-114.17), having received transfusions before 1995 (OR = 12.27; 95% Cl: 5.57-27.69), and having received more than 48 units of blood components (OR = 6.08; 95% CI: 3.06-12.1). In the multivariate analysis, only the year of transfusions (before 1995) remained significantly associated with risk of infection by HCV. CONCLUSIONS: The data show a 3-fold reduction in the infection risk between 1993 and 1995, when the serological screening for HCV in blood donors was being introduced. A reduction greater than 90% was achieved by 1995 when the screening coverage reached 99%.