Impact of COVID-19 Pandemic on Seroprevalence of HIV, HBV, HCV and HTLV I-II in a Blood Bank in Medellín, Colombia, 2019-2022.

The objective of this research was to analyze the impact of the COVID-19 pandemic on seroprevalence of HIV, HBV, HCV and HTLV I-II in donors from a blood bank in Medellin, Colombia, 2019-2022. A cross-sectional analytical study was carried out with three groups: pre-pandemic with 14,879 donors; preventive isolation with 9035; and selective isolation + new normality with 26,647 subjects. Comparisons were made with Chi2 and Bonferroni adjustment, Kruskal-Wallis' H with Dunnett's post-hoc, prevalence ratios, and multivariate logistic regression. COVID-19 decreased donations of men, altruistic and repetitive donors, and increased the age of donors. HIV increased with the COVID-19 pandemic, while HBV, HCV, and HTLV I-II decreased. The pandemic had an independent effect on these viral infections. These findings constitute an alert about what may be happening in the general population and show the importance of improving epidemiological surveillance and the investigation of these infections.

Metaanálisis de la validez del inmunodiagnóstico del virus linfotrópico de células T humanas i/ii en bancos de sangre, 2000-2018 / Meta-analysis regarding the validity of the immunodiagnosis of human T-cell lymphotropic virus I/II in blood banks, 2000-2018 / Meta-análise da validade do imunodiagnóstico do vírus linfotrópico de células t humanas I/II em bancos de sangue, 2000-2018

Resumen Objetivo: Evaluar la validez del inmunodiagnóstico del htlv i/ii en bancos de sangre, con base en estudios publicados en la literatura científica. Metodología: Se efectuó un metaanálisis de pruebas diagnósticas siguiendo la guía prisma y las recomendaciones de Cochrane. Se evaluó la calidad metodológica con quadas y se garantizó la reproducibilidad y la exhaustividad. Se realizó también un análisis de efectos aleatorios para la sensibilidad, la especificidad, los cocientes de probabilidad, la razón de momios diagnóstica y la curva característica operativa del receptor (roc) con sus intervalos de confianza (ic) del 95 %. Resultados: Se tamizaron 4604 estudios, de los cuales solo tres cumplieron el protocolo. Se evaluaron 548 infectados con htlv i/ii y 6643 sanos. El inmunodiagnóstico de htlv i/ii presentó una sensibilidad del 99 % (ic95 % = 98,0-99,0), especificidad del 100 % (ic95 % = 99,9-100), cocientes de probabilidad positivo de 315,8 (ic95 % = 128,2-778,5) y negativo de 0,02 (ic95 % = 0,01-0,04), razón de momios diagnóstica de 24373 (ic95 % = 6864-86545) y área bajo la curva roc del 99,9 %. Conclusión: Se dispone de pocos estudios en este campo del inmunodiagnóstico htlv i/ii. El elevado número de sujetos analizados evidenció alta validez del inmunodiagnóstico, lo que resulta determinante para garantizar la inocuidad de las unidades de sangre, la detección de portadores asintomáticos, la disminución de la transmisión y el inicio de tratamiento.

Abstract Objective: To evaluate the validity of the immunodiagnosis of htlv i/ii in blood banks, based on studies published in the scientific literature. Methodology: A meta-analysis of diagnostic tests was carried out following the PRISMA guidelines and Cochrane recommendations. The methodological quality was evaluated with QUADAS, and reproducibility and completeness were guaranteed. A random effects analysis was also performed with respect to sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and receiver operating characteristic curve (ROC) with their 95 % confidence intervals (CI). Results: 4,604 studies were screened, of which only three complied with the protocol. 548 subjects infected with HTLV I/II and 6,643 healthy subjects were evaluated. The immunodiagnosis of HTLV I/II had a sensitivity of 99 % (95 % CI = 98.0-99.0), a specificity of 100 % (95 % CI = 99.9-100), a positive likelihood ratio of 315.8 (95 % CI = 128.2-778.5) and a negative likelihood ratio of 0.02 (95 % CI = 0.01-0.04), a diagnostic odds ratio of 24,373 (95 % CI = 6,864-86,545), and an area under the ROC curve of 99.9 %. Conclusion: Few studies are available in the field of HTLV I/II immunodiagnosis. The high number of subjects analyzed showed high validity of the immunodiagnosis, which is decisive to guarantee the safety of the blood units, the detection of asymptomatic carriers, the decrease in transmission, and the start of treatment.

Resumo Objetivo: Avaliar a validade do imunodiagnóstico do HTLV I/II nos bancos de sangue, baseados nos estudos publicados na literatura científica. Metodologia: Foi realizada uma meta-análise de testes diagnósticos seguindo a guia PRISMA e as recomendações de Cochrane. Foi avaliada a qualidade metodológica com QUADAS e garantiu-se a reprodutibilidade e a integridade. Realizou-se também uma análise de efeitos aleatórios para a sensibilidade, a especificidade, os quocientes de probabilidade, a razão de probabilidade diagnóstica e a Curva Característica de Operação do Receptor (Curva ROC) com seus Intervalos de Confiança (IC) de 95%. Resultados: Foram selecionados 4604 estudos, dos quais somente 3 cumpriram com o protocolo. Foram avaliados 548 infectados com o vírus HTLV I/II e 6.643 saudáveis. O imunodiagnóstico de HTLV I/II apresentou uma sensibilidade de 99% (IC95% = 98,0-99,0), especificidade de 100% (IC95%= 99,9-100), quocientes de probalidade positiva de 315,8 (IC95% = 128,2-778,5) e negativo de 0,02 (IC95% = 0,01-0,04), razão de probabilidade diagnóstica de 24373 (IC95% = 6864-86545) e área sob a curva ROC de 99,9%. Conclusão: São poucos os estudos disponíveis neste campo do imunodiagnóstico HTLV I/II. O elevado número de pessoas analisadas evidenciou alta validade do imunodiagnóstico, o que é decisivo para garantir a inocuidade das unidades de sangue, a detecção de portadores assintomáticos, a diminuição da transmissão e o início do tratamento.

The Link between Cannabis Use, Immune System, and Viral Infections.

Cannabis continues to be the most used drug in the world today. Research shows that cannabis use is associated with a wide range of adverse health consequences that may involve almost every physiological and biochemical system including respiratory/pulmonary complications such as chronic cough and emphysema, impairment of immune function, and increased risk of acquiring or transmitting viral infections such as HIV, HCV, and others. The review of published research shows that cannabis use may impair immune function in many instances and thereby exerts an impact on viral infections including human immune deficiency virus (HIV), hepatitis C infection (HCV), and human T-cell lymphotropic type I and II virus (HTLV-I/II). The need for more research is also highlighted in the areas of long-term effects of cannabis use on pulmonary/respiratory diseases, immune dysfunction and the risk of infection transmission, and the molecular/genetic basis of immune dysfunction in chronic cannabis users.

Evaluation of Elecsys HTLV-I/II assay in comparison with ARCHITECT rHTLV-I/II assay with Korean samples.

BACKGROUND: The seroprevalence rate of human T-lymphotropic virus I and II (HTLV-I/II) in Korean blood donors has been known as 0.004%, and HTLV-I/II Ab screening test has been performed since 2008 in Korea. Korea Ministry of Food and Drug Safety (MFDS) approved two chemiluminescent microparticle immunoassays (CMIA) for testing HTLV-I/II antibody, ABBOTT PRISM HTLV-I/HTLV-II and ARCHITECT rHTLV-I/II. A multicenter performance evaluation study in Europe and Japan was carried out with the new electrochemiluminescence immunoassay (ECLIA) for HTLV-I/II antibody detection, Elecsys HTLV-I/II assay which launched in 2017, but not in Korea. We aimed to evaluate the clinical performance of Elecsys HTLV-I/II assay in comparison with ARCHITECT rHTLV-I/II for the detection of HTLV-I/II antibody with Korean samples. METHODS: For sensitivity evaluation, 100 HTLV-I/II-positive Korean standards from Korean Red Cross and two HTLV-II-positive samples that were purchased from Seracure were used. For the specificity, 500 potential donor specimens from Korea University Hospital healthcare center were used. All the samples were simultaneously analyzed by the two HTLV-I/II assays, Elecsys HTLV-I/II assay and ARCHITECT rHTLV-I/II assay. RESULTS: Elecsys HTLV-I/II assay and ARCHITECT rHTLV-I/II assay showed a complete agrement. Elecsys HTLV-I/II assay showed 100% sensitivity (95% CI: 96.38-100.0) and specificity (95% CI: 99.26-100.0). CONCLUSIONS: Elecsys HTLV-I/II assay is as reliable as ARCHITECT rTHLV-I/II assay, and can be used as a screening test for HTLV-I/II in Korea.

Human T-cell lymphotropic virus: A simulation model to estimate residual risk with universal leucoreduction and testing strategies in Canada.

BACKGROUND AND OBJECTIVES: In Canada, transfusion transmission risk of Human T-cell lymphotropic virus -I/II (HTLV) is addressed by universal leucoreduction and universal antibody testing. We aimed to estimate the risk with the current policy, if testing only first-time donors and if testing were stopped. MATERIALS AND METHODS: Monte Carlo simulation was employed to estimate the proportion of red cell concentrate, random donor platelet and apheresis platelet units that would be released into inventory in each scenario (10 billion donors each). The model estimated the number of HTLV-positive donations not intercepted by testing, randomly assigned the number of HTLV particles/100 leucocytes using proportions from published data and randomly selected a postleucoreduction leucocyte count from quality control data. Units were considered infectious if ≥9 × 104 copies of HTLV provirus. RESULTS: With universal leucoreduction in place, the residual risk of releasing an HTLV potentially infectious unit with universal testing was 1 in 1·2 billion units (0, 1 in 55·9 million), with testing only first-time donors 1 in 7·1 million (0, 1 in 1·05 million) and with no testing 1 in 1·0 million (0, 1 in 178 600). The efficacy of leucoreduction was >99·5% (lower bound 95·7%) for all scenarios. CONCLUSION: With universal leucoreduction in place, switching from universal testing to testing first-time donors would incur very low risk.

Serological detection of human T-cell lymphotropic virus types I and II among pregnant women in Ilorin, Nigeria.

Human T-cell lymphotropic virus types I/II (HTLV-I/II) is endemic in some parts of the world including Nigeria. Reported prevalence rates in Nigeria have largely focused on blood donors. This study aims at determining the prevalence of HTLV infection among pregnant women in Ilorin North-central Nigeria. Serum samples from 276 pregnant women who were antenatal clinic attendees at General and Civil Service Hospitals in Ilorin were tested for the presence of HTLV-I/II antibodies using Enzyme Linked Immunosorbent Assay test kits from Diagnostic Automation INC., USA. Out of the 276 women tested, 3 tested positive giving a prevalence rate of 1.1%. The result was analyzed on the basis of age, marital status, nature of family, educational status, occupation, religion, parity, and gestational stage of the women. There was no statistical association of HTLV positivity with any of the variables. Although relatively lower than prevalence rate recorded among similar study groups in other parts of the country, the 1.1% prevalence in this study underscores the need for proper education and creation of awareness among antenatal clinic attendees, so as to reduce viral transmission and incidence of HTLV-related diseases.

Prevalencia de enteroparasitos en individuos seropositivos y seronegativos a los virus HTLV-I/II

Para determinar la prevalencia de enteroparásitos en individuos seropositivos a los virus HTLV-I/II, se seleccionaron aleatoriamente 75 donantes que asistieron a los Bancos de Sangre de dos instituciones sanitarias del municipio Maracaibo, Venezuela. Se contactaron personalmente 50 individuos seropositivos a virus HTLV-I/II (grupo muestra) y 25 seronegativos (grupo control), quienes aportaron una muestra fecal para diagnóstico parasitológico. Estas fueron sometidas al examen al fresco con solución salina fisiológica (SSF) al 0,85%, tinción temporal de Lugol y técnica de concentración con formol-éter (Ritchie). Además se realizó cultivo en Agar Nutritivo (método de Arakaki) para investigar la presencia de larvas de Strongyloides stercoralis. Se determinó una prevalencia general de enteroparásitos en el grupo muestra de 54% y 44% en el grupo control. Predominó el monoparasitismo entre todos los individuos estudiados. Las especies identificadas fueron: Blastocystis spp. 47,3% y 15,4%, Entamoeba coli 21% y 15,4%, Endolimax nana 13% y 53,8%, Complejo Entamoeba 10,5% y 15,4%, Giardia intestinalis 5,2% y 0%, y Entamoeba hartmanni 2,6% y 0% en el grupo muestra y grupo control, respectivamente. No se detectó Strongyloides stercoralis ni otros helmintos intestinales, en los individuos estudiados. Blastocystis spp. fue el más frecuente en los pacientes seropositivos (diferencia estadísticamente significativa) que en el grupo control, lo que pudiese relacionarse con una mayor persistencia de este cromista en pacientes coinfectados con HTLV-I/II. Se puede concluir que el estatus serológico del individuo HTLV-I/II positivo parece no influir en la presencia o adquisición de parásitos intestinales.

Prevalence of intestinal parasites in seropositive and seronegative to HTLV I/II viruses

The prevalence of intestinal parasites in individuals seropositive for the HTLV-I/II virus was studied. A total of 75 donors who attended the blood banks of two health institutions in Maracaibo, Venezuela were randomly selected: 50 patients seropositive for HTLV-I/II (study group) and 25 seronegative individuals (control group). The participants in the study were all contacted personally, after which they provided a fecal sample for parasitological diagnosis. The fresh samples were examined using 0.85% physiological saline solution (PSS), Lugol’s solution for temporary staining and the formalin-ether concentration technique (Ritchie). In addition, samples were cultured on nutrient agar (Arakaki method) to determine the presence of Strongyloides stercoralis larvae. Overall prevalences of 54% intestinal parasites in the study group and 44% in the control group were found. Monoparasitism prevailed among all the individuals studied. The species identified in the study and control groups were: Blastocystis spp. 47.3% and 15.4%, Entamoeba coli 21% and 15.4%, Endolimax nana 13.0% and 53.8%, Entamoeba complex 10.5% and 15.4%, Giardia intestinalis 5.2% and 0%, and Entamoeba hartmanni 2.6% and 0 %, respectively. Strongyloides stercoralis and other intestinal helminths were not detected in the individuals studied. Blastocystis spp. was significantly more common in seropositive patients than in the control group, which could be associated with a greater persistence of this chromista in patients co-infected with HTLV-I / II.It can be concluded that the positive serological status of HTLV-I / II infected individuals does not seem to influence either the presence or acquisition of intestinal parasites.

Relative frequency of Human T-cell Lymphotropic Virus I/II in HIV/AIDS patients.

BACKGROUND: Human T-cell lymphotropic virus HTLV-I/II is a retrovirus that has been associated with different diseases. HTLV-I/II routes of transmissions are exposure to contaminated blood, blood transfusion, needle sharing, breast feeding, and sexual contact. The seroprevalence of HTLV-I/II in HIV infected patients has not been well characterized in Iran. We conducted a serological survey to determine the relative frequency of HTLV-I/II in HIV+/AIDS and healthy blood donors in Isfahan. MATERIALS AND METHODS: In this cross-sectional study, we compare the relative frequency of HTLV-I/II in HIV+/AIDS group (56 persons) with asymptomatic blood donors (57 persons) in Isfahan. Participant completed the questionnaires that include demographic information, age, sex, and sexual partnership during last 6 months, sexual behavior and past history of blood transfusion or other blood products. We confirm the HIV+ status in patients group with western blot test. Evaluation of HTLV-I/II were done using ELISA test with DRAPIO third generation kit. Questionnaire data and laboratory results were analyzed by SPSS18. RESULTS: During the period of 2010-2011, a total of 56 HIV-infected patients and 57 healthy persons participated in this study. Among HIV positive patients, one person had positive test for HTILV-I/II representing the relative frequency of 1.8%, and in healthy individuals none of them were positive. CONCLUSION: In our survey, relative frequency of HTLV-I/II was 1.8% in HIV+ patients. This study reveals that relative frequency of HTLV-I/II in HIV positive patients is considerable but determining the need for screening of HTLV-I/II requires further investigation.

Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis and delay in starting antiretroviral therapy for AIDS patients

OBJECTIVE: To compare the clinical characteristics and outcomes of HIV-1-HTLV-1 coinfected patients, in Bahia, Brazil. METHODS: Retrospective, comparative study. RESULTS: Among a total of 123 consecutive HIV infected patients, 20 men (20.6 percent) and 6 women (23.1 percent) had detectable antibodies against HTLV-I/II. The major risk factor associated with coinfection by HTLV was intravenous drug use (57.7 percent of coinfected patient versus 9.2 percent of HTLV seronegative patients, p < 0.0001). Coinfected patients had higher absolute lymphocyte counts (1,921 + 762 versus 1,587 + 951, p = 0.03). Both groups of patients had similar means of CD4+ and CD8+ cell counts. However, among patients with AIDS CD4+ cell counts were significantly higher among those coinfected with HTLV-I/II (292 ± 92 cells/mm³, versus 140 ± 177cells/mm³, p = 0.36). The frequency and type of opportunistic infections were similar for both groups, but strongyloidiasis and encephalopathy were more frequently diagnosed in coinfected patients (p < 0.05). On the other hand, patients coinfected with HTLV-I/II received significantly less antiretroviral therapy than singly infected by HIV-1. CONCLUSION: Coinfection by HTLV-I/II is associated with an increased risk of strongyloidiasis for HIV patients. Higher CD4 count may lead to underestimation of immunodeficiency, and delay to initiate antiretroviral therapy.

Prevalence of Human T Cell Leukaemia Virus amongst Blood Donors.

BACKGROUND: Human T cell leukaemia virus (HTLV) I/II are retroviruses implicated in transfusion transmitted infection. Present study was undertaken to assess seroprevalence of HTLV in voluntary blood donors along with pattern of blood utilisation. METHODS: A total of 258 healthy blood donors who were free from infectious markers in transfusion as per current transfusion guidelines were enrolled. They were screened for HTLV-I/II antibodies by commercially available enzyme immuno assay (EIA) and their blood utilisation data was analysed. RESULT: Five (1.9%) donors were found seropositive for HTLV-I/II of which 1.2 % were first time and 0.9% were repeat donors. Blood utilisation data revealed 20.9% and 38.8% units were utilised within 5 and 6-14 days of collection respectively. 45.9% recipients were transfused with single blood unit. 42.9% recipients were immunosuppressed due to underlying disease. CONCLUSION: The high prevalence of HTLV in blood donors, coupled with single unit transfusion, use of fresh blood, non availability of acellular blood products and immunosuppression in recipients can lead to significant transfusion transmitted HTLV infection. We suggest judicious use of blood products and screening of blood donors in prevention of transfusion transmitted HTLV-I/II.

Soroprevalência do vírus linfotrópico de células T humanas (HTLV I/II) em indivíduos doadores de sangue do hemocentro da cidade de Maringá-PR / Seroprevalence of human t-cell lymphotropic virus type (HTLVI/II) in blood donors from the blood bank in Maringá-PR, Brazil

O vírus linfotrópico de células T humanas (HTLV) é transmitido por transfusões, uso compartilhado de agulhas, aleitamento e contato sexual. A prevalência varia de acordo com a região geográfica, grupo racial e população estudada. Cerca de 1 a 4% dos indivíduos infectados desenvolvem algum tipo de doença em decorrência da infecção. É reconhecida a associação entre a infecção pelo HTLV-I e Leucemia de Células T do Adulto e Paraparesia Espástica Tropical (PET). O objetivo deste trabalho foi realizar uma avaliação da prevalência de soropositividade para HTLV I/II na população de doadores de sangue do Hemocentro Regional de Maringá-Pr. Foram analisados os registros laboratoriais de 28.194 doadores de sangue do Hemocentro Regional de Maringá, no período de abril de 2003 a março de 2006, e observou-se que a soropositividade para o HTLV-I/II pelo teste ELISA na população geral de doadores (n=28.194) foi de 0,067% (n=19), das quais 52,63% eram do sexo feminino e 47,36% do sexo masculino. Através deste, conclui-se que medidas eficazes de saúde pública devem ser desenvolvidas para prevenir a disseminação dos vírus-T linfotrópicos humanos, pois não existem maneiras efetivas de se controlar as doenças associadas ao vírus. O aconselhamento de indivíduos soropositivos também deve ser observado, sendo uma das principais formas de prevenção.

The Human T cell Lymphotropic Virus Type (HTLV) is transmitted by transfusions, shared use of needles, breast feeding, and sexual contact. The prevalence varies according to the geographical area, racial group, and studied population. About 1 to 4% of the infected individuals develop some type of disease due to infection. The association is recognized among the HTLV-I infection and Leukemia of the Adult?s T-cells, and Tropical Spastic Paraparesis (PET). The objective of this article is to evaluate the seropositivity prevalence for HTLV I/II in the blood donors from the Maringá Regional Blood Bank population. 28.194 blood donors from the Maringá Regional Blood Bank data lab were analyzed from April,2003 to March,2006; and it was observed that the seropositivity for HTLV-I/II through the ELISA test in the donor population (n=28.194) was 0,067% (n=19), as 52,63% were female and 47,36% male. Thus, it is concluded that effective public health actions should be taken in order to prevent the of the human-T lymphotropic virus spread, because there are not effective ways of controlling the diseases associated with it. Counseling seropositivity individuals should also be taken into account as one of the major prevention ways.