Prevalence of human T-cell lymphotropic virus infections in Germany

Prevalence of Human T-Lymphotropic Virus Type 1 in Brain-Dead Organ Donors

Background: This study aimed to assess the prevalence of human T-lymphotropic virus type 1 (HTLV-1) among brain-dead organ donors at Masih Daneshvari Hospital in Tehran, Iran. Methods: By enzyme-linked immunosorbent assay (ELISA), 54 organ donors were screened for HTLV-1 virus in this descriptive cross-sectional study. Following that, Western blot confirmation was performed to confirm the HTLV-I infection. Results: Anti-HTLV-1 antibodies were detected in 2 (3.4%) cases out of 54 patients tested by ELISA. A western blot was performed in cases of positive results, but none of the subjects tested positive for HTLV-1 infection. Conclusions: The results of the present study indicated rare cases of HTLV-I infection in brain-dead organ donors. However, it is recommended that organ donors be investigated for the prevalence of this virus.

No significant HTLV seroprevalence in German people who inject drugs

Background

Although human T-lymphotropic virus (HTLV) is transmitted via the same routes as human immunodeficiency virus (HIV), its worldwide seroprevalence differs drastically because HTLV is transmitted mainly via infected cells rather than free virus. The sharing of needles and other equipment places people who inject drugs (PWID) at particularly high-risk for such blood-borne diseases.

Methods

To validate the methodology used to process and analyze the dried blood spots (DBS) utilized in the study, dried serum spots (DSS) with dilutions of sera from known HTLV infected individuals were analyzed by ELISA and Western blot. DBS collected between 2011 and 2015 from 2,077 PWID in eight German cities recruited by respondent-driven sampling were tested for HTLV-specific antibodies.

Results

The validation demonstrated that the use of DSS allowed identification of samples with even low titers of HTLV-specific antibodies, although a confirmatory Western blot with an additional venous blood sample would often be required. Despite numerous HIV and HCV positive individuals being identified within the study population, none tested positive for HTLV.

Conclusion

While the HIV and HCV prevalences in German PWID are comparable to those in other European countries, the very low prevalence of HTLV reflects the situation in the general population.

The epidemiology of HTLV-I in Europe

Although human T-lymphotropic virus type I (HTLV-I) infection in Europe is thought to be unusual except amongst people who have immigrated from countries where HTLV-I is endemic, the screening of blood donors has revealed a low seroprevalence across Europe, not only in donors originating from endemic areas but also in the indigenous population. Data from blood donors should not be extrapolated to other groups because blood donors are selected to be at low risk of parenterally transmissible infections. Unfortunately only small studies have been conducted in other population groups, including women attending antenatal clinics, despite the importance of breast-feeding in vertical transmission. Data from metropolitan areas of the United Kingdom and France suggest that the seroprevalence of HTLV-I in pregnant women is up to 100 times higher than in blood donors. HTLV-I infection is also more common in patients attending sexually transmitted disease clinics, whilst HTLV-II is endemic in many cities amongst intravenous drug users. There are few incidence data for diseases associated with HTLV-I, even though cases of adult T-cell leukemia/lymphoma and HTLV-I-associated myelopathy have been described in many European countries. Data on the seroprevalence of HTLV-I in central and eastern Europe are scanty but the few published studies suggest a higher rate than has been documented in western Europe.