HIV and HTLV infections in 1305 transfusion-dependent thalassemics in Italy. The COOLEYCARE Cooperative Group.
OBJECTIVE
To evaluate the prevalence of antibodies to HIV-1/2 and HTLV-I/II in 1305 transfusion-dependent beta-thalassemics treated in 36 centres in Italy.


METHODS
Patient serum samples were collected during 1990 and tested in Milan.


METHODS
Sera were screened using an enzyme-linked immunosorbent assay (ELISA) containing viral lysate antigens from HIV-1 and HIV-2, and a particle agglutination assay for the detection of antibodies to HTLV-I and HTLV-II. Repeatedly reactive samples were examined by Western blot (WB) assays containing recombinant and viral lysate antigens. Differential diagnosis was finally made by ELISA based on synthetic peptides.


RESULTS
Samples from 36 of the 1305 patients (2.76%) contained anti-HIV-1 antibodies. In four patients seroconversion occurred after the implementation of anti-HIV-1 screening in blood donors in Italy (1985). Of the 36 HIV-1-antibody-positive samples, four were HIV-2 [corrected] WB indeterminate. These four samples were negative in assays based on specific synthetic peptides, suggesting cross-reactivity. Anti-HTLV-I antibodies were found in two patients from Sicily and one from Apulia, both southern Italian regions. Anti-HTLV-II antibodies were detected in another patient from Sicily.


CONCLUSIONS
Antibodies to HIV-1, HIV-2, HTLV-I and HTLV-II were detected in 2.76, 0, 0.23 and 0.08% of patients, respectively. The residual risk of HIV-1 infection through blood transfusion after the implementation of anti-HIV-1 screening in blood donors in Italy was approximately 1:50,000 blood units; this is based on an approximate number of 200,000 blood units administered to our group of patients during 1986-1990 and the occurrence of four new anti-HIV-1 seroconversions. Seroconversions to HTLV-I/II suggest that these viruses are present in Italian blood donors.
Centro Trasfusionale e di Immunologia dei Trapianti, Ospedale Maggiore Policlinico, Milano, Italy.
F
F
Mozzi
P
P
Rebulla
F
F
Lillo
O E
OE
Varnier
C
C
Biadati
L
L
Calcagno
S
S
Melotti
G
G
Sirchia
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006800:Deltaretrovirus Infections / Q000150:complications / Q000453:epidemiology*; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D013789:Thalassemia / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D065227:Transfusion Reaction