Relative prevalence and risk factors of HTLV-I and HTLV-II infection in US blood donors.
The clinical significance of human T-cell lymphotropic virus type II (HTLV-II) infection, unlike that of HTLV-I, is unknown, and the major known association of HTLV-II seropositivity is with intravenous drug abuse. Screening of blood donors for HTLV-I, now routine in North America, does not distinguish this retrovirus from HTLV-II. To find out more about the seroepidemiology of and risk factors for HTLV I and II, blood from 480,000 volunteer donors in five geographically separate US urban centres was tested for antibodies to HTLV-I/II and HIV-1. Confirmed HTLV-I/II seropositive donors were then followed up by DNA amplification to distinguish type I from type II and by interviews focusing on possible risk factors. HTLV seroprevalence was 3.3 times greater than that for HIV-1 (0.043% vs 0.013%). DNA amplification on 65 of the 207 HTLV-I/II seropositive donors revealed that 34 (52%) had HTLV-II infection and 28 (43% had HTLV-I; 3 samples were uninformative. Interviews of 49 donors showed that whereas HTLV-I was principally associated with donor origin from endemic regions, the major risk factor for HTLV-II infection was intravenous drug use. The surprisingly high rate of HTLV-II infection in US blood donors raises important public health and donor counselling issues since HTLV-I infection is associated with adult T-cell leukaemia and a neurological disorder while the pathogenicity of HTLV-II is as yet unclear.
Abbott Laboratories Diagnostic Division, North Chicago, IL 60064.
H H
HH
Lee
P
P
Swanson
J D
JD
Rosenblatt
I S
IS
Chen
W C
WC
Sherwood
D E
DE
Smith
G E
GE
Tegtmeier
L P
LP
Fernando
C T
CT
Fang
M
M
Osame
D000328:Adult; D001782:Blood Donors / Q000706:statistics & numerical data*; D004279:DNA, Viral / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D015491:HTLV-II Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014481:United States / Q000453:epidemiology
D004279:DNA, Viral