title: Differential serological diagnosis of HTLV-I and HTLV-II infection by external membrane protein peptide-based enzyme immunoassays.
abstract: BACKGROUND
  HTLV antibody screening assays detect both antibodies to the etiological agent of adult T-cell leukemia and tropical spastic paraparesis HTLV-I and to the less pathogenic HTLV-II. It is critical to make a differential diagnosis of the two viruses.
  
  
  OBJECTIVE
  To design and evaluate synthetic core and envelope-derived peptide enzyme immunoassays (EIA) for serological differential diagnosis.
  
  
  METHODS
  Peptide EIAs were evaluated with a panel of 202 plasma samples comprised of HTLV antibody positive, serologically classified as confirmed, indeterminate, or non confirmed, characterized as HTLV-I, HTLV-II or neither by genomic amplification. The peptide EIA with the best performance was further used to differentiate between HTLV-I and HTLV-II antibodies in 807 samples from 18 countries in four continents and to provide ratios between the two infections.
  
  
  RESULTS
  The gp46 peptide EIA correctly identified 96.5% of HTLV-I and 98.6% of HTLV-II antibody-confirmed samples. HTLV-I was found exclusively in Japan and Caribbean countries; almost exclusively in Africa. HTLV-II represented 10-25% of samples from Canada, Chile and Venezuela and was predominant in the US.
  
  
  CONCLUSIONS
  Differential diagnosis between HTLV-I and HTLV-II can be reliably performed using specific peptides from the gp46 envelope protein of each virus.
authors.affiliation: Department of Haematology, University of Cambridge, UK.
authors.forename: H H
authors.initials: HH
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Shih
authors.forename: D
authors.initials: D
authors.lastname: O'Donnell
authors.forename: P
authors.initials: P
authors.lastname: Swanson
authors.forename: T
authors.initials: T
authors.lastname: Mann
authors.forename: J P
authors.initials: JP
authors.lastname: Allain
mesh_terms: D000956:Antigens, Viral / Q000276:immunology; D015480:Deltaretrovirus Antibodies / Q000032:analysis* / Q000276:immunology; D006800:Deltaretrovirus Infections / Q000175:diagnosis* / Q000276:immunology*; D015368:Human T-lymphotropic virus 1 / Q000276:immunology* / Q000302:isolation & purification; D015367:Human T-lymphotropic virus 2 / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007124:Immunoenzyme Techniques; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D014758:Viral Core Proteins
chemical_list: D000956:Antigens, Viral; D015480:Deltaretrovirus Antibodies; D014758:Viral Core Proteins