A pilot study of HTLV-I infection in high-risk individuals & their family members from India.
OBJECTIVE
Human T lymphotropic virus-I (HTLV-I) has been associated with adult T cell lymphoma/leukemia (ATLL). There are Indian studies on HTLV-I infection among people with sexually transmitted infection, but no large study has been conducted on individuals with haematological malignancies. In this group of individuals, serology is known to under-diagnose HTLV-I infection. This study was carried out to identify serologically and where possible with molecular techniques, HTLV-I infection in individuals with haematological malignancies. To understand the modes of transmission, family members of individuals with proven HTLV-I infection were also studied. Individuals with sexually transmitted infection (STI), blood donors and pregnant women were also studied.


METHODS
Particle agglutination test was used to detect antibody to HTLV-I. HTLV genome was amplified by polymerase chain reaction (PCR) and detected with probes by digoxiginin (Dig) ELISA.


RESULTS
There was no serological evidence of HTLV-I infection among the healthy blood donors and pregnant women studied. High prevalence of anti-HTLV-I antibody was identified in the patients with haematological malignancies (8 of 86 patients, 9.3%) and a lower prevalence in individuals with STI (8 of 670 individuals, 1.2%). In the STI group, all 8 individuals seroreactive to HTLV-I were coinfected with human immunodeficiency virus (HIV). In the group with haematological malignancies, three of 22 (13.6%) patients with leukemia, 3 of 11 (27.3%) with cutaneous T-cell lymphoma (CTCL) and 2 of 53 (3.8%) with lymphoma were reactive for anti-HTLV-I antibody. In this group, PCR identified all the seroreactive individuals tested. There were also seronegative infected individuals who were only identified by PCR. There was also a large number of seronegative family members who were only positive by PCR.


CONCLUSIONS
The study revealed a strong disease association of HTLV-I with haematological malignancies and evidence for both horizontal and vertical transmission of the infection in the Indian population. HTLV-I infection appears to be common among family members of individuals with HTLV-I associated haematological malignancies.
Ramalingam
S
S
Department of Clinical Virology, Christian Medical College & Hospital, Vellore, India.
Kannangai
R
R
Prakash
K J
KJ
Ajithkumar
K
K
Jacob
M
M
George
R
R
Pradeepkumar
S
S
Daniel
D
D
Dennison
D
D
Babu
P G
PG
D000328:Adult; D005190:Family; D005260:Female; D015490:HTLV-I Infections / Q000150:complications / Q000453:epidemiology* / Q000635:transmission; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D007194:India / Q000453:epidemiology; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011247:Pregnancy; D012307:Risk Factors