Epidemiology of human T-lymphotropic virus type II (HTLV-II) infection in Spain

The human T-lymphotropic virus type II (HTLV-II) has recently been associated with the genesis of some subacute neurological syndromes and, rarely, with atypical T-lymphoid malignancies. The virus is endemic in some Amerindian and African tribes, and among intravenous drug users (IDUs) in North America and Europe. Given that HTLV-II is transmitted by the same routes as other human retroviruses, the screening of antibodies to HTLV-II in blood donors has became a matter of controversy in some countries. Herein, we describe the clinical, epidemiological and virological features of 113 individuals with HTLV-II infection identified in Spain up to September 1995. Most of them (94/113; 83%) were male, and all but seven were natives. Four were African immigrants living in Madrid and 3 had been born in other European countries. All but six subjects were IDUs, and sexual transmission of HTLV-II and transfusion were involved in five and one individual, respectively. Eighty-four percent of the IDUs infected with HTLV-II were co-infected by HIV-1 (93/107). Clinical manifestations potentially linked to HTLV-II were absent, although an IDU male co-infected by HIV-1 and HTLV-II developed a severe non-inflammatory proximal myopathy. In conclusion, HTLV-II infection is present in Spain, mainly among IDUs, with a growing incidence and a current overall prevalence of 2.0 percent.The members of the HTLV Spanish Study Group are listed in the Appendix.     

长沙地区献血人群HTLV感染情况调查与策略研究

目的 调查长沙无偿献血人群中人类T淋巴细胞白血病病毒(human T-lymphotropic virus, HTLV)感染情况,为湖南省血液中心开展HTLV抗体检测及采取相关措施确保血液质量与安全提供依据。方法 2016年9-10月对湖南省血液中心无偿献血人群进行常规检测的同时采用双抗原夹心酶联免疫法筛查HTLVⅠ/Ⅱ,初筛阳性标本血浆送国家临检中心确认。采用Sigmaplot画图软件分析处理2010-2016年湖南省血液中心无偿献血者中户籍为湖南省与福建、广东等沿海地区及其他省组成分布。结果 无偿献血者共16 767份标本,初筛阳性标本24份,经蛋白免疫印迹实验确证,1份阳性,1份抗体不确定,其他为阴性。初筛阳性率为14.31/万,确认阳性率为5.96/10万,确认阳性者来自福建,不确定者为湖南本地人。献血人群户籍分布可见福建、广东等沿海地区献血人数比湖南献血人数增幅较大。结论 湖南血液中心无偿献血人群属于HTLVⅠ/Ⅱ感染的非流行区或低发区,但来自HTLV高流行的福建、广东等沿海地区献血人群比例日渐壮大,为确保血液安全和受血者的健康,建议在湖南省血液中心开展HTLV抗体检测及采取相关措施确保血液质量与安全。     

Human T-lymphotropic virus type I (HTLV-I) seroprevalence in Jamaica. I. Demographic determinants

During 1985 and 1986, the authors measured antibodies to human T-lymphotropic virus type I (HTLV-I) in a cohort of 13,260 Jamaicans from all parts of the island who applied for food-handling licenses. HTLV-I seroprevalence was strongly age and sex dependent, rising from 1.7% (10-19 years) to 9.1% (greater than or equal to 70 years) in men and from 1.9% (10-19 years) to 17.4% (greater than or equal to 70 years) in women. In a logistic regression analysis, women were more likely to be seropositive than were men, and farmers, laborers, and the unemployed were more likely to be HTLV-I seropositive than were those reporting student or professional occupations. In men, African ethnicity was associated with HTLV-I seropositivity in the univariate analysis but was not a risk factor after adjustment for age and sex. There was a trend toward higher age-stratified HTLV-I seroprevalence among younger women who reported more pregnancies, but older multigravidas had lower rates of HTLV-I seropositivity. Persons born outside Jamaica had significantly lower seroprevalence than did those born in Jamaica, but they were of slightly different ethnic and occupational compositions than those born in Jamaica.     

献血者中人类嗜T—淋巴细胞病毒Ⅰ型流行病学

人类嗜T-淋巴细胞病毒Ⅰ型(HTLV-Ⅰ)是成人T-细胞白血病(ATL)的病因[1],且与某些神经系统疾病如:热带痉挛性下肢瘫痪/HTLV-Ⅰ相关脊髓病(TSP/HAM)密切相关[2],输血是传播HTLV-Ⅰ的重要途径,日本、美国、法国等许多发达国家,均将HTLV-Ⅰ检测列为献血者必检项目,以预防和控制HTLV-Ⅰ经输血传播.目前,我国献血者中HTLV-Ⅰ感染、流行情况已有一些报道[3],但尚未规定对献血者开展HTLV-Ⅰ检测.为了解南京地区献血者状况,作者对南京地区献血者进行了HTLV-Ⅰ流行病学调查,现将结果报告如下.     

HIV-1急性感染

HIV-1是目前AIDS流行的主要病原体.疑诊HIV-1急性感染,用定量HIV-1 RNA或p24抗原检测可缩短诊断时间.一旦确诊,应考虑早期采用以免疫为基础的联合治疗.     

Absence of antibodies to human herpesvirus-6 in patients with slowly-progressive human immunodeficiency virus type I infection

To evaluate a possible role for Human Herpesvirus-type 6 (HHV-6) coinfection as a co-factor in the progression of HIV-1 disease, we investigated the prevalence of seropositivity for HHV-6 in a cohort of HIV-1 infected patients. These patients were retrospectively divided into two groups according to the decline of CD4+ T cells during the follow up: 11 were classified as rapid decliners (< 400 CD4+/cmm within 1 year), and 38 as slow decliners (> 400 CD4+/cmm after at least 4 years' follow up). HHV-6 antibodies were detected by a commercial immunofluorescence assay and by a Western blotting assay developed in our laboratory. Our results show that Western blot appears to provide results satisfactorily free of false positivities. We found that the frequency of HHV-6 seropositivity was significantly lower in the group of slow decliners, compared both to rapid decliners and to the general population. These data suggest a role for HHV-6 co-infection in the progression of HIV-1 disease.     

EB病毒感染外周血淋巴细胞比值与EBV-DNA载量的相关性分析

目的探讨EB病毒感染外周血淋巴细胞和异型淋巴细胞比值变化,观察其与EB病毒(EBV)-DNA间的相关性。方法将122例经临床确诊为呼吸道感染患儿作为研究对象,根据EBV-DNA载量分为阳性组(EBVDNA>500IU/ml)和阴性组(EBV-DNA≤500IU/ml),选取同期50例正常健康儿童为对照组。检测两组EBVDNA定量,计算EBV-DNA含量;收集两组淋巴细胞总数与淋巴细胞比值等。分析外周血淋巴细胞和异型淋巴细胞比值与EBV-DNA载量间的相关性。结果对照组未检出EBV-DNA;EBV-DNA阳性者40例,阳性率为32.79%(40/122),阳性组EBV-DNA载量平均为(3.61±0.72)logIU/ml。不同年龄间患儿EBV-DNA阳性率相比较(P<0.05)。阳性组患儿外周血淋巴细胞比值为(52.71±17.44)%,高于阴性组、对照组(P<0.05);阴性组高于对照组(P<0.05)。阳性组异型淋巴细胞比值为(6.97±3.52)%,高于阴性组、对照组(P<0.05);阴性组高于对照组(P<0.05)。外周血淋巴细胞比值与EBV-DNA载量呈正相关性(r=0.611,P<0.001);异型淋巴细胞比值与EBV-DNA载量呈正相关性(r=0.758,P<0.001)。结论检测呼吸道感染患儿外周血淋巴细胞、异型淋巴细胞比值可有助于临床诊断EB病毒感染,为临床医师诊断和治疗提供参考。     

Cost-effectiveness of testing for human immunodeficiency virus and hepatitis C virus among blood transfusion recipients.

OBJECTIVE: To choose the most cost-effective option for detecting human immunodeficiency virus (HIV-1) and hepatitis C virus (HCV) among blood transfusion recipients. DESIGN: Cost-effectiveness analysis. Effectiveness was expressed as the number of HIV-1 or HCV infections detected, regardless of whether they were related to transfusion. To estimate costs, we assumed hospital insurance would cover costs related to detection and compensation, when granted. SETTING: A 2,890-bed acute care teaching hospital in Bordeaux, France. METHODS: Eight options were defined, from the simplest, which would be to do nothing, to a maximal approach, which would be to keep a serum sample in a serum library for a lookback and perform tests for antibody to HIV-1 and to HCV before and 3 months after transfusion. Data on probabilities and costs were taken from the literature and experiences of French hospitals. RESULTS: The most cost-effective option was to perform viral antibody testing before transfusions (option 3), which would detect 27 infections per 1,000 patients, for an expenditure of US $1,260 per detected patient Option 6, obtaining a serum sample before transfusion and performing tests for antibody to HIV-1 and to HCV 3 months after transfusion, had a similar cost-effectiveness ratio but detected only 16 infections per 1,000 patients. Performing tests before and 3 months after transfusion (option 4), compared with option 3, would detect 1 additional infection for an additional cost of US $8,322. CONCLUSION: The most cost-effective options are not specific to blood transfusion recipients and might be more suited to all hospitalized patients.     

无偿献血员中人类T淋巴细胞病毒感染状况调查

目的 :调查盐城市输血员中人类 T淋巴细胞病毒 ( HTL V- )的感染状况。方法 :采用酶联免疫吸附试验 ( EL ISA)测定血清中 HTL V- 抗体 ,阳性结果采用蛋白印迹法 ( Westem blot,WB)确证。结果 :14 3 6份采自无偿献血员的血清中检出抗体可疑阳性 5份 ,WB试验证实为假阳性。结论 :调查的献血员中没有 HTL V- 感染者 ,提示本市人群中 HTL V- 感染率可能较低     

Human T-lymphotropic virus type I (HTLV-I) seroprevalence in Jamaica. II. Geographic and ecologic determinants

An island-wide cohort of 13,260 Jamaicans who applied for food-handling licenses during 1985 and 1986 were tested for antibodies to human T-cell lymphotropic virus type I (HTLV-I). Demographic and residence history data were linked to geographic and ecologic measures of elevation, rainfall, crop-growing areas, population density, and additional measures of urbanization and correlated with HTLV-I antibody status. By logistic regression analysis (performed separately for men and women), men and women who currently resided at low elevation (less than or equal to 1,000 ft (305 m)) were more likely to be HTLV-I infected than were those residing at high elevation. Men, but not women, who were born in citrus-growing areas were more likely to be HTLV-I infected than were men who were born in other areas. By univariate analysis, there was a significant positive trend of increasing HTLV-I seroprevalence with increasing amount of annual rainfall associated with birthplace and primary residence areas. However, these associations did not remain significant after adjusting for age and sex. These environmental associations raise the possibility of new modes of viral transmission or host response to infection, although they may simply be surrogates for socioeconomic status, breastfeeding habits, or sexual behavior, which are known determinants of HTLV-I zero prevalence.     

Prevalence of human T-cell lymphotropic virus type I infection in Singapore: a preliminary report.

Human T-cell lymphotropic virus type I (HTLV-I) infection is endemic in southwestern Japan, the Caribbean basin, Colombia, Africa and in several isolated populations in Papua New Guinea, the Solomon Islands and Vanuatu. To determine the seroprevalence of HTLV-I infection in Singapore, we tested sera from 115 hospitalized patients with acute nephritis, 50 patients with suspected leptospirosis, 34 patients with non-A, non-B hepatitis, and from 28 healthy volunteers for IgG antibodies against HTLV-I using an enzyme-linked immunosorbent assay. Antibodies were detected in sera from 6 of the 199 patients and from 3 of the 28 healthy volunteers, but these positives could not be confirmed by Western immunoblotting. Our data are consistent with other reports of low seroprevalence of HTLV-I infection despite extensive Japanese contact in Korea, Taiwan, the People's Republic of China and Micronesia. Further studies on a larger sample size, however, are necessary to confirm the absence of any focus of infection in the Singapore population.     

Enhanced immunogenicity of a conformational epitope of human T-lymphotropic virus type 1 using a novel chimeric peptide

The ability of a peptide vaccine derived from the human T-lymphotropic virus type 1 (HTLV-1) surface envelope glycoprotein protein (gp46) to mimic the native protein and elicit a protective immune response has been examined. This peptide construct, designated MVFMF2, comprises amino acids (aa) 175-218 of gp46 linked by a four residue turn (GPSL) to a promiscuous T-cell epitope from the measles virus fusion protein (MVF, aa 288-302). The peptide was structurally characterized by circular dichroism (CD) spectroscopy and was found to contain alpha-helical secondary structure. The immunogenicity of MVFMF2 in rabbits and mice was evaluated by direct ELISA and competitive ELISA using peptide constructs and the recombinant protein ACH-RE3 (aa 165-306). This peptide, when administered with adjuvant (N-acetyl-glucosamine-3yl-acetyl-L-alanyl-D-isoglutamine, nor-MDP) was immunogenic in an outbred population of both rabbits and mice. Furthermore, the peptide construct was encapsulated in biodegradable microspheres of poly(D,L-lactide-co-glycolide) to eliminate booster immunization and to examine adjuvant requirements. The data indicate that MVFMF2 shows enhanced immunogenicity when encapsulated in biodegradable microspheres. Inoculation of the encapsulated peptide produced a similar humoral response to that of the free peptide, but did not require the use of adjuvant. Elicited anti-rabbit and anti-mouse antibodies recognized whole viral preparations and the recombinant protein ACH-RE3 in ELISA assays. Additionally, inoculated rabbits exhibited enhanced reactivity to viral antigens by western blot compared to non-vaccinated controls. Although anti-rabbit and anti-mouse antibodies were capable of inhibiting syncytium formation at low dilutions, rabbits were not protected from cell-associated viral challenge. Future development of vaccines to HTLV-1 may need to incorporate the ability to elicit cell-mediated immune responses in order to protect against cell-associated viral infection.     

323例患者输血后丙型肝炎病毒感染的前瞻性研究

为了解上海地区医院输血后引起的丙型肝炎病毒(HCV)感染状况和制定防治对策 ,自 1 993年 1 0月至 1 998年 4月对输血后的HCV感染作了前瞻性研究 ,现报告如下。1 .对象与方法 :(1 )研究对象 :以 32 3例因外科手术或内科疾病住中山医院治疗接受输血者为研究对象 ,同期住院治疗的其他内科疾病未输血者共 1 95例作为对照。输血者和对照者入院后首次抗 HCV检测结果须阴性。(2 )研究方法 :①对接受输血者分别于输血后 1、3和 6个月 ,未输血的同期住院患者于入院后 1、3个月采血 ,留取血清标本储存于 - 30℃冰箱备检。常规检测ALT并用华怡公司…     

2例TTV感染者中TTV DNA的基因变异分析

目的探讨TTV的基因变异情况。方法PCR扩增BD与CSH血清中的TTV DNA后进行分子克隆,每例挑选10个不同TTV DNA克隆进行测序。不同克隆之间及其与G1 a亚型TA278之间进行序列比较并进行进化树分析。结果BD存在2种不同的TTV病毒株,都为G1 a亚型。CSH中存在7种不同的TTV病毒株,分别属于G1 a和G1b亚型。结论CSH中TTV的基因变异比BD中的复杂得多。     

输血感染艾滋病病毒1型母婴传播概率回顾性定群研究

目的 研究HIV-1型母婴传播率.方法 对某市8个乡全部居民普查出的63例一次性输血感染HIV的母亲及其子女进行研究,调查母亲的受血时间、子女的出生时间、出生方式、母乳喂养等情况.母亲输血感染HIV的84名子女作为母婴传播的观察对象,采集的血清标本用ELISA法进行HIV抗体初筛,用Western-blot法进行确证.结果 存在母婴传播危险因素的子女母婴感染率为32.1%(27/84).存在宫内、分娩、母乳3个因素和存在分娩、母乳2个因素的感染率分别为36.8%(7/19)和35.7%(5/14),存在宫内、分娩2个因素的感染率为14.3%(2/14);单纯母乳喂养感染率为37.9%(11/29).经合并分析,存在母乳喂养因素的母婴传播组HIV-1感染率(36.9%,24/65)显著高于人工喂养的母婴传播组(11.8%,2/17).结论 一次性输血感染HIV的母亲,母婴感染率因传播危险因素不同而有所不同,母乳喂养在母婴传播HIV中具有重要作用.