Carneiro-Proietti Anna Bárbara F, Sabino Ester C, Leão Silvana, Salles Nanci A, Loureiro Paula, Sarr Moussa, Wright David, Busch Michael, Proietti Fernando A, Murphy Edward L
Hemominas Foundation, Belo Horizonte, Minas Gerais, Brazil.
AIDS Res Hum Retroviruses. 2012 Oct;28(10):1265-72. doi: 10.1089/AID.2011.0143. Epub 2012 May 3.
Human T-lymphotropic virus type 1/2 (HTLV-1/2) infection is endemic in Brazil but representative donor prevalence and incidence data are lacking. All blood donations (2007-2009) from three blood centers in Brazil were studied. Samples reactive on one HTLV screening test (EIA) were retested with a different EIA; dual EIA reactivity correlated strongly with a confirmatory Western blot. Prevalence, incidence, and residual transfusion risk were calculated. Among 281,760 first-time donors, 363 were positive for HTLV on both EIAs (135 per 10(5), 95% CI 122-150). Prevalence differed considerably by region, from 83 to 222 per 10(5). Overall incidence rate was 3.6/10(5) person-years and residual transfusion risk was 5.0/10(6) per blood unit transfused. The logistic regression model showed significant associations with: age [adjusted odds ratio (aOR)=5.23 for age 50+ vs. <20], female sex (aOR=1.97), black (aOR=2.70 vs. white), and mixed skin colors (aOR=1.78 vs. white), and inversely with education (aOR=0.49, college vs. less than high school). HTLV testing with a dual-EIA strategy is feasible and can be useful in areas with low resources. Incidence and residual risk of HTLV-1 transmission by transfusion were relatively high and could be reduced by improving donor recruitment and selection in high prevalence areas. Blood center data may contribute to surveillance for HTLV infection.
人类嗜T淋巴细胞病毒1型/2型（HTLV - 1/2）感染在巴西呈地方性流行，但缺乏具有代表性的献血者感染率和发病率数据。对巴西三个血液中心2007年至2009年的所有献血进行了研究。在一项HTLV筛查试验（酶免疫测定，EIA）中呈反应性的样本，用另一种不同的EIA进行复测；双重EIA反应性与确证性免疫印迹法密切相关。计算了感染率、发病率和残余输血风险。在281,760名首次献血者中，两种EIA检测HTLV均呈阳性的有363人（每10⁵人中135人，95%置信区间122 - 150）。不同地区的感染率差异很大，每10⁵人中从83人到222人不等。总体发病率为3.6/10⁵人年，每输注一个血液单位的残余输血风险为5.0/10⁶。逻辑回归模型显示与以下因素有显著关联：年龄[50岁及以上与20岁以下相比，调整后的优势比（aOR）=5.23]、女性（aOR = 1.97）、黑人（与白人相比，aOR = 2.70）、混合肤色（与白人相比，aOR = 1.78），与受教育程度呈负相关（大学学历与高中以下学历相比，aOR = 0.49）。采用双重EIA策略进行HTLV检测是可行的，在资源匮乏地区可能有用。通过输血传播HTLV - 1的发病率和残余风险相对较高，可通过改善高流行地区的献血者招募和筛选来降低。血液中心的数据可能有助于HTLV感染的监测。
