Immunology Department, Adolfo Lutz Institute (IAL), São Paulo, São Paulo, Brazil.
Advanced Laboratory of Public Health, Gonçalo Moniz Institute (IGM), FIOCRUZ-BA, Salvador, Bahia, Brazil.
J Clin Microbiol. 2019 Dec 23;58(1). doi: 10.1128/JCM.01384-19.
Difficulties in confirming and discriminating human T-cell lymphotropic virus type 1 (HTLV-1) and HTLV-2 infections by serological Western blot (WB) assays (HTLV Blot 2.4; MP Biomedicals) have been reported in Brazil, mainly in HIV/AIDS patients, with a large number of WB-indeterminate and WB-positive but HTLV-untypeable results. Nonetheless, a line immunoassay (LIA) (INNO-LIA HTLV-I/II; Fujirebio) provided enhanced specificity and sensitivity for confirming HTLV-1/2 infections. To add information concerning the improved ability of the LIA in relation to WB when applied to samples of individuals from different risk groups from Brazil, we performed the present study. Three groups were analyzed: group 1 (G1), with 62 samples from HIV/AIDS patients from São Paulo, SP (48 WB indeterminate and 14 HTLV untypeable); group 2 (G2), with 24 samples from patients with hepatitis B or hepatitis C from São Paulo (21 WB indeterminate and 3 HTLV untypeable; 17 HIV seropositive); and group 3 (G3), with 25 samples from an HTLV outpatient clinic in Salvador, Bahia (16 WB indeterminate and 9 HTLV untypeable; all HIV seronegative). Overall, the LIA confirmed HTLV-1/2 infection (HTLV-1, HTLV-2, or HTLV) in 66.1% (G1), 83.3% (G2), and 76.0% (G3) of samples. Interestingly, the majority of WB-indeterminate results were confirmed by the LIA as being HTLV-2 positive in G1 and G2 but not in G3, in which the samples were defined as being HTLV-1 or HTLV positive. These results agree with the virus types that circulate in such patients of different regions in Brazil and emphasize that the LIA is the best serological test for confirming HTLV-1 and HTLV-2 infections, independently of being applied in HTLV-monoinfected or HTLV-coinfected individuals.
在巴西，通过血清学 Western blot（WB）检测（HTLV Blot 2.4；MP Biomedicals）确认和区分人类 T 细胞嗜淋巴细胞病毒 1 型（HTLV-1）和 HTLV-2 感染存在困难，主要在 HIV/AIDS 患者中，出现大量 WB 不确定和 WB 阳性但 HTLV 不可分型的结果。然而，线性免疫分析法（LIA）（INNO-LIA HTLV-I/II；Fujirebio）提高了确认 HTLV-1/2 感染的特异性和敏感性。为了提供有关 LIA 应用于来自巴西不同风险群体的个体样本时与 WB 相比提高能力的更多信息，我们进行了本研究。分析了三组：组 1（G1），来自圣保罗州的 62 名 HIV/AIDS 患者的样本（48 个 WB 不确定，14 个 HTLV 不可分型）；组 2（G2），来自圣保罗州的乙型或丙型肝炎患者的 24 个样本（21 个 WB 不确定，3 个 HTLV 不可分型；17 个 HIV 血清阳性）；组 3（G3），来自巴伊亚州萨尔瓦多的 HTLV 门诊患者的 25 个样本（16 个 WB 不确定，9 个 HTLV 不可分型；均为 HIV 血清阴性）。总体而言，LIA 确认 HTLV-1/2 感染（HTLV-1、HTLV-2 或 HTLV）在 G1 中占 66.1%，在 G2 中占 83.3%，在 G3 中占 76.0%。有趣的是，G1 和 G2 中大多数 WB 不确定的结果通过 LIA 确认为 HTLV-2 阳性，但在 G3 中则不是，G3 中的样本被定义为 HTLV-1 或 HTLV 阳性。这些结果与巴西不同地区此类患者中流行的病毒类型一致，并强调 LIA 是确认 HTLV-1 和 HTLV-2 感染的最佳血清学检测方法，无论应用于 HTLV 单一感染还是 HTLV 合并感染个体。
