Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Institut Pasteur, UMR 3569, CNRS, Paris, France.
Université de Paris, Paris, France.
Transfusion. 2020 Jul;60(7):1483-1491. doi: 10.1111/trf.15838. Epub 2020 May 15.
The African continent is considered to be the largest endemic area of HTLV-1 infection, with at least several million infected individuals. Systematic screening of blood donors can prevent the transmission of HTLV-1 in blood. Gabon is one of the countries with the highest prevalence of HTLV-1 worldwide, and yet the routine testing of blood donors has still not been introduced.
All blood donations collected between April and July 2017 at the Centre National de Transfusion Sanguine of Gabon were studied. Plasma samples were screened by ELISA for the presence of HTLV-1/2 antibodies. Western blot (WB) and polymerase chain reaction (PCR) tests were used for confirmation.
In total, 3123 blood donors were tested, including 1740 repeat and 1378 first-time blood donors (FTBDs). Of them, 132 samples tested positive for HTLV-1/2 by ELISA (4.2%). WB and PCR confirmed HTLV-1 infection for 23 individuals. The overall prevalence of HTLV-1 was 0.74% [95% CI 0.47%-1.10%], 1% in FTBD, and 0.5% in repeat donors. Age and sex-adjusted prevalence was five-fold lower in FTBD than in the general adult population of rural areas of Gabon. All detected HTLV-1 strains belonged to the central African HTLV-1b genotype but were highly diverse.
We report an overall prevalence of HTLV-1 of 0.74%, one of the highest values reported for blood donors in Africa. Given the high risk of HTLV-1 transmission in blood, it is necessary to conduct cost-effectiveness studies to determine the need and feasibility of implementing screening of HTLV-1 in blood donors in Gabon.
非洲大陆被认为是 HTLV-1 感染的最大地方性流行区，至少有几百万感染者。对献血者进行系统筛查可以预防 HTLV-1 在血液中的传播。加蓬是世界上 HTLV-1 感染率最高的国家之一，但常规献血者检测仍未引入。
研究了 2017 年 4 月至 7 月期间在加蓬国家输血中心采集的所有血液捐献。使用 ELISA 检测血浆样本中是否存在 HTLV-1/2 抗体。使用 Western blot（WB）和聚合酶链反应（PCR）进行确认。
共检测了 3123 名献血者，包括 1740 名重复献血者和 1378 名首次献血者（FTBD）。其中，132 份样本 ELISA 检测 HTLV-1/2 阳性（4.2%）。WB 和 PCR 确认 23 人感染了 HTLV-1。HTLV-1 的总感染率为 0.74%[95%CI 0.47%-1.10%]，FTBD 为 1%，重复献血者为 0.5%。与加蓬农村地区一般成年人口相比，FTBD 的年龄和性别调整后患病率低 5 倍。所有检测到的 HTLV-1 株均属于中非 HTLV-1b 基因型，但高度多样化。
我们报告的 HTLV-1 总感染率为 0.74%，这是非洲献血者报告的最高值之一。鉴于血液中 HTLV-1 传播的高风险，有必要进行成本效益研究，以确定在加蓬实施献血者 HTLV-1 筛查的必要性和可行性。
