How serious is the risk of HTLV-1 infection in Iranian hemodialysis-dependent patients?

OBJECTIVE

The transmission of infectious agents through hemodialysis is one of this critical treatment's most significant side effects. Human T-lymphotropic virus 1 (HTLV-1) is an endemic oncogenic virus in Iran. Due to its relatively lower prevalence, the infection with this virus is not routinely screened for in patients before hemodialysis. In this study, we aimed to evaluate the seropositivity of HTLV-1 in hemodialysis-dependent patients of Iran to better understand how this treatment can help the virus spread.

METHODS

A comprehensive systematic review and meta-analysis were performed by searching PubMed, Scopus, Google Scholar, and Web of Science databases for studies on the prevalence of HTLV-1 among hemodialysis-dependent patients. The meta-analysis was conducted using R.

RESULTS

Twelve studies were included. Overall, the prevalence of HTLV1 among patients dependent on hemodialysis treatment was 2.37% (I2 = 70.8% /p-value < 0.0001). The funnel plot asymmetry and trim and fill analysis results showed three studies with higher prevalence as outlier results which all were originated in endemic region of Iran, Khorasan. Highlighting the higher prevalence in the endemic areas.

CONCLUSION

Considering the significantly higher prevalence of infection with HTLV-1 in hemodialysis-dependent patients compared to the general population of Iran, more efforts seem necessary to prevent the transmission of the virus through this treatment, even considering screening protocols similar to blood transfusion protocols.