Monplaisir N, Neisson-Vernant C, Bouillot M, Duc-Dodon M, Ugarte E, Valette I, Dezaphy Y, Ouka M, Eudaric M G, Gazzolo L
Centre de Transfusion de Fort-de-France, Martinique, French West Indies.
AIDS Res Hum Retroviruses. 1993 Sep;9(9):869-74. doi: 10.1089/aid.1993.9.869.
We have investigated HTLV-I and HTLV-II infection in children born to HTLV-I-seropositive or indeterminate Western blot mothers in Martinique by using the polymerase chain reaction (PCR). Only HTLV-I and no HTLV-II-positive samples were found in this study. All the samples from HTLV-I-seropositive children and adults were PCR positive, whereas the four HIV-I-seropositive and Western blot HTLV-I-negative mothers and their eight children were all PCR negative. Therefore, PCR and serology were in complete agreement in these patients. However, two of the six mothers who were first indeterminate by Western blot, and who later became seronegative, were found positive by PCR. Of the 27 children (ages 2-12 years), born to HTLV-I-seropositive and PCR-positive mothers, 2 were seropositive and PCR positive, 5 were seronegative and PCR positive with 2 primer pairs in gag and pol, and 4 were seronegative and PCR positive with only 1 of the primer pairs. In contrast to an initial rate of transmission of 7% estimated by serology we found a rate of transmission of 28 to 41% (whether or not children who were positive with only one of the primer pairs were included). Thus, our study confirms that PCR is useful in detecting HTLV-I infection in children before seroconversion and underlines the potential lack of sensitivity of serology to detect contaminating HTLV-I blood units in endemic areas.
我们通过聚合酶链反应（PCR）对马提尼克岛HTLV-I血清反应阳性或免疫印迹结果不确定的母亲所生儿童中的HTLV-I和HTLV-II感染情况进行了调查。本研究中仅发现HTLV-I阳性样本，未发现HTLV-II阳性样本。所有来自HTLV-I血清反应阳性儿童和成人的样本PCR检测均为阳性，而4名HIV-I血清反应阳性且免疫印迹HTLV-I阴性的母亲及其8名子女的样本PCR检测均为阴性。因此，在这些患者中，PCR检测结果与血清学检测结果完全一致。然而，6名最初免疫印迹结果不确定、后来血清反应转为阴性的母亲中，有2名经PCR检测呈阳性。在27名由HTLV-I血清反应阳性且PCR检测阳性的母亲所生的儿童（年龄2至12岁）中，2名血清反应阳性且PCR检测阳性，5名血清反应阴性但用gag和pol基因的2对引物进行PCR检测呈阳性，4名血清反应阴性但仅用1对引物进行PCR检测呈阳性。与血清学估计的7%的初始传播率相比，我们发现传播率为28%至41%（无论是否将仅用1对引物检测呈阳性的儿童纳入计算）。因此，我们的研究证实PCR在检测儿童血清转换前的HTLV-I感染方面是有用的，并强调了在流行地区血清学检测污染的HTLV-I血液单位时可能缺乏敏感性。
