Couroucé A M, Pillonel J, Lemaire J M, Maniez M, Brunet J B
Institut National de Transfusion Sanguine, Paris, France.
AIDS. 1993 Jun;7(6):841-7. doi: 10.1097/00002030-199306000-00013.
To evaluate the serological and epidemiological characteristics of HTLV-I/II-positive blood donors in continental France during the first 6 months of universal screening of blood donations (n = 1,816,927).
A collaborative investigation of all confirmed anti-HTLV-I/II-positive samples reported by blood transfusion centres was performed. Seventy-three out of 77 reported samples were retested at two reference laboratories. Epidemiological data on risk factors were compiled.
Of the 73 retested samples, 66 were confirmed to be HTLV-I-positive and one to be HTLV-II-positive; six samples were designated false-positive, mainly because of non-specific reactivity to recombinant gp21 in Western blot. The overall prevalence of HTLV-I/II in continental France is 0.039 per thousand. The main risk factor identified for HTLV-I infection was directly (origin) or indirectly (heterosexual contact) linked to endemicity in the Caribbean. The cost per case of avoided contamination in the 6-month period of this study was 1.36 million French francs.
Sixty-two per cent of HTLV-I/II-infected blood donations would not have been discarded through the previous targeted HTLV screening or through other mandatory tests, including anti-hepatitis B core. To avoid false-positive results, we propose a new algorithm of diagnosis.
评估在法国大陆献血者普遍筛查的前6个月（n = 1,816,927）中HTLV-I/II阳性献血者的血清学和流行病学特征。
对输血中心报告的所有确诊抗HTLV-I/II阳性样本进行了合作调查。报告的77个样本中的73个在两个参考实验室进行了重新检测。收集了关于风险因素的流行病学数据。
在重新检测的73个样本中，66个被确认为HTLV-I阳性，1个为HTLV-II阳性；6个样本被判定为假阳性，主要是因为在蛋白质印迹法中对重组gp21有非特异性反应。法国大陆HTLV-I/II的总体患病率为千分之0.039。确定的HTLV-I感染的主要风险因素直接（来源）或间接（异性接触）与加勒比地区的地方流行性有关。在本研究的6个月期间，每避免一例污染的成本为136万法国法郎。
通过先前有针对性的HTLV筛查或通过其他强制性检测（包括抗乙肝核心抗体检测），62%感染HTLV-I/II的献血不会被丢弃。为避免假阳性结果，我们提出了一种新的诊断算法。
